Dr. Henry Paul, MD

Psychiatrist, Author and Educator


March 5th, 2014

Sandy has been scaring us. She seems to wake up screaming, terrified, and agitated. She bolts up. After a few minutes she goes back to sleep. It not only scares us but she doesn’t even remember the whole thing the next morning.

There is a group of sleep disorders called Parasomnias. These syndromes present as unusual behaviors or movements that occur during sleep. They occur mostly in children and are rarely serious. They usually are gone by adolescence and the most effective interventions are parent education and counseling.  Medication is rarely needed for most cases. They are rarely associated with major mental disorders. The most common ones encountered in practice are Nightmares, Night Terrors, Sleepwalking, and Bedwetting.

I will discuss all four in my next few blogs, but we’ll start with nightmares today.  Nightmares or bad dreams are quite common in young people. These are dreams in which the child experiences himself in danger, vulnerable, frightened, and helpless. There is great distress, sometimes even panic and horror. Common themes often involve being chased, drowning, and other frightening losses of control. These dreams usually happen in the second part of the night, and the child often wakes up scared and remembers the dream content.

The child is often quite anxious, possibly believing that the dream was reality. He has a fast heart rate and might be perspiring, as well.  Children usually need soothing and reassurance. Sometimes from the content of the nightmare the parent will be able to figure out what might be causing a passing stress or anxiety and might be able to help. Of course, there might be causes for repetitive nightmares such as chronic stress/anxiety. Some physiological causes might be the administration of certain antidepressants or stimulant medication for ADHD and post-traumatic stress disorder. If nightmares have become disruptive to the point of interfering with functioning then treatment to decrease stress, a fitness program, relaxation therapy, yoga, and even meditation have all been reported to help. In the most severe cases, such as those following a severe stressor, medication has been used with success and includes the antidepressants Trazadone or Serzone, some mood stabilizer, and possibly a Benzodiazepine anti-anxiety drug for the short term (a week or so).

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

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