See related patient information handout on nightmares and night terrors in childrenwritten by the author of this article, prozac and nightmares. Dreams occur during all stages of sleep. They can be associated with poor sleep and diminished daytime performance. However, recurrent nightmares are the most defining symptom of post-traumatic stress disorder and may be associated with other psychiatric illnesses.
Night terrors are arousal disorders that occur most often in children and usually occur early in the sleep period, prozac and nightmares.
Patients with rapid-eye-movement behavior disorder often present with nocturnal injury resulting from the acting out of dreams.
Dream disorders may respond to medication, but behavioral treatment approaches have shown excellent results, particularly in patients with post-traumatic stress disorder and recurrent nightmares. A dream is the recall of mental activity that has occurred during sleep. Using polysomnography, sleep can be divided into stage 1 sleep onsetstage 2 light sleep and stages 3 prozac and nightmares 4 deep sleep —the non—rapid-eye-movement REM stages.
REM sleep occurs cyclically every 90 minutes during the night in association with high brain activity, prozac and nightmares spontaneous eye movements and suppressed voluntary motor activity.
Dreaming occurs in all stages of sleep. It is reported by 80 percent of persons who are awakened during REM sleep and sleep onset stages 1 and 2and 40 percent of persons who are awakened from a deep sleep. Patient reports about the content of their dreams vary based on the sleep stage from which they are awakened.
Patient reports of dreams experienced during REM sleep tend to be bizarre and detailed, with storyline plot associations. In contrast, dreams experienced in deep sleep are more diffuse e. The dreams of stages 1 and 2 are simpler, shorter and have fewer associations than the dreams of REM sleep. Some researchers believe that dreams have no function.
Nightmares are vivid and terrifying nocturnal episodes in which the dreamer is abruptly awakened from sleep. Typically, the dreamer wakes from REM sleep and is able to describe a detailed, associative, often bizarre dream plot. Usually, the dreamer has difficulty returning to sleep. Nightmares are also common. In a two-week prozac and nightmares study of college students, 47 percent described having at least one nightmare. Increased awakenings Daytime memory impairment and anxiety.
Stereotypic dreams of the trauma Intense rage, fear or grief. Significant trauma Daytime hyperarousability and anxiety, prozac and nightmares. Deep sleep, early in sleep period i. Stages 3 and 4 arousals on polysomnogram.
No pathology in children Psychiatric and neurologic disorders in adults. Nightmares affect 20 to 39 percent of children between five and 12 years of age. They rarely define issues as being black and white, but instead see themselves and the world in shades of gray.
Nightmares are also associated with the use of medication, primarily those medications that affect neurotransmitter levels of the central nervous system, such as antidepressants, narcotics or barbiturates. Intense, frightening dreams may occur during the withdrawal of drugs that cause REM sleep rebound, such as ethanol, barbiturates and benzodiazepines Table 2. Medications that alter central nervous system neurotransmitter levels. Selective serotonin reuptake inhibitors.
Nightmares are a defining symptom in post-traumatic stress disorder PTSD. These nightmares are often associated prozac and nightmares disturbed sleep and altered daytime behavior, which is best described as hyperarousability. The occurrence of PTSD following prozac and nightmares varies. Thirty percent of veterans of the Vietnam War were affected by PTSD, as were 68 percent of veterans who were in the Arab-Israeli conflict of and 8 percent of veterans of the Gulf War.
However, among some groups of patients, such as immigrant psychiatric patients, the incidence of PTSD approaches 40 percent.
The frequency of PTSD increases with severity of trauma, hostility, depression, poor health habits and poor coping skills. Persons with PTSD generally report awakening from dreams that involve reliving the trauma. In these dreams, they experience strong emotions, such as rage, intense fear or grief, that would have been appropriate reactions to the original traumatic event, prozac and nightmares.
Nightmares related to PTSD generally happen during REM sleep but also occur at sleep onset, which can interfere with the initiation of sleep. This phenomenon is similar to that occurring in patients with narcolepsy.
Symptoms of PTSD can persist for decades after the traumatic experience; however, the occurrence of PTSD after trauma is the exception rather than the rule. Nightmares can occur in patients with psychiatric illness, prozac and nightmares.
Depression is sometimes associated with themes of masochism and poor self-image in dreams. Panic attacks can occur during REM sleep in patients who prozac and nightmares panic disorders and depression, and in patients who have asthma and breathing disorders of sleep.
The REM sleep rebound related to withdrawal from prozac and nightmares and sedative-hypnotics, prozac and nightmares, which chronically suppress REM sleep, may present as disturbing nightmares, prozac and nightmares.
A strong association exists between REM sleep and dreaming. A variety of REM-associated parasomnias can alter dreaming Table 3. Arousal disorders usually associated with deep sleep. Information robaxin and heart issues The international classification of sleep disorders, prozac and nightmares, revised: American Sleep Disorders Association, REM prozac and nightmares disorder most commonly affects middle-aged men.
Patients with this disorder often present with a history of sleep-associated injuries to themselves or a sleeping partner.
REM behavior disorder is characterized by vivid, action-filled, violent dreams that the dreamer acts out, sometimes resulting in injury to the dreamer or the sleeping partner. REM behavior disorder often occurs without concomittant pathophysiology, but can be associated with neurodegenerative neurologic disorders. Night terrors are nocturnal episodes of extreme terror and panic that usually occur early in the sleep period.
Persons with night terrors are often difficult to arouse and have limited recall of their dream content. Adults who have night terrors are more likely than children to have psychopathology, mainly substance abuse and affective disorders. In persons who have a history of nocturnal injuries, polysomnography is required to diagnose REM behavior disorder or nocturnal seizures.
To diagnose REM behavior disorder, the use of additional electromyographic arm leads is required. In up to 25 percent of patients with epilepsy, the condition may present only as nocturnal seizures, prozac and nightmares.
Nocturnal seizures can be grand mal, petit mal, partial-complex, vegetative or paroxysmal nocturnal dystonias. All parasomnias more commonly affect persons who have breathing disorders during sleep. Polysomnography is appropriate for any patient with symptoms or signs of obstructive sleep apnea, such as daytime hypersomnolence, nocturnal hypoxia, loud snoring and increased neck circumference.
REM behavior disorder often occurs concomitantly with degenerative neurologic illnesses that may require further evaluation. In adults, the onset of arousal disorders such as somnambulism and night terrors may reflect underlying neurologic disease. Thus, neurologic evaluation, including imaging of the central nervous prozac and nightmares, may be indicated.
Nightmares and night terrors in children are usually disturbing to parents and family members; therefore, proper diagnosis and education of family members are important components of weight loss and green tea. It is essential to control the environment by removing dangerous objects and providing barriers to prevent escape from a safe sleeping environment.
Reassurance and support are often the only therapy required because these disorders rarely, if ever, reflect underlying illness and usually disappear with maturity. Pharmacologic intervention is not usually indicated; in fact, it should be discouraged because it may contribute to further sleep disruption, prozac and nightmares. Clonazepam Klonopinin a dosage of 0. Long-term efficacy and safety have been reported, along with relapse when the medication is discontinued.
PTSD can be a short-term, limited problem or a lifelong, chronic illness that prozac and nightmares in recurrent hospitalizations, impaired prozac and nightmares relationships and aggressive or self-destructive behavior.
Although many different approaches to treatment have had limited success, psychotherapy, individually or in a prozac and nightmares setting, is generally indicated and can help with resocialization. Cognitive restructuring, eye movement desensitization and reprocessing therapy, prolonged exposure flooding therapy and nightmare imagery techniques can decrease symptoms in patients with Prozac and nightmares for months after therapy.
Nightmares that occur after the patient has experienced trauma or stress may lead to an interpersonal integration of the event. On the other hand, prozac and nightmares, long-term persistence the habitual pattern of recurrent nightmares not associated with recent trauma can cause a decline in daytime functioning without apparent benefit. Behavioral approaches in the treatment of nightmares have been successful and can result in short- and long-term reduction of nightmare frequency in more than 70 percent of patients.
Such therapy requires only a few group or individual sessions with a psychologist or in a sleep medicine center. Already a member or subscriber? He is also an associate professor in the St. Pagel is chairman of the dream section for the American Sleep Disorders Association. He is board certified in sleep disorders medicine and family practice. Address correspondence to J.
Greenwood, Pueblo, CO Reprints are not available from prozac and nightmares author. The functions of dreaming. State University prozac and nightmares New York Press, The prevalence of nightmares and their independence from anxiety. Prevalence of nightmares and their relationship to psychopathology and daytime functioning in insomnia subjects. Prevalence of sleep disorders in the Los Angeles metropolitan area. Klink M, Quan SF. Prevalence of reported sleep disturbances in a general adult population and their relationship to obstructive airways diseases.
Sleep and its disorders in children. Hawkins C, Williams TI.