Academic literature on the topic 'Nightmare frequency'

Abstract Introduction Imagery Rehearsal Therapy (IRT) is an efficacious treatment for Nightmare Disorder. In IRT, patients practice pleasant guided imagery techniques, then use these skills to re-script recurring nightmares, which lowers the frequency and intensity of overall nightmare activity. However, the most efficacious methods and dosage of guided imagery and nightmare re-scripting is undetermined. Report of Case The patient was a 70-year-old male with Nightmare Disorder. Patient denied any precipitating event or trauma associated with nightmare onset. He has a longstanding history of depression and OSA (uses CPAP). He was taking Seroquel, which reduced severity of nightmares but not frequency. Trials of other medications for nightmares had failed (including prazosin, Depakote, and trazodone). Patient presented as highly distressed, exhibited distrust towards medical providers, and was skeptical about the effectiveness of IRT. Despite his skepticism, patient self-initiated very detailed and media-enhanced methods for pleasant guided imagery and nightmare re-scripting, including written narratives, voice recordings, and created a movie of his re-scripted nightmare with pictures set to music. He listened to the recordings 2-3x/day. Themes of nightmares included lack of mastery over problems; patient’s re-scripted dreams put him back in control of frightening scenarios. Nightmare logs at baseline showed sleep quality=1.9/5; average=2.0 nightmares/night; average intensity= 6.2/10. At week 15 of treatment, sleep quality=3/5; nightmares/night average=0.25; average intensity=6/10. Sleep disturbance also improved (ISI=18-moderately severe clinical insomnia to 11-subthreshold insomnia); mood was stable (PHQ=5-mild depression). Conclusion Previous studies have suggested that IRT increases patients’ sense of mastery or perceived self-efficacy over nightmares (Rousseau et al., 2018). Additionally, higher verbal memory in persons with trauma-related nightmares has been shown to improve nightmare frequency and severity in IRT (Scott et al., 2017). In this case study, self-efficacy may have been activated by the highly detailed and media-enhanced imagery the patient created. Further empirical research on the mechanisms for enhancing IRT is warranted.

Chronotype refers to individual differences in sleep timing (“owls” and “larks”) and “eveningness” has been associated with nightmares. However, it has not been tested as to whether neuroticism mediates this relationship. Urbanicity refers to being raised in an urban region and/or currently living in an urban region and is associated with heightened risk for developing mental disorders, and thus might be related to nightmare frequency and nightmare distress. Overall, 2492 persons (1437 women, 1055 men) completed an online survey between 23 March 2015 and 8 April 2015. The mean age of the sample was 47.75 ± 14.41 years. The findings indicate that the previously reported relationship between chronotype and nightmare frequency was mediated by neuroticism and “morningness” was related to higher dream recall compared to persons with a late bedtime preference. Urbanicity was not related to nightmare frequency but to lower nightmare distress, raising the interesting question as to whether beliefs about nightmares might be an important variable that contributes to nightmare distress. Based on the few studies so far, there are still many unresolved questions about the interaction between nightmares, chronotype, and urbanicity.

The present study was designed to investigate empirically the relationship between self-reports of nightmare frequency and ego strength and death anxiety in both men and women. In addition, the interrelations among these variables were assessed. 20 undergraduates with high frequencies of nightmares and 20 with low frequencies (10 men and 10 women per group) were administered the Barron Ego Strength Scale and a death anxiety scale. Significant differences were found between nightmare groups on the Barron scale for men and women but none on the death anxiety scale either by nightmare frequency or sex. A significant negative correlation of −.47 between death anxiety and ego strength was found for women and in one high frequency group. Women with high frequencies of nightmares showed the highest correlation, −.83. These data suggest that nightmare frequency may be a mediating factor in the relationship between ego strength, death anxiety, and sex of subject.

The present study was designed to investigate empirically the relationship between self-reports of nightmare frequency and ego strength and death anxiety in both men and women. In addition, the interrelations among these variables were assessed. 20 undergraduates with high frequencies of nightmares and 20 with low frequencies (10 men and 10 women per group) were administered the Barron Ego Strength Scale and a death anxiety scale. Significant differences were found between nightmare groups on the Barron scale for men and women but none on the death anxiety scale either by nightmare frequency or sex. A significant negative correlation of -.47 between death anxiety and ego strength was found for women and in one high frequency group. Women with high frequencies of nightmares showed the highest correlation, -.83. These data suggest that nightmare frequency may be a mediating factor in the relationship between ego strength, death anxiety, and sex of subject.

An eighteen month follow-up of chronic nightmare sufferers treated with imagery rehearsal, a cognitive-behavioral method, demonstrated significant and clinically meaningful decreases in nightmare frequency. Sixty-eight percent of subjects decreased their nightmares below criteria for a “Chronic Nightmare Disorder”. Significant improvement was also noted for sleep quality and daytime anxiety. The findings support the theory that nightmares may be clinically conceptualized as a primary sleep disorder in some chronic sufferers.

Abstract Background and objectives Occasional nightmares (distressing dreams that awaking the sleeper) and bad dreams (distressing dreams that do not awaking the sleeper) are very common in children and adolescents. About 5% of children experience frequent nightmares (once a week or more often) and the question arises as to what factors contribute to significant nightmare distress which is basic for diagnosing a nightmare disorder. Materials and methods A sample of 624 school-aged children (10–16 years; mean age 12.45 ± 1.33 years) completed a dream questionnaire and an anxiety inventory. Results About 11% of the participants reported frequent bad dreams; 3.5% reported frequent bedtime anxieties due to bad dreams. Similar to the findings in adults, distress due to bad dreams was not only related to bad dream frequency but also to trait anxiety—controlling for the direct effect of trait anxiety on bad dream frequency, i.e., bad dream frequency and trait anxiety contributed independently to bedtime anxiety due to bad dreams. In the exploratory part, the cultural background of the children’s parents showed only minor effects on bad dreams. Conclusion Similar to nightmare studies in adults, bad dream frequency and trait anxiety contributed independently to bad dream distress. Based on the current diagnostic criteria of the nightmare disorder, it would be interesting to have the opportunity to treat children with significant distress due to nightmares or bad dreams and study the long-term benefit—given that many adult nightmare sufferers reported that their nightmares started in childhood.

Abstract Introduction Nurses report a higher prevalence of posttraumatic stress disorder (PTSD) than the general population, and approximately 18% of nurses report having depression. Nightmares are a common symptom of PTSD, and both nightmares and PTSD are correlated with depression. Nightmares may represent a possible clinical target for improving outcomes in both disorders. This study assessed associations between PTSD and depressive symptoms with nightmare severity, and whether depressive symptoms moderated associations between PTSD and nightmare severity. Methods Participants were 461 nurses (91% female; 77% white, mean age = 38.39 years) recruited from two hospitals for a parent study. Participants completed the Patient Health Questionnaire (PHQ-9), Post-traumatic Stress Disorder Checklist (PCL-5), and 14 days of sleep diaries to assess daily nightmare frequency and severity (on a scale of 0 = not at all severe to 3 = very severe). Results 22.1% of participants reported at least one nightmare across the 14 days, with a mean daily nightmare frequency of 1.17 (SD = 2.15) and a mean severity of 0.11 (SD = 0.18). PCL-5 and PHQ-9 scores were significantly correlated with nightmare severity (r = 0.27; r = 0.24, respectively) and each other (r = 0.69). PHQ-9 scores moderated the association between PCL-5 scores and nightmare severity (β = -.01, SE = <0.01, p = 0.015). For individuals 1 SD below the PHQ-9 mean, higher PCL-5 scores were associated with higher nightmare severity. For individuals 1 SD above the PHQ-9 mean, higher PCL-5 scores were associated with higher nightmare severity, but to a lesser degree. Conclusion Both depressive and PTSD symptoms were associated with more severe nightmares. Surprisingly, the association between PTSD symptoms and nightmare severity was stronger for those with lower depressive symptoms. Results suggest depression, PTSD, and nightmares may represent a partially overlapping symptom cluster. Research should investigate how nightmare treatment may reduce PTSD and depressive symptoms. Support NIAID R01AI128359-01

Nightmares are prevalent in psychiatric disorders, and personality disorder features might be associated with nightmare experience, especially in nightmare disorder patients. The authors invited 219 healthy volunteers and 118 nightmare disorder patients to undergo tests of the Nightmare Experience Questionnaire (NEQ), the Parker Personality Measure (PERM), and the Plutchik-van Praag Depression Inventory. Compared to healthy volunteers, nightmare disorder patients scored significantly higher on annual nightmare frequency and NEQ Physical Effect, Negative Emotion, Meaning Interpretation, and Horrible Stimulation, and higher on PERM Paranoid, Schizotypal, Borderline, Histrionic, Narcissistic, Avoidant, and Dependent styles. Borderline, Schizotypal, and Passive-Aggressive styles in healthy volunteers and Dependent, Avoidant, Histrionic, and Paranoid in patients were significant predictors of some NEQ scales. Higher annual nightmare frequency, higher scale scores of nightmare experience and personality disorder styles, and more associations between the two were found in nightmare disorder patients, implying the need for personality-adjustment therapy for nightmare disorder.

Abstract Background Since people with nightmares rarely seek help, low-threshold interventions and self-help methods are needed. Among different treatment approaches for nightmares, imagery rehearsal therapy (IRT) is the method of choice. Objective In the current study, the authors tested whether IRT is also effective when applied in a short version, within the scope of a single session of telephone counseling. Methods The nightmare frequency and nightmare distress of 28 participants was investigated before and 8 weeks after one session of telephone counseling. The 30-minute session included information on nightmare etiology as well as a short version of IRT. The session was followed by an 8‑week period of self-practice. Participants were either part of a student group or part of a group of patients from a sleep laboratory. Within-group and between-group differences were assessed. There was no control group. Results The intervention significantly reduced nightmare frequency and nightmare distress in the total sample and in both samples individually analyzed. Effect sizes were very high compared to those of waiting-list control groups of similar studies. Conclusion We were able to show that a one-session intervention can be enough to achieve significant relief from nightmares. As nightmares are underdiagnosed and undertreated, this approach might help to provide a low-threshold intervention for nightmare sufferers.

Nightmares are intense and unpleasant dream experiences that characterize approximately 4 percent of the adult population at least on a weekly basis. Nightmare frequency is often co-morbid with other mental complaints; however, recent results indicate that nightmare disorder is independent from waking mental dysfunctions. Nightmare disorder is intimately related to poor subjective sleep quality, and according to polysomnographic studies nightmare subjects’ sleep is characterized by increased sleep fragmentation and hyper-arousal. These findings suggest that instead of the psychopathological perspective nightmare disorder should be viewed as a specific sleep disorder that requires targeted treatment. Nevertheless, in order to choose the adequate treatment procedure clinicians should examine the co-morbid mental disorders as well taking into consideration the severity of nightmare distress, the latter supposed to be the mediator between nightmare frequency and waking mental dysfunctions. Orv. Hetil., 2013, 154, 497–502.

Four studies were conducted with the following samples a): people with frequent nightmares; b) people with sleep apnoea; c) fire-fighters and d) people with traumatic brain injury. Nightmare frequency was significantly elevated in these groups compared to the normal population. Correlations between nightmare frequency and various measures of psychopathology and individual differences were similar in size to those found in student samples. However, partialling out nightmare distress did not render nightmare frequency - psychopathology correlations negligible. Indeed, in the fire-fighters study, only one fire-fighter reported having a problem with nightmares. Nightmare frequency is thus not an artifact of nightmare distress in these samples. Defining nightmares as having to wake up the sleeper made no difference to between subjects correlations with the individual difference and psychopathology variables, and to within subjects correlations with state mood. However, requiring the dream to be very unpleasant as opposed to just moderately unpleasant to be classed as a nightmare did result in increased sizes of correlations. Within subjects correlations of pre-sleep mood with the presence/absence of a nightmare that night were small in comparison to between subjects analyses. Nightmares are thus more likely to be caused by general trait or long-term poor well being than by acute poor well-being. None of the individual difference variables assessed in this study predispose individuals to have nightmares under conditions of high anxiety or high depression. This was despite the individual difference variables in many cases having significant between subjects correlations with nightmare frequency. Ratings of PTSD correlated with nightmare frequency in individuals who had undergone repeated exposure to trauma (emergency service workers), and in individuals who had had one severe trauma (individuals with traumatic head injury). Despite sleep fragmentation there was no indication of cessation of dreaming in the patients with apnoea, but approximately one third of the participants with brain injury had complete cessation of dreaming. These results are discussed in terms of theories of nightmare formation, and of the continuity of waking and sleeping cognition.

The nightmare prevalence literature to date has largely focused on nightmare episode severity (i.e. frequency), with 8%-87% of individuals reporting these events in the past week to year. While this has helped to determine the prevalence of these events, focus on the episode severity alone is problematic because it means little is known about the actual prevalence of nightmare disorder. Moreover, focus on episode severity likely overestimates the actual prevalence of clinically significant nightmares while also obscuring clinically significant consequences of the disorder. Understanding the prevalence of nightmare disorder can help guide treatment planning and interventions. The present study recruited UNT undergraduates (N = 372; 351 analyzed) and managed all participant data using Research Electronic Data Capture (REDCap). The present study aimed to determine the prevalence of nightmare disorder, as stated in the DSM-5, to facilitate accurate characterization of the disorder. Additionally, as part of the secondary aim the influence of gender on nightmare disorder status and psychological wellbeing as measured by psychological and sleep outcome variables was examined. Finally, comparisons of individuals with DSM-5-defined nightmare disorder to those without the disorder were conducted on previously examined correlates (e.g., trauma symptoms, depression).

The possibility that a positive correlation between nightmare frequency and hypnotic susceptibility reported by Belicki and Belicki (1986) was an artifact of administering a sleep questionnaire in the context of a hypnosis experiment was tested in the present study. Measures of vividness and absorption were also administered. Forty subjects, twenty of whom were told that the measures were related to hypnotic responding, completed the questionnaires immediately prior to hypnosis. Twenty other subjects, who completed the questionnaires in contexts unrelated to hypnosis, were later hypnotized. The hypothesis that context of administration of the questionnaires influenced the relationship between the measures and hypnotic susceptibility was not supported. Replication using a larger sample was recommended.

Cette thèse avait pour objectif général d’approfondir nos connaissances sur les rêves dysphoriques (mauvais rêves et cauchemars), selon deux axes. Premièrement, nous avons voulu éclaircir les implications méthodologiques reliées aux différentes mesures de la fréquence de rappel de rêves (articles 1 et 2). Deuxièmement, nous avons voulu étudier un aspect encore peu exploré des rêves dysphoriques : leur contenu (article 3). Dans la première étude, nous avons comparé systématiquement différentes méthodes rétrospectives et prospectives utilisées pour mesurer la fréquence des cauchemars et des mauvais rêves chez 411 participants. En plus de reproduire les résultats d’études antérieures selon lesquelles les mesure rétrospectives sous-estiment la fréquence des rêves dysphoriques, nous avons démontré que ces fréquences n’étaient pas affectées de manière différentielle par le format de la mesure prospective (journaux de rêves narratifs ou à choix de réponse). Dans la deuxième étude, nous nous sommes intéressés à la fréquence de rappel onirique en général (i.e. de tous les rêves) auprès d'un échantillon de 358 participants pour approfondir les résultats relatifs à la comparaison entre les deux types de journaux de rêves obtenus dans la première étude. Nos résultats soulignent que la fréquence de rappel obtenue par un journal à choix de réponse est plus élevée que celle obtenue d’un journal narratif, et que le présumé effet d’augmentation de rappel attribué aux mesures prospectives est limité dans le temps. Ces résultats suggèrent que des facteurs motivationnels sont impliqués dans la tenue d’un journal de rêves, et que dans le cas des journaux narratifs, ces facteurs outrepasseraient les facteurs attentionnels favorisant le rappel onirique. Dans la troisième étude, nous avons comparé le contenu de 253 cauchemars et 431 mauvais rêves obtenus prospectivement auprès de 331 participants, offrant ainsi l’une des descriptions de ce type des plus détaillées à ce jour. Nos résultats démontrent que cauchemars et mauvais rêves partagent de nombreuses caractéristiques mais se différencient en plusieurs points : le contenu des cauchemars est davantage caractérisé par des menaces physiques, et celui des mauvais rêves par des menaces psychologiques. De plus, les cauchemars ont plus souvent la peur comme émotion principale, ont une intensité émotionnelle plus forte, se terminent plus souvent de façon négative et sont plus bizarres que les mauvais rêves. Ces différences de contenu entre mauvais rêves et cauchemars suggèrent que ces deux types de rêves sont des manifestations d’un même phénomène variant en termes d’intensité, et que cette intensité est multidimensionnelle. Les résultats de l’étude 3 sont discutés en lien avec différentes théories sur l’étiologie et la fonction des rêves.<br>The overall goal of this thesis was to further our understanding on disturbed dreaming (bad dreams and nightmares) along two main lines of inquiry. First, we examined the methodological implications associated with the different instruments used to measure dream recall frequency (articles 1 and 2). Second, we investigated the actual content of disturbing dreams, a dimension for which empirical data remain surprisingly scarce (article 3). Study 1 compared the frequency of nightmares and bad dreams obtained with retrospective methods and with two types of prospective instruments (narrative and checklist logs) in 411 participants. In addition to replicating findings showing that when compared to daily logs, retrospective self-reports underestimate current nightmare and bad dream frequency, we showed that these frequencies were not differentially affected by the type of prospective log. Our second study extended these findings by comparing the differential effects of narrative and checklist logs on general dream recall in 358 participants. The results indicate that checklist logs yield higher prospective dream recall frequency than narrative logs, and that prospectively measured dream recall frequency tends to peak at the beginning of the log and then remains stable over time. Thus, improved dream recall arising from subjects' increased attention towards their dreams is short-lived and the effect quickly offset by motivational factors. Our third article presents a comprehensive and comparative description of the content of 431 bad dreams and 253 nightmares collected prospectively from 331 participants. The results indicate that although nightmares and bad dreams share many content characteristics and features, they also differ along several dimensions: nightmares tend to involve physical threats whereas psychological threats predominate in bad dreams; nightmares are more likely than bad dreams to contain fear as their principal emotion as well as being significantly more emotionally intense; and when compared to bad dreams, nightmares are more bizarre and contain significantly more aggressions, failures, and unfortunate endings. Taken together these findings support the view that nightmares represent a more intense expression of the same basic phenomenon and that this intensity manifests itself along a number of content dimensions. These results are discussed in relation to different theories on the etiology and function of dreams.

AbstractThis chapter shows how nationally framed war experiences occupied and shaped Finnish dreams during and after World War II. By studying written dream reminiscences from the 1980s and a war veteran survey from 1999 to 2000, Kivimäki analyzes how the war nationalized the most private spheres of life. Civilians’ war dreams were more symbolic than those of soldiers, which were characterized rather by a relentless reenactment of traumatic experiences. War-related dreams had an impact on people’s nightlife long after the war was over. Yet the frequency and content of war-related dreams changed over time, and sometimes the dreams themselves could become a site of relief from recurrent nightmares.

Parasomnias are undesirable and abnormal movements, behaviors, emotions, perceptions, and dreams that occur during or immediately surrounding sleep. The parasomnias are categorized as nonrapid eye movement (NREM) sleep parasomnias, rapid eye movement (REM) sleep parasomnias, and other parasomnias. This chapter provides an overview to the epidemiology, clinical characteristics, differential diagnoses, diagnostic approach, and treatment of common parasomnias encountered in clinical practice. These common parasomnias include NREM parasomnias, considered to be disorders of arousal from NREM sleep and which include a heterogeneous spectrum of sleep behaviors encountered following arousal from NREM sleep exemplified by the phenotypes of sleep terrors, sleep walking, confusional arousals, sleep-related eating disorder, and sexsomnias; the REM parasomnias, including nightmare disorder, recurrent isolated sleep paralysis, and REM sleep behavior disorder, which is strongly associated with prodromal or overt alpha-synucleinopathy neurodegenerative disorders such as Parkinson disease and dementia with Lewy bodies; and other parasomnias, including a spectrum of “leftovers” that do not map well to NREM or REM sleep specifically such as exploding head syndrome, sleep-related hallucinations, sleep enuresis, and parasomnias ascribed to medical disorders, medication or substance use, or unspecified etiologies. It is important for a psychiatrist to be conversant with the complete range of parasomnias given the importance of effective management of frequent psychiatric and psychological comorbidities, which serve as drivers of the frequency and severity of nocturnal events, and to ensure timely referral for polysomnography or other necessary sleep diagnostics where appropriate.

This chapter illustrates the antecedents of Dead of Night and charts its line of influence. In many respects, Dead of Night was more a cinematic pinnacle of a storytelling tradition than a forebear of a new form. Fundamentally, the frame narrative is a device that dates back to some of the earliest known examples of recorded storytelling, which were frequently collections of even earlier tales originating in oral storytelling cultures. Beyond these early ancestral highpoints of the frame story form, there are more direct forerunners to Dead of Night to be found in nineteenth-century literature, particularly Victorian Gothic literature. The chapter then looks at the anthology format. During the decade after Dead of Night, British cinema may have been dark at times — there were numerous British noir films made in that period, several of which were produced by Ealing Studios — but it rarely delivered full-blown scares. It would take Hammer Films' move into the horror genre for this to recommence.

Virtual reality- and augmented reality-supported games can be used to appeal to all tastes and audiences, especially for people who seek adventure, adrenaline, and fear and who want to take a break from their daily life with action. The element of fear, which has been used frequently in every branch of art, has been indispensable in the field of entertainment and art, although it is far from the functioning of this feeling. When we look at the purpose of fear, it is an unconscious sensation that allows the person to take action against a situation that threatens or endangers the life of the person. The person is afraid of danger and develops a reaction to the situation. Fear within the boundaries of entertainment and art, although parallel to this situation, is a controlled and safe form of true fear. Fear of man in the face of art or game area creates emotional satisfaction because it will not cause a life threat. For this reason, films and games created, especially in the genre of fear, are indispensable for the masses.

The application software life cycle considers the functionality of a given collection of components within the context of a consumer’s requirements definition. One set of requirements that are frequently overlooked are the requirements for application integration within the context of the enterprise environment. If an application creates vulnerabilities for other applications, is an administrative nightmare to maintain, or does not consider the security context required for execution; the application may not fulfill the intended requirements. This chapter addresses the question of the consideration of the enterprise information system’s administrative and execution context as a component of the application software development process. The potential impact these considerations have on the acceptance of an application by the application’s user community is presented, with illustrations of some representative problem areas for the reader’s consideration.

This chapter proposes to aid clinicians in handling cultural differences encountered by patients and clinicians. Our overarching emphasis involves ‘migratory psychiatry’—a context in which patients may have migrated to an unfamiliar culture. We also include contexts in which clinicians have migrated to the patient’s culture, as this situation can produce similar problems that the clinician must manage. From innumerable possible topics, we have selected seven areas owing to their frequency and/or clinical importance: negotiated psychiatric encounters, dreams, and nightmares, social units as patient/pathogen/therapeutic resource, theories of psychiatric disorder, organic causes, managing differences, and culture-related attitudes and beliefs. Although this list does not cover all potential challenges, it does provide the reader with a format for handling other dilemmas arising between patient and clinician in psychiatric settings. The ‘Methods’ section specifies the means by which the reviewers and authors have approached such matters in their careers. The latter include being thoughtful in learning from their own experiences, benefitting vicariously from the experiences of teachers and colleagues, and reading journals and books on related topics.