Nightmare disorders in children

Abstract

Nightmares are defined as episodes of awakening from REM sleep with accompanying disturbed mentation, which may involve emotions such as fear, anxiety, anger, sadness, disgust, or other dysphoric states. Nightmares are common events in the pediatric population. Approximately half of 3–6-year-old children experience these frightening events. Nightmares are often associated with childhood anxiety disorder, and other psychiatric conditions including posttraumatic stress disorder, affective disorders, psychotic disorders, Tourette’s syndrome, and personality disorders. Nightmares are also more common in children taking a variety of prescription and recreational medications. The differential diagnosis of nightmares includes nocturnal seizures and night terrors. Diagnosis of nightmares can usually be made by history alone. Treatment involves reassurance and lifestyle modifications. Several studies have shown the efficacy of other treatments, such as cognitive behavioral therapies or hypnosis, though these treatments have not been systematically evaluated in children.