Nightmares and Posttraumatic Stress Disorder (PTSD)

Abstract

Nightmares are a unique feature of posttraumatic stress disorder (PTSD). Although nightmares are a symptom of PTSD, they have been shown to independently contribute to psychiatric distress and poor outcomes, including heightened suicidality and suicide. Nightmares are often resistant to recommended pharmacological or psychological PTSD treatments. Fortunately, nightmare-specific treatments are available, and improvements in nightmares are associated with clinically significant improvements in sleep quality and severity of daytime PTSD symptoms. The recent literature on the characteristics, neurophysiology, and treatment of nightmares in the context of PTSD is reviewed. Recent findings on the neurophysiological correlates of nightmares and more generally, dreaming, are also discussed here as they suggest novel directions for understanding the mechanisms underlying nightmares comorbid with PTSD and potential novel treatment approaches.