Nightmares

1) What it is

Nightmares are disturbing dreams that cause fear, anxiety or distress and often wake you up. They can be linked to stress, trauma, anxiety, medication side effects, or sleep disruption.

2) What it feels like

• “I’m scared to go to sleep.”
• “I wake up sweating and panicked.”
• “It feels real and sticks with me all day.”

3) Common signs

• vivid, distressing dreams
• waking scared or panicked
• trouble going back to sleep
• fear of bedtime
• daytime anxiety or fatigue
• replaying dream scenes

4) Causes

• stress and anxiety
• PTSD or trauma
• sleep deprivation
• alcohol (worsens sleep quality)
• certain medications
• illness or fever
• major life changes

5) Triggers

• scary or disturbing content before bed
• trauma reminders
• going to bed anxious
• disrupted sleep routine
• overheating or poor sleep environment

6) What helps now

• grounding after waking: name five things you can see
• slow breathing to reset heart rate
• light on and sip water
• reassurance: “I’m safe, it’s over”
• calming activity (reading, soft music) before returning to sleep

7) Longer-term support

• consistent sleep schedule
• reduce alcohol and frightening media at night
• relaxation routines before bed
• trauma therapy if nightmares are trauma-linked
• imagery rehearsal therapy (rewriting the nightmare ending)

8) Treatment options

• CBT for insomnia or anxiety
• trauma-focused therapy for PTSD-related nightmares
• GP review for medication effects

9) Medication

In some cases, clinicians may prescribe medication for trauma-related nightmares, but this must be specialist-guided.

10) Practical tips

• keep the bedroom cool
• use a night light if helpful
• don’t stay in bed panicking — reset calmly and return when sleepy

11) When to seek urgent help

Urgent help if:

• nightmares lead to suicidal thoughts
• severe sleep loss causes crisis symptoms
• flashbacks and panic become unmanageable

12) UK help & support

• NHS sleep support or GP
• NHS urgent mental health services
• Samaritans / Shout

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