Nightmares.Nightmares .- Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Mental Disorders

nightmares or frightening dreams containing a threat to life or safety charge us negative emotions for the day.It is estimated that about 4% of the adult population nightmares, among children and adolescents the percentage is much higher and is approximately 70%.

By definition, the International Classification of Diseases Tenth Revision, nightmares, sleep disorders are parasomnias (translated from Latin means Somnus "Dream"), which are connected with the violation of REM sleep.

Causes nightmares

Nightmares may have different origins and go "hand in hand" with mental disorders.Diseases that can cause nightmares: substance abuse, anxiety disorder, schizophrenia, borderline personality disorder and traumatic stress disorder.

There are several kinds of typical nightmares.Particularly noteworthy nightmares associated with PTSD .They appear in 80% of patients and it is this kind of nightmares more amenable to diagnosis, as the stress that underlies the terrible dreams, obtained as a result of a traumati

c experience, for example as a result of an accident, stay in the zone of military operations, rape or bereavement.This kind of parasomnias may accompany the patient throughout life.

Repeated nightmares are based on real traumatic events of the past.Scientists suggest that recurring dreams are stored in memory in the form of a fixed model (fixed in the memory of stressful experiences).The nightmare scenario is most often autobiographical.Unlike other memories, terrible dream reproduces the events of the past in its entirety, makes you experience not only at night but also during the day.

High stress can cause nightmares.Thus, a "vicious circle", stress causes a realistic nightmare and the nightmare carries a strong negative impact on a person's feelings after awakening.The mechanism is repeated over and over again.The higher the level of stress, the greater nightmare.Attempts to avoid nightmares lead, eventually, to violations of REM sleep and early awakenings.Such a person will not feel rested and not sleep.

Nightmares may be a result of exposure psychoactive substances that disrupt the function of mediator (conductor) systems in the brain (mainly related to norepinephrine, serotonin and dopamine, and acetylcholine and gamma-aminobutyric acid, GABA).

Under what symptoms need to see a doctor

To get rid of nightmares need to be treated under the supervision of a specialist.The problem is that most patients do not recognize this as sleep disorder, a disease.Appeal to graduates with work experience - this is the best and most effective way to combat insomnia and nightmares.
symptoms that require treatment by a doctor or a sleep therapist:
- have more difficulty falling asleep.
- Can not sleep longer than 30 minutes,
- wake up several times a night, and then can not sleep,
- repeated awakening episodes of sleep accompanied by a feeling of great anxiety, fear, anger, sadness, disgust and other negative emotions,associated with the content of the dream,
- awakening takes place in "full combat readiness," with a sense of confusion, immediately comes very clear recollection of the content of the dream,
- the presence of the real events of the past, which carries negative emotions and echoes the dream content.

treatment of conditions in which dreams nightmares

Fortunately, there are many treatment options and ways to deal with nightmares.People who were able to defeat the disease, improved quality of sleep, they wake up rested and less overworked at work, less sleep during the day.Getting rid of the nightmares improves overall physical condition.Every nightmare is unique and only a doctor can decide what type of treatment to use.

There are several ways to eliminate nightmares.

1. At the beginning is to analyze your habits , associated with falling asleep, because in many cases they are a slight modification can greatly improve the quality of sleep.

2. It is possible to resort to drug therapy (always used under the supervision of a doctor !!!).Hypnotics most commonly used in the treatment of sleep disorders.Their efficiency mainly depends on the cause of nightmares.Drug therapy is best proven in the treatment of parasomnias associated with substance abuse and nightmares from the night awakenings.

Medications.
Hypnotics: bromisoval (Bromisovalum), Diphenhydramine (Diphenhydraminum), doxylamine (Doxylaminum), temazepam (Temazepamum), Phenobarbital (Phenobarbitalum), Flunitrazepam (Flunitrazepamum), flurazepam (Flurazepamum), Estazolam (Estazolamum), Zaleplon (Zaleplonum),Zolpidem (Zolpidemum), Zopiclone (Zopiclonum), clomethiazole (Clomethiazolum), Midazolam (Midazolamum), Nitrazepam (Nitrazepamum).
All drugs are addictive when used more than 4 months, are strictly prescription.It is best tolerated hypnotics group diazepines.

Hormone therapy.
safer drugs in the treatment of parosomny is melatonin (melatonin).Melatonin - is a hormone produced by the pineal gland (located in the brain refers to fotoendokrinnoy system), but after thirty years it produces too little.There are disturbances of circadian (cyclic) sleep rhythm: fatigue, depressive syndrome develops.One can compensate for the lack of melatonin in the body using synthetically synthesized.It is sold in the pharmacy network of the same name, but different manufacturers (Italian, Indian, and Russian).

Phytotherapy.
Lavender flowers - a natural sedative, improves sleep.It is used not only as a drug with parasomnias, but also as a means to mitigate the stress and irritability.Lavender is often added to the bath.Bouquets of flowers plants placed in the bedroom, are able to provide a healthy sleep.
Melissa herb - an infusion of the leaves of lemon balm acts as a sedative.It treats sleep disorders.Especially recommended for the elderly.
Valerian root - infusion of plants helps to sleep, soothing, eliminates insomnia.Valerian is also used to deal with stress.

Each drug contains substances that interfere with the body's natural cycle.Therefore, we must be careful and moderation in the use of medications for sleep.The constant use of herbs and other natural medicines can lead to psychological dependence.Swallowing tablets before going to bed becomes a kind of ritual that is repeated every night.Natural backfilling would be impossible, since the brain is constantly sending signals that prompt to action to take medication.

3. Psychotherapy. best choice psychotherapeutic help will be cognitive-behavioral therapy.Different techniques of cognitive-behavioral therapy have proven effective in reducing the incidence of nightmares.The therapy aims to change the nightmare scenario of the mechanism by influencing the cognitive model of the formation of dreams.
most widely used: imaging method or rehearsal therapy.The approach to treatment is based on the destruction of bad thoughts, emotions and behavior.Therapeutic procedure itself is very structured.
- patient retrieves from memory their nightmares, their records.
- Then, under the guidance of a therapist, change some of the elements and details of individual events so as to replace all the negative to the positive elements of sleep.
- later secured a positive experience, which can affect the content of nightmares that arise in the future.

Preventing nightmares

1. If you have sensitive sleep, then remove all of the sounds in the bedroom, which interfere with sleep.Noise "paralyze" the dream.
2. Remove the large dials of the bedroom, away from your field of vision.You can hang them on the head or put on the ground next to the bed.If you look at the clock before going to bed, it seems that time passes more slowly, then formed the stress and excitement.
3. It is important to the lighting in the bedroom.The eyelids are very easy to transmit light and just close your eyes may not be sufficient to maintain an adequate level of darkness for a restful sleep.Good curtains or blinds should be protected from light from the street lamps in the evening and night, from the first rays of the sun in the morning.If you like to read a book before going to sleep, you should make sure that the light has a warm, natural color, preferably a small lamp power (but enough to keep tire the eyes when reading text).
4. If there are problems associated with the awakening, try to expose themselves to sunlight or bright light.This will restore the biorhythms and when they come twilight, it will be easier to cope with falling asleep.
5. Always take care of the timely change of bed linen.Ventilate the room a few minutes before going to bed.
6. Avoid extraneous strong smells in the bedroom (the smell of food, air freshener).
7. Do not bring food into the bedroom, the smell of food can cause hunger at the wrong time.Furthermore, the presence of food in the bedroom can increase probability of allergic mold and mildew.
8. An hour before bedtime, you can afford to snack containing carbohydrates, but not exceeding caloric value up to 100 - 200 calories (calories, tend to eat on the packaging of any food product).It is better to arrange a short snack in the evening, which will help prevent the urge to eat at night, hunger leads to sleep loss.
9. Day or 3-4 hours before going to bed to do exercise at least 30 minutes.In addition, physical activity helps to prevent stress, which is one of the main factors that disrupt sleep.
10. It is very important to sleep in a room temperature.The bedroom should be colder than the rest of the apartment.The room for the bedroom in an apartment is better to choose with the least number of windows that are not on the sunny side, or simply equip air-conditioned room.
11. Limit consumption of alcoholic beverages in the evening.After 19 hours of alcohol is better not to eat.Alcohol, in the beginning, makes it easy to fall asleep, but sleep is not deep, and intermittent.The more alcohol consumed, the more time is needed for the body to its processing.Sleep in this period will be of poor quality, time has not come fast phase.As a result, it will increase the likelihood of nightmares.
12. Do not drink coffee, strong tea for more than two cups a day.After 15.00 should not drink coffee at all.Caffeine stays in the body for a considerable period of time, and its presence can cause disruption and fragmentation (disruption of) sleep.

Respect for fundamental principles of sleep hygiene can help eliminate many of the causes parosomnii, but in some cases this may not be enough to solve all the problems associated with nightmares.Good sleep hygiene is a prerequisite to any planned treatments have the desired positive effect.

Psychiatrist Kondratenko NA