We don’t know the exact cause of nightmares, but they often can be linked to trauma, stress, mood disorders, or even medications.
Healthy sleep habits and stress management are effective ways to reduce nightmares.
Both therapy and medication can help reduce nightmares and get you back to restful sleep.
Most of us have had a nightmare at least once in our lives. You might have dreamt about horror-movie tropes or had recurring dreams about an upsetting memory from your past. It may not be possible to stop having nightmares altogether — and the occasional nightmare isn’t cause for alarm. But if constant nightmares are affecting your day-to-day life, it’s important to get the support you need.
If you live with chronic nightmares, therapy and/or medication can help you sleep peacefully again.
What triggers constant nightmares?
The exact cause of chronic nightmares is unknown, but many factors can play a role. Nightmares can both be a symptom of (or linked to) certain mental health conditions.
Some underlying causes and risk factors for constant nightmares include:
Trauma: If you’ve experienced a traumatic event, you might continue to have nightmares about it after it’s over. Nightmares are a symptom of post-traumatic stress disorder (PTSD), a mental health condition that can develop after trauma.
Anxiety: Although nightmares aren’t an official symptom, people who live with an anxiety disorder are more likely to experience upsetting nightmares.
Mood disorders: Mood disorders — including depression and bipolar disorder — have been linked to nightmares in research.
Medications: Certain medications can cause nightmares as a side effect.
Unhealthy substance use: Many substances can lead to nightmares — especially during the withdrawal stage.
Sleep disorders: Having a condition that disrupts your sleep can cause you to have nightmares. For example, people with insomnia, restless leg syndrome, and sleep apnea are all more likely to experience nightmares.
It’s also worth noting that there’s a specific sleep disorder, called nightmare disorder, that’s characterized by frequent disturbing nightmares. If your nightmares can’t be explained by another condition, you could be diagnosed with nightmare disorder.
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How to manage nightmares
Nightmares affect most of us, and the occasional nightmare isn’t anything to worry about. But if you’re experiencing nightmares on a regular basis, it can start to seriously impact your mental health. Some research even shows that nightmares might even increase the risk of suicide.*
There are habits you can try to lessen your nightmares and sleep more peacefully.
*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. Any of these resources will ensure that the person in crisis receives support right away. For more information on getting help, go to 988lifeline.org
If experiencing a life-threatening emergency or you need immediate help, please call 911.
1. Practice good sleep hygiene
Good sleep-hygiene habits are helpful for getting more restful sleep. They can make a big difference when practiced consistently.
Follow these tips to help you sleep:
Go to bed at the same time every day, regardless of your schedule
Have a relaxing and consistent wind-down routine
Avoid exercise, screens, and caffeine for several hours before your bedtime
If you wake up from a nightmare and can’t get back to sleep, do another activity for 15 minutes
2. Avoid substance use, especially before bed
Many substances can cause nightmares as well as other sleep problems. This can happen both when the substances are in your system as well as when they’re leaving your body. Try to avoid unhealthy substance use before bed.
3. Manage stress levels
Anxiety and stress can play a big role in nightmares. When you’re under a lot of stress, you might notice that you might have more nightmares. It might help to learn effective ways to manage your stress levels.
There are many evidence-based ways you can deal with stress. For example, exercise is one of the best natural ways to regulate stress. Other options include practicing mindfulness meditation or trying journaling before bed to process the day’s worries.
4. Talk to your primary care physician
Certain medical issues could be contributing to nightmares, like medications or health conditions. So it’s worthwhile to make an appointment with your doctor to see what’s going on.
They can conduct different tests, including blood work, to try to get to the bottom of your nightmares. They may also be able to make adjustments to your current medications if needed. You should never stop taking prescribed medications without medical approval and supervision.
5. Medication
Some psychiatric medications have been found to be effective for reducing nightmares. Medications can also treat underlying mental health conditions that could be making your nightmares worse. So it’s important to talk to a psychiatrist about what would help you find relief.
6. Seek professional help
Working with a therapist can be a helpful — and sometimes necessary — strategy to deal with nightmares. If your nightmares are so distressing or frequent that they’re affecting your daily life, you could benefit from therapy.
A few different therapy methods have been found to be effective for reducing nightmares. These include:
Image rehearsal therapy (IRT): IRT involves recalling a nightmare while awake, then rewriting the story with a more positive or neutral ending. Practicing this new version before bed may help retrain your brain to dream differently.
Systematic desensitization: With this method, gradual exposure to the feared nightmare imagery is combined with relaxation techniques. Over time, you may feel less fear connected to the frightening things you’re dreaming about.
Exposure, relaxation, and rescripting therapy (ERRT): ERRT is a technique that can help you confront the nightmare imagery while practicing relaxation. It helps reduce both the intensity and frequency of nightmares.
Sleep dynamic therapy: This method focuses on working through the emotional themes behind your dreams. It emphasizes insight into how nightmares connect with your challenges in waking life.
Eye movement desensitization and reprocessing (EMDR): EMDR is an evidence-based treatment for PTSD, but it can also be used for nightmares. It uses guided eye movements while recalling distressing memories to help the brain process them in a less disturbing way.
A therapist can also address any underlying mental health conditions, like PTSD, that could be a factor in your nightmares. If you live with a mental health condition that’s causing your nightmares, the best way to deal with them is to treat the underlying cause.
Chronic nightmares can leave a person feeling like they’re carrying a heavy weight all day. Many people don’t realize how much it can affect mood, focus, and sense of safety. Therapy can help you unpack these effects and find ways to regain calm and rest.
Brandy Chalmers, LPC
Clinical reviewer
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Nightmares can leave you feeling exhausted and anxious — especially if they’re chronic. By practicing healthy sleep habits, lowering stress, and getting the right treatment, you can find relief. And if you’re experiencing constant nightmares, therapy and psychiatric care can also make a difference.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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Rula's editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.
Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
