Nightmare Disorder

Nightmare disorder is characterized by recurrent, disturbing dreams causing awakening and significant distress or impairment in social, occupational, or other areas of functioning. Etiology includes stress, trauma, psychiatric disorders, and certain medications. Clinically, patients experience vivid, frightening dreams, often related to personal concerns, resulting in sleep disturbance or daytime anxiety. Diagnosis is clinical, based on patient history and exclusion of other sleep disorders or medical conditions. Management involves psychotherapy (e.g., imagery rehearsal therapy), pharmacologic agents in refractory cases, and sleep hygiene optimization.