Diseases & Conditions


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Nightmares


Frightening dreams that usually force at least a partial awakening. Nightmares are experienced by almost all children at one time or another; one out of every four children has nightmares more than once a week. Most children have nightmares between the ages of three or four and seven or eight, which seem to be a part of normal development and do not generally signal a mental problem. Most nightmares occur late during the sleep cycle (usually between 4 A.M. and 6 A.M.). Nightmare themes may vary widely from child to child, and from time to time for the same child, but the most common theme is being chased. Children are commonly chased by an animal or some fantasy figure. The nightmares of early childhood probably reflect the struggle to learn to deal with normal childhood fears and problems. Many children also experience nightmares after they have suffered a traumatic event, such as surgery, the loss of a loved one, or a severe accident. The content of these nightmares is typically directly related to the traumatic event, and the nightmares often occur over and over. Finally, some children experience frequent nightmares that seem unrelated to their waking lives; these individuals tend to be more creative, sensitive, trusting, and emotional than average. After a nightmare, the child may wake up and seek comfort from parents; usually, the child can relate what happened in the dream and why it was scary. Children may have trouble going back to sleep after a nightmare and may have the same dream again on other nights. Nightmares decrease in frequency as children get older, and often stop completely in adolescence, although some—especially those who are imaginative and creative—may continue to have nightmares into adulthood. Treatment Experts usually suggest that parents encourage young children to discuss their nightmares with their parents or other adults, but that children generally do not need treatment. However, if a child is suffering from recurrent or very disturbing nightmares, the help of a therapist may be needed to have the child draw the nightmare, talk with the frightening characters, or imagine how the nightmare could change to help the child feel safer and less frightened. Nightmares that replay a traumatic event actually reflect a normal mental healing process and will occur less often and be less frightening if the child is recovering. Nightmares in children can occur up to six months after a stressful physical or emotional event. However, if nightmares continue and interfere with a child’s sleep, they can affect the child’s ability to function during the day. For this reason, parents may want to consult a doctor to see whether any treatment is appropriate to help the child. (See also NIGHT TERRORS.)