Why am I having so many nightmares?

What is the role of a nightmare?

Nightmares are a touching normal phenomenon that occurs in the second half of the night, during REM sleep. It affects between 2 and 6% of adults (both men and women), compared to 10 to 50% of children and adolescents (mainly between 6 and 10 years old). Their frequency tends to decrease with age. Nightmares are bad dreams that serve to regulate our emotions. When we dream, our memory, our fears, our emotions and our feelings reorganize. Dreams thus serve to calm our nerves, to de-dramatize: we review events with a distance and we digest them better. Nightmares thus help us to absorb the brutal changesanxiety, stress, they soothe a buried fear. “The dreams allow us to forget our mistakes, our shocks, our worries, to continue to lead our lives. The more the dream becomes negative, the more it translates an emotional element difficult to digest”explains Benjamin Putois, doctor in cognitive sciences, associate researcher at Inserm, psychologist and psychotherapist specializing in sleep disorders, and author*.

“The nightmare therefore has, initially, a positive function. It is useful, for example, to be able to overcome trauma (car accident, attack, sexual abuseaggression etc.)” says our expert. Indeed, during REM sleep, our body is completely calm: reviewing what worried us in this state of serenity allows us to no longer be affectedto desensitize to what has stressed us. “It’s only when the nightmare becomes chronic, that it is the sign of a disorder or dysfunction. The “digestion” function no longer works: the disc continues to spin unnecessarily, as if it were scratched”.

When can we speak of trouble?

It is normal to have many nightmares following a traumatic event. However, nightmares become problematic when they are too recurrent (one nightmare per week, or even several per night) and persist over time, generally beyond six months. But also when they are very dark and occur in a person who, a priori, has no traumatic event to digest. The nightmare leaves our body in a state of exhaustion and tension.

Sleep is no longer a source of rest but of fatigue, the impact of which is felt during the day and especially on health, because insomnia awaits. Going to bed at night becomes synonymous with anxiety. Frightened, we no longer dare to go back to sleep. The hours pass, without sleep. The vicious circle of fatigue and suffering sets in. “You really have to make the difference between the traumatic nightmare, which occurs normally in a context of post-traumatic stress, and the idiopathic nightmare, which has no place to be, insists Benjamin Putois. What you need to know is that there is not necessarily a trauma behind every nightmare. There are “chronic nightmares”, which have not yet suffered a dramatic event. Parents, in particular, can be reassured on this point. In any case, we can treat idiopathic nightmares, such as traumatic ones”.

Repeated nightmares: what solutions?

The first thing is to draw up an inventory of your sleep and keep, for example, a diary to know where you are. When do nightmares occur? What is their frequency? What are they talking about ? Are they still the same? What is their impact on your sleep? What symptoms do you suffer from?… Difficulty falling asleep, fragmented sleep, anxiety about going to bed, difficulty staying awake, insufficient or unrestful sleep, inability to go back to sleep, difficulty waking up on morning…

What is the influence of these nightmares on your state of health during the day? Gloomy mood, fatigue, frustration, lack of energy, drowsiness, impatience, fear, irritability, tension, anxiety, loss of control, discouragement, stress…

Keep a “dream diary” and learn to differentiate nightmares from night terrors or sleep paralysis. If in doubt, consult a sleep doctor.

Mental image re-scripting therapy

In which cases?

Developed in the 1990s by a network of American researchers, this technique of behavioral and positive approach is today the only natural method, without chemical substances and without side effects, recommended by the American Academy of Sleep Medicine.¹ : scientific studies attest to its effectiveness in significantly reducing the intensity and frequency of nightmares. It is recommended for pathological nightmares (whether traumatic or idiopathic), that is to say recurring and very disturbing.

What is it about ?

Many sleep specialists now offer it in France. “It’s a brief therapy (3 to 4 months), which works on 70% of peopleaccording to Benjamin Putois. Its principle is simple: it consists in undergo daily training of his visual mental imagery ability to transform the negative scenario of nightmares into a positive scenario. To sum up: it’s about changing the way you look at your nightmares, to better tame them”.

How’s it going ?

By using your imagination, it is indeed possible to visualize a nightmare during the day and modify certain elements to imagine a happier outcome. “The more we repeat this positive scenario while awake, the more it will imprint itself on us and be evoked spontaneously during the next few nights.reveals the specialist. By working like this, nightmare after nightmare, in a progressive and gentle way, the nightmares and their share of negative emotions gradually disappear”. Learning to create new scenarios by visual mental imagery is thus carried out in 4 phases:

• Understand how sleep and dreams work;
• Understand how nightmares persist;
• Train their capacity for visual mental imagery;
• Train his ability to turn nightmares into dreams.

“In short, it is a simple, playful technique, much appreciated by patients because it does not directly target either the traumatic memory or the origin of the nightmare. We do not need to work specifically on traumatic memories. when they are therenotes Benjamin Putois. But above all, the clinical improvements are maintained over the long term”.

What are the conditions for the therapy to work?

Several elements must come together for the therapy to be successful.

• It is first of all a therapy based on learning: it only works if you are motivated. “It is not enough to understand the problem, you have to revisit your beliefs in relation to nightmares and carry out daily training to succeed in changing the scenario of the nightmare”emphasizes Benjamin Putois.
• It must be associated with good sleep hygiene. Ensure the regularity of your sleeping and rising rhythms. “The more you sleep, the more you dream. If you spend too much time lying around in bed, you are more likely to have nightmares”, says the psychologist. No late mornings therefore and short naps (no more than 20 minutes), so as not to interfere with nighttime sleep. “Reducing the time spent in bed accelerates falling asleep, reduces nocturnal awakenings, condenses deep sleep and therefore offers a more restful night”continues the therapist.
• Pay attention to your consumption of psychoactive substances! Medications (especially antidepressants), alcohol, cannabis disrupt REM sleep and promote nightmares. Their weaning also leads to an intensification of the phenomenon.
• Finally, the sleep apnea, are also a cause of chronic nightmares and may be one of the causes of therapy failure.