Nightmares are common -- almost 90% of us have disturbing dreams
Image reversal therapy may quickly teach how to fight your nightmares
A bomb rips through the Humvee in the road ahead, sending it flying into the air. The pop of gunfire is everywhere.
The man next to you – your best pal in this godforsaken place – suddenly slumps over. Screams and dense smoke fill the air.
It’s the stuff nightmares are made of, and all too real most nights for many returning veterans.
“Six to eight months after I got home, the nightmares really started to come in,” said Army Reserve veteran Aaron. “Middle of the night, all of a sudden I’m back in Iraq, full battle mentality, running, chasing people down.”
Aaron is one of many soldiers identified by their first names who shared their stories on video on Make the Connection, a US Department of Veterans Affairs website devoted to returning veterans.
“I was having to sleep on the front porch, I couldn’t even sleep in my wife’s bed,” added Mike, who served in Iraq for the Army Reserve and National Guard. “When I slept in her bed, I’d wake up every 30 minutes with nightmares that someone had come into the house and were harming my family, my kids.”
“Over half all veterans have nightmares,” said psychologist David Cooper, who works with traumatized veterans at the Department of Defense National Center for Telehealth and Technology. “It’s a common symptom that comes along with PTSD, or post-traumatic stress syndrome.”
But it’s not just veterans who struggle with nightmares. The American Sleep Association estimates between 80% and 90% of us have disturbing dreams at night.
The dark side of nightmares
For most of us, nightmares occur when we are stressed and worried, or when we’ve experienced an upsetting event. Nightmares tend to stay with us longer if they are fear-based, but studies show confusion, guilt, disgust and sadness are the most common triggers.
It’s not just feelings. Late-night snacks, some medications, and even the withdrawal of medications or alcohol can trigger repugnant dreams.
Science says these types of dreams may actually be good for our psyche. Instead of living with vague feelings of unease, the brain, usually during the REM stage of sleep, consolidates our bad feelings into a concrete memory that we can then process, file away, and forget.
But for the unlucky among us, nightmares can become chronic, and turn into a disorder that rips apart sleep and destroys productive lives.
“I started having a lot of trouble sleeping, sleeping for two, three hours a week,” said US Army veteran Bryan in a Make the Connection video. Bryan served several tours in Iraq. “I just couldn’t sleep through the whole night.”
“They start avoiding sleep for fear of the nightmares,” said neuropsychologist William Kerst. He worked with soldiers with PTSD and nightmares while in the Air Force and now counsels vets in his private practice in Alaska.
“And chronic sleep deprivation is associated with lots of bad things,” Kerst continued. “Obviously their attention, concentration and memory are going to suffer … depression risk, it goes way up … there’s even lots of studies to show a really clear link between chronic sleep deprivation and suicidal thoughts.”
It can happen to any of us
You don’t have to be a veteran to have PTSD and the accompanying nightmares. Anyone who has suffered or witnessed major trauma, such as natural disasters, domestic violence, rape, terrorism, even a terrifying car accident, can develop ongoing, frightening memories of the event. The National Center for PTSD estimates 10 out of every 100 women and four of every 100 men will develop PTSD at some point in their lives, and as a result, may suffer nightmares.
And here’s the really nightmarish thing. Even if the PTSD is addressed and overcome, studies show the gut-wrenching dreams may not go away.
“The tendency for these individuals to have trauma related nightmares and then sleep disruption and sleep disturbances continued well after successful PTSD treatment was complete,” said Kerst.
The reason why may lie in how PTSD and nightmares are treated.
“When I’m working with a patient with PTSD one of the things I want them to do is expose themselves to those traumatic feelings over and over again so that their body learns to calm down and not react as much,” said Cooper. “But traumatic nightmares are not treated the same way as other PTSD symptoms. Instead we give something new for the brain to focus on which eventually reduces the overall frequency of the nightmares.”
The approach is called Imagery rehearsal therapy or IRT. The goal of this type of therapy isn’t to relieve or process the trauma in your nightmare. Instead you want to change it – tweak it, really – so the nightmare loses its power over your mind and your sleep.
“Let’s say I’m working with someone who has a nightmare about going on patrol in Afghanistan where their Humvee was blown up by an IED,” said Cooper. “I may want to have them change that explosion to confetti, or a balloon popping.”