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Nightmares and nightmare disorder in adults

Rochelle Zak, MD
Anoop Karippot, MD, FAASM
Section Editor
Alon Y Avidan, MD, MPH
Deputy Editors
April F Eichler, MD, MPH
Richard Hermann, MD


Nightmares are common beginning early in childhood and extending throughout the lifespan. The condition is strongly associated with stress, anxiety, and trauma.

While nightmares are not by definition pathologic, those that are frequent or disabling and impair social, occupational, emotional, and physical wellbeing are considered a disorder and are often a sign of underlying and treatable psychopathology. Common causes include stress, negative life events, the experience of trauma as in posttraumatic stress disorder (PTSD), depression, other psychiatric disorders, and medication side effects.

This topic reviews the causes, differential diagnosis, evaluation, and management of nightmares in adults. Nightmares in children and other parasomnias in children and adults are reviewed separately. (See "Sleepwalking and other parasomnias in children" and "Disorders of arousal from non-rapid eye movement sleep in adults".)


The true prevalence of nightmares and nightmare disorder is uncertain due to varying terminology and criteria for defining nightmares across studies. Nonetheless, it is clear that the occurrence of an occasional nightmare is common, and that nightmare disorder is much less common, particularly in adults.

Approximately 50 percent of children report ever having nightmares, and up to 20 percent report having frequent nightmares [1]. Approximately 85 percent of adults report having a nightmare at least once a year, and 2 to 6 percent report having frequent (weekly) nightmares [2].

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Literature review current through: Nov 2017. | This topic last updated: Oct 23, 2017.
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