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Why do I keep having nightmares? Add to ...

The question

I keep having violent dreams that wake me up in the middle of the night. What's going on?

The answer

We don't understand very well why we dream, whether dreams have meaning, and why some people have vivid dreams, while others rarely can remember having a dream at all.

We do know from studies that look at dream content that we tend to consistently have and remember more negative dreams than positive ones. Some theories suggest that there is an adaptive function to having threatening dreams - it helps us simulate threatening events and situations (in a safe environment) with the result of helping us be more cognitively prepared for threats when they come up in real life.

More related to this story

There are a few reasons you may be having violent dreams. It may be that you are currently under a high level stress or that you are (or feel you may be) in a threatening situation that you need to get out of. Consider the current stressors in your life and think about ways you can get help with these difficulties. Individuals who have experienced traumatic events (abuse, assault, life-threatening situations including accidents or illnesses) are at higher risk for having nightmares. A mental health professional can help you work past traumas.

Violent dreams can also be the result of a sleep disorder, known as parasomnia. Speak to your family physician if you are having recurrent violent dreams as an overnight sleep study, called a polysomnography, may be helpful to determine the cause.

Finally, side effects of a number of medications can include violent dreams and nightmares (as many medications affect the stage of sleep in which we dream - the REM, or rapid eye movement, stage). Changing medications or dosages may help to solve the problem.

Independent of the specific cause, there are a number of pre-sleep rituals that may help minimize the intensity or frequency of your violent dreams. Try to minimize talking or thinking about stressful situations before bed. Relaxation or meditation strategies can help to slow your mind and body down. Have a warm bath, or listen to soothing music to distract your mind. Avoid reading books or watching TV or movies with upsetting content.

If you are woken by a violent dream, get out of bed and practice some deep breathing and do something relaxing, such as listening to soothing music or having a warm glass of milk, before you get back into bed.

Information on sleep disorders are available at the following websites: www.css.to and www.sleepdex.org.

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Samra.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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