When to seek help
Nightmares as a Clinical Signal
Occasional nightmares are normal and often psychologically productive. But frequent, distressing nightmares, particularly when accompanied by disrupted sleep, daytime distress, or avoidance of sleep, may signal a condition that benefits from professional support. About 4% of adults report frequent nightmares, 3.5% of men and 4.8% of women in a Finnish population study of 69,813 people (Sandman et al., Sleep, 2013), and effective treatments exist.
PTSD-related nightmares deserve special attention. Unlike ordinary nightmares (which occur during REM), trauma nightmares can intrude into earlier sleep stages, are often exact replays of the traumatic event, and may be accompanied by physical thrashing or vocalization. If nightmares are connected to trauma, working with a trauma-informed therapist is recommended.