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The Scary Truth About Nightmare Disorder And Top Treatments that Work

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The Scary Truth About Nightmare Disorder And Top Treatments that Work

Most of us have had the experience of deeply distressing nightmares that wake us up. But for those suffering symptoms of nightmare disorder, the experience can be terrifying, let alone the idea of falling asleep in the first place.

Untreated, nightmare disorder can have a significant, dastardly impact on our ability to just function normally, day to day. It’s not just about having a restless night’s sleep and struggling to get out of bed the next morning laden with fatigue.

If you suffer nightmare disorder, you often experience greater frequency of your nightmares either across different nights or as a sequence of disturbing dreams in the same night.

Fear and anxiety often wreak havoc on you emotionally, mentally and physically when trying to fall asleep, during and between your sleep cycles and also upon waking. You’re terrified of sleeping!

If you’re tired of experiencing no change even though you’ve reduced your alcohol intake, started exercising and have been going to bed earlier, there is help at hand.

Yes, physical changes you make can be extremely helpful (e.g. modifying your diet and eating plan, listening more to positive, inspiring audio books, music and podcasts, doing yoga) but you may be missing some key psychological strategies that can really help to kick your symptoms to the kerb.

How to know if I have nightmare disorder?

The International Classification of Sleep Disorders III provides minimum criteria to determine if individuals suffer from nightmare disorder described below:

a) Dreams are recurrent, clearly recalled and involve vividly feeling threats to survival, safety or physical integrity which often jolt you to awaken;

b) Upon wakening, you rapidly feel highly alert and become quickly oriented;

c) The nightmare itself or the sleep disturbance caused when awakening from it, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning as indicated by experiencing at least one of the following:

Mood disturbance – emotions upon waking persist after the nightmare

The emotions aren’t vivid and distressing only during your nightmare. Even as you awaken they remain very real, are highly intense and usually contain intense levels of anger, fear, terror and/or sadness.

In fact the mood you experience can persist for awhile after you awake from the nightmare and the feeling is difficult to shake.

Dream recall is vivid

Many people find it difficult to recall their dreams upon waking even with making a concerted effort to do so.

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With nightmare disorder, dream recall is quick and vivid and there is little to no confusion about the details of the dream.

Falling asleep again is challenging

You can often suffer physical symptoms upon waking. Breathlessness, sweatiness and tightness in the chest can heighten your attention to remain awake.

Being unable to calm yourself physically and mentally makes falling asleep again not only difficult, but awfully frightening.

There also can remain the fear of re-entering the nightmare you’ve jolted awake from or re-experiencing the dream again.

You develop avoidant behaviors

Bedtime anxiety can become a common feature. A fear of the darkness associated with sleep time can also develop.

Social, interpersonal and occupational function starts to subside

Your ability to concentrate and focus at work or be fully present during social interactions starts to drop.

You might also start to feel silly and ashamed that you can’t ‘get over’ a silly nightmare.

Daytime sleepiness, fatigue and low energy

Your energy levels and fatigue can suffer from not getting enough of the right quality sleep, having incomplete sleep cycles and not getting enough cycles in the first place.

During the day you wake up groggy and feel like you’re dragging your feet to concentrate, focus and get anything done.

Other symptoms

In addition to the above, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) explains that a diagnosis of nightmare disorder is not catalyzed by the effect of medication nor drugs and also is not attributed to the presence of another mental disorder (e.g. post-traumatic stress disorder). The DSM-V also indicates how severe a diagnosis might be pending the different time periods of experiencing the symptoms.

To gain an accurate diagnosis, work with a qualified, registered mental health professional. Explore your medical history, your previous and current use of drugs and medication, your previous sleep disturbances as well as presence of any similar sleep disturbance in your family and the experience of traumatic events and/or relationships.

Whilst there doesn’t yet exist a stand-alone diagnostic tool for nightmare disorder, there can be valuable clues in exploring these potential influences as well.

The Scary Truth About Untreated Nightmare Disorder

According to the American Academy of Sleep Medicine, 4 % of the population suffer from nightmare disorder.[1] Untreated, prolonged effects can lead to the development of anxiety and depressive disorders. For those who might already be suffering symptoms of these, it can worsen them.

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Whilst development of different types of insomnia, breathing problems such as asthma and snoring have been linked to nightmare disorder, one of the most alarming links is the likelihood of the disorder to suicidality. Studies have not only discovered relationships between nightmares and the presence of suicidal thoughts (ideation) but also suicide attempts.

For many, time is not on their side. Having suffered long enough, medication can be a quick and instant way to dampen and numb the symptoms and provide temporarily relief.

However, there are some incredibly effective psychological treatments that have not only helped restore an astonishing quality of slumber to sufferers but opened their gateway to rebuilding a remarkable quality of life.

5 Top Treatments to Turn Your Sleep Experience Around

If you don’t feel you have time on your side, you may wish to consult with a medical professional to explore medication that could provide instant relief.

Medication or not, the guidance of suitably trained and qualified mental health professionals can help you learn incredible strategies that will accelerate you back to experiencing a far better quality of life.

Let’s look at some of the top recommended strategies below.

1. Image Rehearsal Therapy (IRT)

Image rehearsal is a great technique applied whilst you are awake. You write down your dream but change the theme, story line, ending, or any part of the dream to be a far more positive one.

In rewriting the dream scenario, you build in all the sensations, thoughts and emotions you want to experience instead. You are working to displace the distressing experiences you originally had with your newly orchestrated dream.

This technique works by challenging the traumatic theme of your original nightmare by injecting a cognitive shift. You choose and design the shift.

By then rehearsing this scenario for just 10 – 20 minutes a day, you can be on your way to greatly reducing your symptoms and enjoying a slumber journey to paradise as opposed to the Amityville Horror House.

2. Eye Movement Desensitization Reprocessing (EMDR)

EMDR combines elements from a number of different therapies. It has become a primary treatment for those suffering from nightmares connected with having experienced either a single traumatic event or multiple events over time.

Using an eight-step approach a therapist manually induces processing of disturbing memories and experiences by stimulating neural mechanisms similar to those activated during rapid eye movement (REM) sleep.[2]

During sessions, therapists direct clients to switch their eye movements to swing back and forth, left to right either following the therapists fingers (or some other object) whilst recalling the disturbed memory. Tones directed through headphones alternately into each ear might be used in similar fashion, or alternate physical taps to each hand.

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Clients identify and process the disturbed memory and past experience, current triggers and also positive experiences to develop a helpful adaptive response to the traumatic experience.

Even though EMDR is a highly effective treatment, there are pre-requisites for engaging this method and this process should only be applied by well-trained professionals who are licensed and qualified to administer it.

However, when you experience the benefits, not just your sleep but your quality life can turn around in a massive way!

3. Graded Exposure Therapy

Graded exposure therapy is also known as systematic desensitization. Once again it is best advised to undertake the first steps of this process with a qualified, trained professional.

With this method, you build resilience to the distressing parts of the nightmare through gradually exposing yourself to recalling the experience of it.

Re-experiencing the memory of the traumatic parts of the dream are identified and organized into a hierarchy of what is least distressing to what is most distressing. Working with parts you feel you can handle, you gradually expose yourself to the different parts of the nightmare memory and re-ignite the stressful emotions, thoughts and sensations one by one at a pace you can handle.

As you experience and learn that you are not in danger, your resilience builds and your fear of experiencing the nightmare again gradually drops.

Research has shown graded-exposure therapy to be helpful in reducing the frequency of nightmares but more effective when used in combination with progressive deep muscle relaxation (PDMR).

4. Progressive Deep Muscle Relaxation

Whilst research has shown that PDMR has been effective in reducing the frequency of nightmares, the technique has a wide range of uses in managing types of anxiety.

In itself, it is an incredible mental health and physical self-care strategy everyone can benefit from, nightmare disorder or not.

Working sequentially through the muscle groups in your body – from head to toe or in the reverse direction – you deliberately tense your muscles for a few seconds, then let the tension go and concentrate on how relaxed you feel for longer.

By deliberately telling your body to relax and increasing focus on how calm and relaxed you physically feel, you send messages to your brain to relax. Working through the muscle groups sequentially helps to pacify those of us who can get particularly wound up.

There are plenty of electronic apps you can access for free on your android phone or download to your iPod (e.g. Calm, Relax Lite). Guided PDMR (i.e. with instructions) is extremely helpful to start with. You surrender to the voice guiding you how and when to tense and relax each muscle group. By creating a deeply relaxed state just before falling sleep, you increase the potential for you to have a more pleasurable sleep experience.

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By getting started with PDMR straight away you not only have a tool to help you alleviate your nightmare symptoms, but a great relaxation technique to help you combat the challenges life throws at you.

Just be sure to consult a medical professional beforehand if you are recovering from an injury or could be at risk some other way. If so, whatever muscle groups could be affected, simply skip those and go on to the next ones.

5. Exposure, Relaxation and Re-scripting Therapy (ERRT)

ERRT is a combination of different steps targeting the anxiety symptoms that exist with the experience of nightmare disorder. If you’re not yet familiar with them, you’ll undertake an introduction to sleep hygiene practices.

Clearing out electronic devices from your bedroom, reducing your exposure to blue light from electronic tablets, television and android phones at least 1 ½ hours prior to wanting to fall asleep…..they all help to reduce symptoms of anxiety that can escalate your experiencing nightmares.

Looking at bedding and undertaking relaxing activities at night before bed time all contribute to creating blissful sleep opportunities.

Once you have your bedroom and pre-sleep activities sorted, you then apply the PDMR strategies which direct your focus on sensations of feeling completely relaxed. You are telling and preparing your mind and body to wind down and prepare for calm, serene sleep.

Looking at problem-solving, rescripting (similar to IRT) and coping strategies when you might awaken are all reviewed so you have an all round plan to (i) prepare your mind and body for sleep, (ii) help catalyze a far better dreaming experience and (iii) also have a plan of what to do when you awake suddenly.

The bottom line

Today might have been a wake-up call and you might have thought medication might be the only solution. You have been suffering and letting those symptoms rob you of your ability to rest, restore and regenerate your mind and body long enough.

If you have not been aware until now of the techniques and strategies above, make the decision today to get acquainted and consider undertaking an assessment with a mental health professional.

You might just turn the tables to discover a whole new lease on life!

Featured photo credit: rawpixel via unsplash.com

Reference

More by this author

Helen D'Silva

Performance Psychologist for Business and Entrepreneurship, Sport and Personal Development

How to Improve Focus: 7 Ways to Train Your Brain How to Cope with Anxiety at Work: 5 Psychology Techniques How to Cultivate a Positive Mindset (A Step-By-Step Guide) How to Manage Anxiety: Sound Advice from a Mental Health Expert The Scary Truth About Nightmare Disorder And Top Treatments that Work

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Last Updated on January 18, 2022

How to Improve Digestion: 6 Ways For Stressful People

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How to Improve Digestion: 6 Ways For Stressful People

Does your digestive system seem off lately? Or has it been like that for a while? Have you been experiencing feelings of stress or burnout? If the answer to both these questions is yes, it could be the stress that’s driving your digestive system out of whack. You might also be wondering how you can improve your digestion.

Studies show that your stress levels can wreak havoc on both your mind and body.[1] One of the biggest ways that stress can impair your body’s condition is by disrupting the performance of your digestive system, resulting in a variety of adverse health consequences.

How Stress Affects Digestion

Some of the most common digestive issues caused by stress include heartburn, acid reflux, ulcer, diarrhea, and indigestion. Stress can also indirectly trigger the development of irritable bowel syndrome by affecting your immune system.

Researchers have also shown that individuals already suffering from IBS tend to have frequent flare-ups of systems when they are under considerable stress.[2] Conditions such as IBS and other gastrointestinal tract diseases are considered stress-sensitive disorders. Effective treatment usually entails the patient learning to cope with and manage their stress levels.[3]

A scientific review also discovered that there could be a strong correlation between high levels of stress and eating disorders, such as overeating and obesity.[4] When an individual is experiencing stress, their adrenal glands release cortisol, which is also known as the stress hormone. This hormone is known to increase appetite, leading to overeating and other related eating disorders. People with high cortisol levels are more likely to consume foods with high fat and/or sugar content, resulting in more digestive issues and weight gain.

Effectively reducing your stress levels can help reduce inflammation in your gastrointestinal tract and lower the sensitivity of your gut. Moreover, lower stress levels contribute to easing any gastrointestinal distress you may be experiencing, while at the same time optimizing nutritional uptake.

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If you find that your stress levels are high affecting your digestion, here are some tips that can help heal your gut.

1. Increase Your Level of Physical Activity

One way to boost your digestion and, at the same time, lower your stress levels is by engaging in moderate physical activity regularly. Physical activity helps increase blood flow to the different parts of your digestive system, which makes it easier for food to move along the digestive tract while improving the efficiency of the digestive muscles.

This movement of food along the digestive tract is known as peristalsis. Common signs that your peristalsis is not working optimally include constant constipation and diarrhea, and in some extreme situations, motility disorder.

Movement and exercise are also important in triggering the release of endorphins, which help relieve tension and are considered natural pain relievers. Endorphins are also quite effective at boosting one’s sleep quality, which is essential in combatting high levels of stress.

Physical activities that are known to improve digestion include regular running, walking, and biking. Yoga poses that focus on improving posture and alignment are also helpful in easing and eradicating gastrointestinal distress and act as a potent stress reliever.

2. Consider Foods That Are Natural Stress Relievers

Scientists have also discovered that some foods naturally contain mood-boosting properties. Consuming such foods can help relieve your stress symptoms while still providing your body with critical nutrients for optimal health.

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Almonds, for instance, contain high levels of magnesium, a mineral that has been proven to help manage cortisol levels in the body. Almonds also contain high levels of vitamin B, which, together with magnesium, help in increasing the production of serotonin, a powerful mood stabilizer and feel-good hormone.

Moreover, low levels of serotonin in the body have been linked to the development of irritable bowel syndrome, GERD, and duodenal ulcers, as well as episodes of bloating, cramping, constipation, and diarrhea.[5]

Dark chocolate is another type of snack that can help boost your digestion and bring down your stress levels. It is considered a highly efficient mood booster, but it also has a direct impact on your body’s digestive system. For starters, dark chocolate has a high concentration of flavonoids, a major antioxidant agent.

This chocolate also has high fiber content, mainly because of the cocoa used in production. When the gut bacteria ferment the antioxidants and fiber contained in the dark chocolate, anti-inflammatory compounds are released.[6] These compounds are not only essential in fighting inflammation within your digestive system, but they also play a crucial role in improving cardiovascular function and combatting inflammation-related disorders throughout your body.

Cocoa has also been shown to trigger the production of more healthy microbes in the colon, a further boost to your digestive system. It is also highly recommended to eat foods that are rich in probiotics and prebiotics. These compounds are critical in the production of good gut bacteria.

The abundance of good bacteria in the gut is essential for proper digestion of food and controlling inflammation within your digestive system and other parts of the body. Examples of foods rich in probiotics include yogurt, kombucha, kefir, tempeh, and natto.[7] Fruits and vegetables rich in prebiotics include the likes of onions, asparagus, garlic, and bananas. Consider making these gut-boosting foods part of your regular diet for enhanced digestive performance.

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3. Try Probiotic Supplements

Probiotics can also help improve your digestion. If you find that you don’t like probiotic foods or find them difficult to obtain, try a probiotic supplement instead. Research has shown probiotics to have remarkable effects on digestion, stress levels, immunity, and much more.[8]

Look for a probiotic that uses time-release tablets as these are more likely to deliver the probiotic bacteria safely past your stomach acid. Most probiotics in capsules are damaged or destroyed before they reach your intestines.

4. Avoid Foods That Can Impair Digestion

Just as there are good foods that can help improve digestion and simultaneously provide stress relief, there are foods that can wreak havoc on your digestive system.

Remember, when you are experiencing high levels of stress, your appetite increases, and you are more inclined to consume foods with a lot of (added) sugar and fats. Both these things are known to increase inflammation in people’s digestive systems, resulting in a variety of GI issues like constant bloating, diarrhea, and excessive gas.

Other major food culprits that can disrupt your digestive function include processed bread, white chocolate, coffee, and highly acidic foods.

5. Identify and Avoid Your Stress Triggers

An examination into what triggers your high-stress levels can help you identify these factors, and allow you to mitigate their impact on your physical and mental well-being.

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Cognitive-behavioral therapy (CBT) is a form of therapy that helps you uncover the source of your negative thinking as well as the triggers that cause your stress levels to elevate. CBT has been shown to reduce stress in individuals with IBS. Consequently, these individuals suffered fewer IBS symptoms. This demonstrates the effectiveness of therapy in minimizing stress, which then directly boosts the digestive health of the individual.[9]

Meditation and mindfulness are also powerful techniques that can help you ease your stress levels. Studies have also shown that these practices can also help ease inflammation across the body, including along your gastrointestinal tract. Meditating as well as doing some breathing exercises before eating can help relax you, which in turn allows your digestive system to function optimally.

6. Quit Smoking and Excessive Consumption of Alcohol

Our stress coping techniques can also significantly impair our digestive function. If you are using cigarettes and/or alcohol to cope with your stress, you are inadvertently introducing a host of dangerous chemicals that will affect your digestive health.

Smoking and alcohol consumption have been linked to a variety of GI diseases including heartburn, gastroesophageal reflux disease, peptic ulcers, gallstones, pancreatitis, liver diseases, and Crohn’s disease.[10] It’s imperative that you look for healthier stress coping mechanisms, such as meditation and exercise to avoid exposing your digestive system to dangerous compounds.

Final Thoughts

If you’re wondering how to improve your digestion, the first thing you should know is that your stress levels actively impact how well your digestive system functions. Addressing your stress triggers, through exercise, therapy, and physical activity will help bring down your stress levels and allow your body’s digestive system to function optimally.

Moreover, consume foods that are good for your digestion, including foods rich in magnesium, vitamin B, serotonin, fiber, and antioxidants. Lastly, avoid stress coping mechanisms that put your digestive system in jeopardy, like smoking or excessive consumption of alcohol.

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More Tips on How to Improve Digestion

Featured photo credit: Eugene Chystiakov via unsplash.com

Reference

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