Everyone has bad dreams. It becomes a different problem when you start dreading the bed itself.
Occasional nightmares are normal. Recurring nightmares — frequent, distressing dreams that wake you and affect how you function the next day — are a recognised sleep problem, frequently linked to trauma, stress, medication or disrupted sleep. They are treatable, and the treatment with the strongest evidence is not medication.
When it stops being ordinary
Most adults have a nightmare from time to time, particularly under stress. It matters when:
- They happen weekly or more
- You wake fully and struggle to get back to sleep
- You have begun avoiding sleep, or dreading bedtime
- Daytime function is affected — exhaustion, irritability, poor concentration
- The same dream, or the same theme, keeps recurring
- They began after a specific event
The avoidance is the part that turns it into a self-sustaining problem. Delaying bedtime to reduce nightmares produces sleep deprivation, and sleep deprivation increases both REM rebound and nightmare frequency. The strategy makes the problem worse, which is exactly the pattern described in insomnia.
What drives them
Trauma. The most common identifiable cause. Trauma nightmares often replay the event or its emotional content and are a core feature of PTSD. See PTSD in adults and the trauma hub. Given how common road accidents, armed robbery, medical trauma and bereavement are here, this is a substantial and under-recognised group.
Stress and anxiety. Nightmare frequency rises reliably during difficult periods — exams, job insecurity, family crisis.
Grief. Dreams of the deceased are extremely common after a death and are not in themselves a problem, though they can be painful. See grief after losing a parent.
Disrupted or insufficient sleep. Shift work, call rotas, late nights. When you finally sleep, REM rebounds and dreams intensify.
Alcohol and substances. Alcohol suppresses REM early in the night and produces a rebound later — which is why heavy drinkers often report vivid, unpleasant dreams in the early hours.
Medication. Several classes can affect dreaming, including some blood pressure medications and some antidepressants, and stopping certain medications can cause a temporary surge. Never adjust a prescription on your own — raise it with your doctor.
Suggested read: Sleep Paralysis: Ogun Oru or Sleep Disorder?
Depression. More frequent and more distressing dreams are common.
Fever and illness, which produce a temporary spike.
Nightmares in children
Common and usually developmental, peaking in the preschool and early school years, and generally outgrown.
Worth distinguishing from night terrors, which look far more alarming and are a different thing: the child sits up, screams, appears terrified, and does not recognise you — then remembers nothing in the morning. With a nightmare the child wakes properly and can describe it. Night terrors are usually outgrown and are best managed by keeping the child safe and not attempting to wake them.
Take it further if nightmares become frequent, if they follow a specific event, or if there are other changes — withdrawal, regression, new fears. See teenage mental health: a Nigerian parent’s guide for the older end, and childhood trauma in adults for how early experiences carry forward.
The treatment that works
Imagery rehearsal therapy has the strongest evidence for recurring nightmares, including trauma-related ones. It is brief and it does not involve medication.
The principle: while awake, you write out the recurring nightmare, then deliberately rewrite it with a different ending or a changed element — anything that removes the helplessness. Then you rehearse the new version daily, in your imagination, for a few minutes.
Over weeks, the rewritten version tends to displace the original. It works, in short, because nightmares are partly a learned pattern, and the pattern can be overwritten.
Two cautions. Where nightmares are trauma-related, do this with a therapist rather than alone — deliberately rehearsing traumatic content without support can increase distress rather than reduce it. And it requires consistency over a few weeks; a single attempt does nothing.
Alongside it:
Suggested read: Dissociation: Feeling Unreal or Far Away
- Regular sleep and enough of it. Nightmare frequency drops with adequate, consistent sleep.
- Reduce alcohol, particularly in the evening.
- Treat the underlying condition. Where PTSD, depression or anxiety are present, treating those reduces nightmares directly.
- A wind-down that is not your phone. What you consume before bed genuinely affects dream content.
- Do not lie in bed after waking from one. Get up briefly, do something calm and low-light, return when sleepy. Same principle as insomnia treatment.
Medication is occasionally used for trauma-related nightmares and is a decision for a doctor. See therapy or medication.
You can filter for trauma and sleep experience in our directory.
The spiritual reading
Recurring bad dreams — being chased, drowning, seeing a dead relative, being attacked — are widely interpreted here as spiritual, and many people seek deliverance for them rather than assessment.
As with sleep paralysis, the useful position is not an argument about belief. It is that these dreams have identifiable drivers — trauma, stress, alcohol, broken sleep, medication — and a treatment that works. You can pursue whatever your faith directs and also fix your sleep, reduce your drinking and treat the trauma. The second set is what changes the frequency.
Frequently asked questions
What causes recurring nightmares?
Most often trauma, stress, disrupted sleep, alcohol, certain medications or depression. Recurrence usually means something specific is driving them.
How do I stop nightmares?
Imagery rehearsal therapy has the best evidence — rewriting the dream while awake and rehearsing the new version daily. Do it with a therapist if the content is traumatic.
What is the difference between a nightmare and a night terror?
After a nightmare the person wakes properly and can describe it. In a night terror they appear terrified, do not recognise you, and remember nothing afterwards.
Can medication cause nightmares?
Yes, several classes can, and stopping some medications can cause a temporary increase. Raise it with your doctor rather than adjusting anything yourself.
Should I be worried about nightmares after a death?
Dreams of the deceased are very common in grief and usually ease with time. Persistent, distressing nightmares that disrupt sleep are worth treating.
