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Unfortunately, most of the data on these types of occurrences are anecdotal. For example beta-blockers have been known to cause nightmares in a fair number of patients using them for cardiac issues or controlling hypertension, but I am unaware of a definitive explanation for how this operates in the mind-body. There are many OTC sleep aids on the market. The only obvious connection to nightmares might be related to actually promoting more REM sleep. The more REM someone experiences, then the more dreaming occurs. In many individuals the longer they dream, there may be the tendency for the dreams to turn unpleasant. Last, it is well-known that some opiates trigger bouts of nightmares, and I would add I got my start in nightmare treatment research when discussing the problem in a patient who was using codeine. When she stopped the codeine the nightmares went away. With opiates, one working theory is they decrease respiratory drive, and it's now increasingly common to see sleep breathing problems in opiate users, thus the respiratory compromise itself, regardless of any other impact of the drug, could lead to panicky feelings while asleep, which then trigger a nightmare.

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Is it common for people who suffer from chronic nightmares to have suffered from night terrors as children and sleep walking/ acting out dreams?

Are nightmares also more common in people who have sleep apnea?

In my experience doctors often believe that nightmares stem from mental health issues. I have questioned that reasoning for my 20 year old son who suffered from night terrors as a child, and continues to have problems with extreme nightmares, sleep walking and sometimes acting out his dreams.

I also ask if there is a connection between nightmares and OSA because when my son was diagnosed with OSA and started using CPAP, his nightmares and sleep walking improved a huge amount; yet they are still problematic.

Thank you Dr. Krakow!

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I have a second question Dr. Krakow, can you shed any light on why certain sleep remedies natural and prescription can increase your chances of having nightmares?

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Great question, Ms. Z. The evidence is overwhelming that the vast majority of those who are traumatized and experience nightmares will see their nightmares decrease if not disappear in the first few months, often as early as one month. Researchers have been puzzled by this phenomenon and still don't have a clearcut answer. Pragmatically, the most likely explanation is that the brain has its own mechanism for promoting recovery and strengthening mental health. This brain system is probably related to our REM sleep., which many have called our "therapist-in-residence" while we sleep. In sum, whatever this healing system is, it seems to work on many people to dissolve their bad dreams soon after trauma. Unfortunately, there's still a substantial number of trauma survivors who suffer nightmares and PTSD, and these problems can persist for years and decades. The great news is there are many treatment options to decrease or eradicate chronic nightmares.

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Good evening Dr. Krakow, I have a question about how to handle trauma and nightmares. Can you explain why some trauma survivors have to deal with nightmares for many years and other trauma survivors may only deal with them for a few months or less.

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