Nightmares are underassessed and undertreated, leaving many suffering from frequent unsettling dreams.

Nightmares are inherently distressing, cause awakenings, and can be remembered afterward.

Imagery rehearsal therapy is the most effective treatment for nightmare disorder and trauma nightmares.

You are outside on a clear evening. As you gaze out across the dewy grass, you notice dozens of snakes in the distance, a massive tangle of pythons inexplicably colored neon pink, orange, and green. Just as you spot these gargantuan reptiles, they turn in unison so that every single one of them is looking right at you. They open their mouths, displaying their fangs. And then the pythons writhe in your direction, moving at rapid speed.

Why are you the target? Because you are in a nightmare. Your own nightmare. Are you in the part of the dream right before you wake up in a puddle of your own sweat?

Most people have nightmares at some point in their lives, although the frequency and intensity vary by person. Nightmares primarily occur during rapid eye movement (REM) sleep and, therefore, are more likely to occur during the second half of the night, when REM is typically more prevalent. Nightmares are psychologically defined by several main features:

Nightmares have inherently upsetting content. Themes of nightmares often include attempts to avoid death, injury, or violent aggression. Like that neon python dream, they are also commonly bizarre and can involve a sense of helplessness.

Nightmares cause you to wake up from your sleep. If you finish a bad dream and never wake up, it is not technically a nightmare. Because they lead to awakenings, frequent nightmares can be a major impediment to getting long stretches of restorative sleep.

Nightmares bring up intense distress, which can take the form of fear, horror, terror, or other negative emotions. Sometimes, people who wake up from a nightmare are afraid of going back to sleep in case they have another unsettling dream. This can increase physiological arousal in bed and, over time, cause or exacerbate insomnia.

Nightmares can be remembered after waking. If you wake up in distress but cannot remember what happened, your dream is not considered a nightmare by the psychological definition. Nightmares can be recounted in depth by the dreamer afterward—including all the scary, painful details.

Having the occasional nightmare is a........

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