Nightmares vs. Night Terrors – what’s the difference and how to stop both
Today we’ll be talking about one of the most misunderstood subjects in the sleep arena – the difference between nightmares and night terrors.
We’ll first address nightmares and the reasons behind them, then explain how they are different from night terrors and finally, offer some actionable tips on how to stop both.
We have a lot of ground to cover, so let’s get to it.
Nightmares can be extremely unpleasant, because the anxiety compromises your sleep quality. This can lead to a state of chronic fatigue and constant mental tension.
It’s a serious problem for some people but to stop them, you first have to understand the reasons behind the issue.
You’re not alone
If you feel alone with your problem, you can let out a sigh of relief. Nightmares are common because our brain is overburdened by the sheer amount of information it receives during the day.
It’s a common misconception to associate nightmares with children only and believe that they simply disappear in adults. For some people they don’t, they go on through the teen years to adult life.
For most people this is not a big problem – most of us will have nightmares every once in a while but , depending on which statistics you look at , between 2 and 8% of adult population will experience chronic and recurrent nightmares.
The primary characteristics of a nightmare (as opposed to night terrors) are very realistic images and emotions that tend to accelerate your heart rate or even wake you up.
At times, you’ll simply wake up and realize that you just had a nightmare but you won’t be able to remember it. The more stressful scenario is that you wake up and remember every detail of the horrible dream, and if it’s especially vivid, you can find it difficult to forget the terrifying images.
Ultimately, nightmares are detrimental to the quality of your sleep, which leads to physical exhaustion and mental tension. Experiencing the problem on reappearing basis can have adverse effect to other areas of your life and lead to long-term health problems.
So, if you are one of those people who suffer chronically, you’ll want to read on and fully understand the reasons behind the terrifying experience and what you can do to stop it.
Nightmares vs. night terrors – what’s the difference?
While most people won’t to know how to precisely describe the difference between a nightmare and night terrors, they are two completely separate types of sleep disturbance.
Nightmares typically occur in the second part of the night, closer to the morning hours. They go hand-in-hand with dreaming and intense imagery.
The content of the dream varies from person-to-person, but there are some common nightmares, the most frequent ones are being chased or falling..
People who lived through a traumatic event re-experience it in the form of nightmares.
Night terrors of cure in the phase of deep sleep and are therefore more frequent during first few hours of sleep.
They are experienced as an intense feeling of fear with no accompanying dreams.
The sleeper will often move or rise to a sitting position, which can wake them up.
Generally, people experiencing night terrors will not remember what the experience was.
So, to summarize..
The response to the question of “nightmares vs. night terrors” and the difference between the two comes down to presence of dreams/imagery or lack thereof.
Should you be worried?
It’s only common sense to be aware of the fact nightmares can be a symptom of a more serious problem.
In most cases, they will appear spontaneously as a result of our brain “crossing” one of its many wires.
“Spontaneously means” that there is no underlying reason and the most probable cause our psychological problems like anxiety, depression and stress. If a person’s life has been interrupted by a significant event traumatic in nature, such as the loss of a loved one or an accident, there will be more likely to face the issue.
The takeaway here is that an occasional nightmare happens to most of us, but if the problem persists, you should talk to a physician to check whether there is an underlying issue like sleep apnea or a restless legs syndrome.
Lastly, there is a growing body of evidence speaking towards the fact that there is such thing as being genetically predisposed to having nightmares, so talking to your parents about it is a smart idea.
If nothing else, it will put your mind at ease if you do establish that the problem runs in the family.
Preventing or stopping nightmares in different scenarios
Addressing the underlying problem
If you nightmares are a result of problems like sleep apnea, the focus should be on the underlying issue and not the dreams that follow the pathology.
If the underlying reasons are psychological in nature, like depression and anxiety, both problems should be addressed at the same time.
While you battle your way out how to the psychological problems, you can ask your physician about the sleep problem and they will probably be able to help, either by recommending some over-the-counter sleep aids like Valerian root (you can read more about it here) melatonin or prescribing some sleep medication (if the problem is more severe).
In the latter scenario, most practitioners prescribe Prazosin, which is a drug commonly used to help people suffering from post traumatic stress syndrome, but it’s also known to help with nightmares.
Let’s get to some actionable tips on how to stop nightmares & night terrors
Avoid eating before bedtime
A meal before bedtime can be a trigger, because food stimulates your metabolism and sends your brain a signal to be more active.
Even snacking is not recommended, especially if the snack is rich in sugar.
Do your best to reduce tension
Stress is a common cause of nightmares, so take the time to relax and make a conscious decision to design a quiet, soothing sleep environment.
Your bedroom should be an oasis of relaxation and an escape from your daily concerns.
Yoga and meditation are two great activities for tension relief and soothing of both body and mind.
Even if you never did it before, consider taking courses or just practice yoga a few minutes every day in the comfort of your home.
Other activities such as reading, knitting or a simple walk can go a long way towards relieving your tensions. The rule of thumb here is that the activity should be something you enjoy, something that takes your mind off of everyday problems and worries.
Doing something along those lines and then following it up with a hot bath before bedtime can do wonders to help you unwind after the hassles of a stressful day.
Medication can cause nightmares
If you notice the pattern of increased frequency or vividness of nightmares when you take certain medication, talk to your doctor about it and explore that as a potential cause.
Antidepressants and some drugs for high blood pressure are often the culprit. The good news is that we all respond in a different way to different types of medication and your doctor might be able to help by switching to something that was still address your primary concern without causing the stressful night experience.
Another scenario here can be an increase or decrease in the dosage of the medicine you’re already taking, in which case the bed dreams should go way as soon as your body adjusts to the new doses.
The spiral of sleep deprivation and nightmares
The connection between lack of sleep and nightmares is similar to the question about the chicken and the egg.
Sleep deprivation can disturb your brain in ways that can cause bad dreams and vice versa.
If this is the case the problem should be addressed holistically.
The place to start is your bedroom
It’s not news that a clean, uncluttered bedroom will with minimal distractions makes for optimal sleep environment.
Apart from minimizing the clutter, make sure that the bedroom is completely dark.
When it comes to temperatures, the rule of thumb is to aim for an environment that’s not too cold or hot.
It is worth mentioning that most people sleep better in the cold and this is congruent with what happens in our bodies as we fall asleep.
As we’re dozing off, our body temperature lowers and the space you sleep in should make that process easier.
For optimal sleep, the recommended temperature suggested by science is in the range of 60 to 67°F.
Your mattress and linen
If you’re still sleeping on that old, dingy mattress you should consider the possibility of that being one of the contributing factors.
Your mattress of choice should not only be adjusted to what feels comfortable but to your body type as well.
For heavy people, a good mattress will be well-balanced between support and comfort.
The goal here is to address issues that might be keeping your spine muscles working through the night trying to avoid any nerve damage.
This tends to happen if you’re a heavy person and choose a mattress that lacks in support, like one made of low density memory foam – you can read more about choosing a good mattress for heavy people here.
Your pillow working with your mattress
The point we made about aligning your spine also applies to choosing a pillow that works for you.
If you’re a big person and go with a thin pillow, the chances of developing Mac and back pain problems increased dramatically. That also applies to the mesomorph body type, especially if your exercise regimen includes lifting weights and you are very muscular.
For a muscular body, a higher pillow will give the person enough elevation in the head area so that the shoulder doesn’t get in the way.
Bedroom is for sleep
You would think that this is an oversimplified statement, but it’s the nature of the modern life that causes the problem.
We tend to take our work with us into the bedroom. Apart from the stimulation that doesn’t allow you to relax, there’s also a secondary issue that follows.
If you bring work into an area that’s supposed to be dedicated to sleep, you may soon find yourself associating the room with stress.
The confusion surrounding physical activity
A physically fit person will generally sleep better.
We feel like there’s no need to make a special plant of physical activity to address sleep problems. The rules here are similar to what is generally considered a healthy lifestyle.
The one thing that would like to stress is exercising before bedtime. It’s a huge no-no because exercise causes your blood to rush through your body, making your brain more alert and active.
An active brain will be more difficult to soothe when you’re trying to get your ZZZs.
As a rule of thumb, avoid exercising 3 to 4 hours before bedtime. This should give your rushing blood enough time to go back to the state of stasis.
The issue of caffeine disturbing your sleep patterns has been rehashed so many times that you probably want to instinctively skip this part of the article.
Before you do that, let us just say that what we’ll offer here is a different, more precise take on the caffeine issue.
Instead of offering vague tips like, “don’t drink coffee in the afternoon,” we’ll go more in-depth so that you can understand what’s really going on.
Don’t hate us for what we are about to say, we’re just the messengers, but the issue is more intricate to be soled by following general advice like the one we mentioned above.
Let’s be more precise
Here is the problem – caffeine has a long half-life (5 to 6 hours). This means that the cup of double espresso at 3 PM is an equivalent to 1 cup at 8 PM.
This is the part that most people either don’t know or don’t fully understand.
It’s easy to just grab a mug of an extra large coffee and shrug it off by telling yourself that it will be long gone by nighttime.
It will stick around and continue to stimulate your brain through today. You might not feel it because you’re comparing it to the feeling of that initial boost it gives you.
Let us explain it on an example
What people know as a “shot” of espresso is approximately 1 lbs. and contains 63.6 mg of caffeine.
Here’s the math:
- A double espresso will deliver a hefty boost of over 125 mg of caffeine.
- If you drink it at, say, 3 PM there will be 64 mg still roaming your body at 8 PM.
- More importantly, it means that you’ll still have about 30 mg of caffeine in your bloodstream at 1 AM.
Let’s put that into perspective
Research shows that the average American consumes about 300 mg of caffeine per day, which is 300% more than the average intake in the rest of the world.
If that sounds bad, let’s take the conversation to a more positive place and mention that the culture of heavy tea-drinking in countries like the UK brings them to the top of the list of caffeine intake.
On average, they consume twice as much as an average American adult.
That’s not an excuse
Patting ourselves on the back and taking comfort in the fact that there is “worse” out there brings us no closer to a solution.
As a conclusion, all we can say is that you should be aware of how caffeine works and its half-life but ultimately, its effects on your sleep quality will depend on how sensitive you are to it.
It’s easy to talk about giving up coffee but to actually do it is a whole different ballgame.
If it makes you feel any better, I have a mug full of coffee on my desk is in writing these lines.
You don’t have to go cold turkey
Does don’t so much of pleasure a person can sacrifice at the altar of optimal health. You don’t have to stop drinking coffee, but you do have to know the facts if you’re not sleeping well.
The alternative to giving up coffee cold turkey is keeping that morning those in your life which, let’s face it is the one that gives us the most pleasure.
For the rest of the day you can go with alternatives that are similar in taste and texture, like Kava Kava.
It’s a beverage made of the extract of a plant, commonly found in the islands of the Western Pacific and it’s known for its anti-anxiolytic effects. The name of the beverage or originates “awa”, which is a Polynesian word for bitter.
There’s been some controversy about it and its regulation. That’s why it’s important that, if you do decide to experiment replacing coffee with, choose a good trusted brand.
A while back we did some research on the topic and came up with a list of the best cover brands for anxiety – you can see it here.
Addressing nightmares through mental imagery therapy
One of the most common approaches sleep therapists take to address severe nightmares is the technique of mental imagery.
The concept is pretty simple and it comes down to encouraging the patient to imagine an alternative end or scenario for the nightmares, especially if they’re reoccurring.
Techniques range from just imagining a more pleasant dream to writing, drawing or painting an alternative version of the nightmare.
For example, if you have a reoccurring dream of somebody chasing you, the therapy might include visualization off befriending the “chaser” or finding out that the reason for the pursuit is to deliver good news.
“Provoking” pleasant dreams
This technique is also based on visualization.
Here’s how it works
Take time during the day to wind down, close your eyes, even if it’s for five minutes only, and go to your happy place.
The technique works best if you choose one happy image that you build on and add details over time.
The happy place you visualize should be isolated, something like a mountain top with a gorgeous view. The important part here is to provoke a feeling that nothing else is important and the moment is just about you on that that mountain top admiring the view.
As you practice the technique, try to make it as real as possible by adding details like sounds, smells and atmosphere.
You should make a habit of thinking about positive things that bring you pleasure just before bedtime.
The science behind this is solid and it’s all about the chemicals in your brain, a small dose of dopamine/serotonin might just be enough to relax.
The experience you think about can be either imaginary or a real memory but shouldn’t be stimulant.
Here’s what we mean by that
Don’t choose an experience like a game of beach volleyball that you particularly enjoyed a decade back. It might be pleasant, but the very thought of intense physical activity will cause a similar reaction in your body and stimulate you.
Instead, go with something relaxing like lying on a beach, basking in the sun and listening to the sound of the waves.
Plan your pastime
A typical person will choose to unwind over a movie or their favorite TV show.
That’s fine if your favorite show is “The Office” but can be a problem if it’s “The Walking Dead”.
The hours before bedtime should be filled with nothing but joy and happy thoughts and violent or horror movies have no place here.
It’s all an acquired skill
If you’re reading this you might think that you can’t possibly do it all.
That’s probably true, at least not at once.
If you’re having sleep problems, they didn’t just suddenly appear at some point in your life (even if it might like it).
They are usually a result of prolonged stress and anxiety that’s been simmering without an outlet before finding its way out through your dreams.
That’s how you should approach reversing the process – take it one step at a time, don’t get discouraged if something doesn’t work and give it time.
There’s no substitute for patience.
When something as important as sleep is at stake, it’s worth it.