Persistent Nightmares
Recurrent, distressing dreams with frightening or threatening content that disrupt sleep and may cause significant daytime distress, fear of sleep, or hyperarousal. A common feature of trauma-related conditions and sleep disorders.
Quick answer
Persistent nightmares (ICD-10: F51.5; ICD-11: 7B01) are a core feature of PTSD and nightmare disorder. Image Rehearsal Therapy has the strongest evidence. EMDR addresses underlying trauma. Prazosin is used pharmacologically for PTSD nightmares. REM sleep behaviour disorder is an important differential in older adults.
Recognition
Do any of these feel familiar?
Vivid, frightening dreams that wake the person from sleep
Difficulty returning to sleep after a nightmare
Residual fear, anxiety, or distress persisting after waking
Avoidance of sleep or bedtime due to fear of nightmares
Nightmares with recurring themes, often related to past traumatic events
What is Persistent Nightmares?
Recurrent, distressing dreams with frightening or threatening content that disrupt sleep and may cause significant daytime distress, fear of sleep, or hyperarousal. A common feature of trauma-related conditions and sleep disorders.
Approaches Commonly Explored
Commonly explored for conditions related to Persistent Nightmares, grouped by mechanism — select your subtype above to highlight the most relevant path.
How to use these approaches
Most people begin with Stabilise approaches, then progress toward Resolve and Sustain.
Cognitive patterns, emotional processing, and stress response.
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