Nightmare Disorder and Isolated Sleep Paralysis

Summary & key facts

This review explains two REM-related sleep problems: nightmare disorder and recurrent isolated sleep paralysis (RISP). Nightmare disorder means repeated, very upsetting dreams that wake a person and cause distress, insomnia, or daytime problems. Nightmares are common, especially in people with psychiatric illnesses and PTSD. RISP is when the body’s muscle paralysis from REM sleep continues after waking and can include very vivid hallucinations. Treatments that do not use medicine, such as imagery rehearsal therapy for nightmares, are effective. Avoiding sleep loss and irregular sleep schedules is the most helpful step for sleep paralysis.

Key facts:

• Nightmare disorder is defined as repeated, well-remembered, very upsetting dreams that usually involve threats and cause significant distress or daytime problems; the DSM-5 adds a frequency criterion of at least once per week for diagnosis.
• Sporadic nightmares are common: about 22% of adults in Austria report them; in Finland surveys 36.2% of men and 45.1% of women reported nightmares. Frequent nightmares were reported in 2.9% of men and 4.4% of women in multiple Finnish surve
• In people with psychiatric disorders, the average prevalence of nightmare disorder was 38.9% across 22 studies. Prevalence by diagnosis was 66.7% in PTSD, 37.3% in mood disorders, 31.1% in personality disorders, and 15.6% in anxiety disorde
• Up to 40% of the general population report experiencing isolated sleep paralysis at least once, though repeated episodes are less common.
• Isolated sleep paralysis is a dissociated REM state where REM muscle atonia persists into wakefulness. It can be accompanied by very intense and vivid hallucinations.
• Nonmedication treatments, especially imagery rehearsal therapy, are reported as especially effective for nightmare disorder. For isolated sleep paralysis, the most effective approach reported is avoiding predisposing factors such as sleep d
• Certain medical conditions (for example migraine, bronchitis, asthma), some drugs (for example beta-blockers and some SSRIs), and alcohol withdrawal have been identified as factors that can provoke nightmares.
• Nightmares and nightmare disorder are often underreported. In one study, 62.2% of people with clinically significant nightmare symptoms had not discussed them with a healthcare provider.

Topics

Memory and Neural Mechanisms Sleep and related disorders Sleep and Wakefulness Research

Categories

Cognitive Neuroscience Life Sciences Neuroscience

Tags

Cognition Computer science Electroencephalography Environmental health Excessive daytime sleepiness Insomnia Medicine Nightmare Non-rapid eye movement sleep Operating system Paralysis Population Psychiatry Psychology Sleep (system call) Sleep deprivation Sleep disorder Sleep paralysis Wakefulness

Conditions & symptoms

Sleep disorder Anxiety or worry Lack of energy or motivation Poor sleep