Documenting & Researching Night Terrors

Nightmare Disorder

Nightmares are the most recognized of all sleep disorders because it is not abnormal. In fact, having nightmares is perfectly natural. From children to adults, everyone is familiar with them. What draws the line between natural and parasomnia?- When the nightmares plague an individual for extended periods of time heightening the perceived ‘normal’ levels of fear and heart elevation.

Nightmares are not to be confused with night terrors. Nightmares often involve risk of personal safety for an individual or loved ones. They cause elevated heart rate, fear, release of sweat glands, strong sensations such as being overwhelmed, helplessness, vulnerability and anxiety. People who have nightmares often wake in fear and vividly recall their experience. Sometimes this causes them to have difficulty falling back to sleep. It can interfere with everyday tasks when lack of quality sleep becomes an issue resulting in fatigue, lack of appetite, and underlying temporary anxiousness. On average adults experience nightmares a few times of year, maximum in rare cases a few times a month. If it more than twice a week, and persists for more than a month it is a sign of nightmare disorder. A sleeping scale of normal and abnormal from 1-10 is as follows:

1)High Quality Sleep (90% of the time no signs of EHS, ND, NT, RLS, or other parasomnia)

2)Quality Sleep (some of the time with a couple of nightmares or restless nights within a year)

3)Satisfactory Sleep (on average experiencing the “okay” quality of sleep mostly affected by stress, anxiety etc…)

4)Normal levels of discomfort (3-6 nights out of the month are accompanied by kicking in sleep, troubles falling to sleep, restless nights, body temperature changes, nightmares, etc…)

5)Unusual levels of discomfort (7+ nights out of the month with poor quality sleep attributed to “other” causes including “minor” levels of parasomnia)

*6)Parasomnia attributed sleep (30% of time in bed consists of low quality and quantity of sleep due to ND, NT, RLS, EHS, LD, REM, NLC, SB, SC, SW, etc…)

7)Parasomnia Based Sleep (When parasomnia represents the base of your sleepless nights at aprox 50% of the time spent in bed for several months)

8.) Parasomnia Bias (I call this a bias because often at this point your experiences with parasomnia have been so frequent that you can almost predict how the night will go before your head hits the pillow merely because the disorder is shadowing you. So it feels as though your decision of sleep quality has been taken away from you and the decision to sleep in a disorder has been made for you.)

9)Parasomnia Level I (This is the lesser of the two most severe experiences of parasomnia where 80% of your sleep is affected by multiple disorders resulting in fear of sleep, low daytime functioning, anxiety, nervousness, sweating, change in appetite all in daylight hours with direct correlation to the night time experience.)

10) Parasomnia Level II (This being the most severe level of parasomnia incorporating on a scale of 1-10 (1 being the least, 10 being the most) a 10+ for levels of fear, anxiety, physical and emotional pain, discomfort, irritability, cognitive functioning, mental alertness, daytime functioning, nervousness, sweating, change in appetite, and overall biological functioning at 50% or less.)

Normal nightmares are set between levels 1-3. At level 4 it is best to start monitoring your sleep because these nightmares have potential to turn into a disorder, At level 5  I would consider this a dissorder, then as it progresses in levels you can measure the severity/escalating level.

*please see parasomnia key on Information page

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