The jury is out on the significance of dreams.  For some, their nocturnal visions are fascinating and mysterious and offer unconscious insight into their personal lives and the world at large; for others, dreams pointless and simply help to pass the time while they get their 40 winks.

But regardless of which point of view you hold, there's no doubt about the fact that some dreams (those that fall under the category of sleep disorders called parasomnias) hold significant meaning-sometimes even signaling an underlying health problem.


These frightening, distressing dreams are quite common in children, but about five to 10 percent of adults also experience them at least once a month or more frequently, according to the International Association for the Study of Dreams (IASD). They can cause a variety of unsettling emotions - anger, sadness, and most commonly, anxiety and fear. The most common theme is being chased, and it's quite common for a nightmare to cause you to awaken.

  • Health indicator: In children nightmares seem to be a normal part of growing up. However, in adults they may be linked to illicit drugs, or medications. They can also occur when you suddenly stop taking these drugs. They can lead to disturbed sleep, and alter your daytime behavior during the day, explains Dr. J.F. Pagel from the University of Colorado Medical School who wrote "Nightmares and Disorders of Dreaming," in the journal, American Family Physician

In some cases, nightmares can be a symptom of grieving, for instance, when you lose a loved one. But, they can also be a sign of heightened stress levels - maybe about financial problems, an illness, or job situation.

In other cases, nightmares - especially recurring ones - can signal post-traumatic stress disorder (PTSD), which occurs after a particularly traumatic event or severe medical illness. According to Dr. Pagel, PTSD is more intense depending on the severity of trauma you suffered, depression, and overall poor health and poor coping skills.


Night terrors are nocturnal episodes of extreme terror and panic that usually occur early in the sleep period, explains Dr. Pagel. They are similar to other arousal disorders during deep sleep, such as sleepwalking. During a night terror you may be confused, let out loud blood-curdling screams, and may be difficult to awaken. They most commonly occur in children between ages four and 12 years old, but can affect adults as well.

  • Health indicator: For adults, there's usually an underlying cause such as substance abuse or an affective disorder, and they may be linked to other sleep problems such as periodic limb movements and obstructive sleep apnea, states Dr. Pagel.


Middle-aged men are most likely to suffer from this sleep problem, which causes patients to suffer vivid, action-filled violent dreams that can cause injury to themselves or to their partner, explains Dr. Pagel. It can cause major jerking of the limbs or the upper body.

  • Health indicator: Sometimes REM behavior disorder is linked to neurodegenerative neurologic disorders, most commonly Parkinson's disease, primary dementia and narcolepsy (when the brain is unable to regulate sleep-wake cycles, which leads to sudden urges to fall asleep). Dr. Pagel adds that computed tomography (CT) and magnetic resonance imaging (MRI) brain scans of people with REM behavior disorder may show lesions and other abnormalities.

What You Can Do About Your Disturbing Dreams

Children often outgrow parasomnias, explains Dr. Carlos Schenck, who practices sleep medicine at the Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center and University of Minnesota Medical School. Adults can improve their symptoms by practicing good sleep habits: Try to keep a regular sleep schedule, find healthy ways to manage stress, create a relaxing bedtime ritual, and get enough sleep.

If your dreams begin to pose a risk to yourself or others, or start to escalate, you should seek medical treatment. Your doctor can order tests to rule out underlying causes, or recommend drug therapies or counselling to help control symptoms.



Study References

Journal: American Family Physician, Vol. 61:2037-42,2044

Study Date: 2000;

Study Name: Nightmares and Disorders of Dreaming.


Author: J.F. Pagel, M.D.