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NightmareAka: Frightening Dream

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  1. See Also
    1. Sleep Stages
  2. Epidemiology
    1. More common in women
    2. Prevalence
      1. Children (ages 5 to 12 years): 20-39% within 1 week
      2. College Students: 47% within prior two weeks
      3. Adults in general: 5-8%
  3. Associated Conditions
    1. Insomnia
  4. Pathophysiology
    1. Most commonly associated with REM Sleep
  5. Symptoms
    1. Vivid, terrifying dreams
    2. Occur late in sleep (4 to 6 am)
    3. Sudden awakening from sleep
    4. Detailed recall of bizarre dream
    5. Difficulty returning to sleep after dream
  6. Differential Diagnosis and Causes
    1. See Medication Causes of Nightmares
    2. Night Terror (Children under age 8 years)
    3. Post-Traumatic Stress Disorder
    4. Depression
    5. Anxiety Disorder with Panic Attacks
    6. Schizophrenia
    7. Chemical Dependency with Drug Withdrawal
      1. Alcohol Abuse with withdrawal
      2. Benzodiazepine Abuse with withdrawal
      3. Barbiturate Abuse with withdrawal
    8. REM Behavior Disorder associated neurologic disorder
      1. Parkinson's Disease
      2. Narcolepsy
      3. Dementia
  7. Management
    1. See Post-Traumatic Stress Disorder
    2. See Night Terrors for Management in Children
    3. REM Behavior Disorder
      1. Consider Clonazepam 0.5 to 1.0 mg qhs
    4. Recurrent Nightmares
      1. Behavioral therapy effective in 70% of patients
  8. References
    1. Pagel (2000) Am Fam Physician 61:2037
    2. Thiedke (2001) Am Fam Physician 63:277
    3. Wise (1997) Pediatr Ann 26:427
    4. Wood (1990) J Abnorm Psychol 99:64

Nightmares (C0028084)

ConceptsFinding (T033)
ICD9307.47
MSHD004325
EnglishDream anxiety disorder, dream anxiety disorders, nightmare, Nightmare disorder, Nightmares, PARONIRIA
Spanishcrisis de ansiedad del sueno, pesadilla, pesadillas, trastorno por pesadillas
Parent ConceptsParasomnias (C0030508), Anxiety Disorders (C0003469), Brain Diseases (C0006111), Dream disorder (C0234458), Ambiguous concept (C1274012)
SourcesAOD, COSTAR, CSP, CST, MSH, MTHICD9, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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