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Nightmares and stress in children
Abstract
Objective: Whereas the effect of stress on nightmare frequency is well-documented in adults, research on this topic in children is scarce. In addition, these studies are often based on data obtained from the parents which may not be valid with regard to nightmare frequency and subjective stress levels. Method: 95 school children (fifth grade; age range: 9 to 11 years) completed a questionnaire about the occurrence of stressors, their subjective stress level and nightmare frequency. Results: The findings indicate that interindividual differences in nightmare frequency were explained by social stressors like quarreling with a sibling, death of a close person and chronic illness of a close person. Conclusions: The next step will be a longitudinal study measuring the occurrence of stressors as well as personality dimensions and the occurrence of nightmares and their content by applying diaries and self-rated scales together with information obtained from the parents.
... Studies having examined self-reported frequency of nightmares over shorter time windows (e.g., past few weeks or past month) in children aged 9 to18 reveal prevalence rates ranging between 30 to 60% [28,30,31,33,34]. ...
... These studies show that frequent nightmares are reported by 6% of 18-year-old boys [15], 44% of children aged 10 to 12 [33], 37% of 13-year-old girls [21], and 34% of adolescents between the ages of 12 and 18 [27]. If instances of children reporting more than one nightmare per week are taken as reflecting very frequent nightmares, we find prevalence rates for very frequent nightmares of 1.7% in children aged between five to 18 years [12], 3% in children five to seven years old [19], and 19% in children between the ages of nine to 11 [31]. ...
... Among preschool-aged children, stressful life events do not distinguish those who have nightmares from those who do not [16]. In school-aged children, however, self-reported social stress (e.g., being excluded from a group, parents separating, fighting with friends or siblings) was associated with self-reported nightmare frequency, although school-related stress (e.g., getting bad grades, homework, being called to the front of the class) was not [31]. Other stressful events associated with the concurrent experience of nightmares include having a loved one become physically ill or passing away as well as having one's parents divorce [22,31]. ...
Peu d’études se sont intéressées aux cauchemars chez les enfants. Nous proposons ici une recension de ces dernières afin d’en évaluer la prévalence et les corrélats chez l’enfant, tout en répertoriant les principaux problèmes méthodologiques. Les résultats démontrent que peu importe comment ils sont définis et mesurés, les cauchemars affectent une proportion significative d’enfants de tout âge, avec un pic de fréquence qui pourrait se situer autour de 10 ans. Des différences de genre dans la fréquence des cauchemars apparaissent entre l’âge de 10 et 15 ans, alors que les filles rapportent plus de cauchemars que les garçons. Bien que les cauchemars soient associés avec des difficultés psychologiques variées (e.g., stress, problèmes de comportement), une anxiété élevée et des troubles du sommeil concomitants (e.g., somnambulisme) font partie des corrélats les plus robustes des cauchemars. Bien que peu de travaux aient porté sur le traitement des cauchemars chez l’enfant, quelques résultats prometteurs ont été obtenus en utilisant un traitement par répétition de l’imagerie mentale. La recherche dans ce domaine a toutefois été ralentie par l’utilisation de définitions inconsistantes du cauchemar, par une grande variabilité des composantes des questionnaires utilisés pour en mesurer leur fréquence et par la méconnaissance de l’impact que peut avoir sur les résultats le fait d’utiliser un parent ou l’enfant lui-même comme répondant. Des études longitudinales seront nécessaires afin de mieux comprendre comment les cauchemars et leurs corrélats évoluent durant l’enfance et l’adolescence, pour préciser leur signification clinique, ainsi que pour développer des approches thérapeutiques efficaces et appropriées à l’âge.
... Plusieurs auteurs ont choisi de s'attarder à des périodes plus courtes, soit aux dernières semaines, au dernier mois ou encore aux quelques derniers mois précédant l'étude. Dans ces recherches, les enfants (âgés entre neuf et 18 ans selon les études) devaient remplir eux-mêmes les questionnaires sur les cauchemars, et les prévalences obtenues allaient de 30 % à 60 % (Abdel-Khalek, 2006 ;Schredl et al., 2008aSchredl et al., , 2008bSchredl et al., 2009aSchredl et al., , 2009b. ...
... Lorsque l'enfant fait plus d'un cauchemar par semaine, on parle de cauchemars très fréquents ou chroniques. Les prévalences des cauchemars chroniques vont de 1,7 % chez des enfants de cinq à 18 ans (Simonds et Parraga, 1982), 3 % chez les enfants de cinq à sept ans (Smedje et al., 1999) jusqu'à 19 % chez des enfants de neuf à 11 ans (Schredl et al., 2008b). ...
... Parmi les enfants d'âge scolaire ayant eux-mêmes rempli les questionnaires relatifs aux cauchemars et au stress, le stress social (par exemple, être exclus d'un groupe, séparation des parents, se disputer avec ses amis ou ses frères et soeurs) serait relié à la fréquence des cauchemars, mais pas le stress scolaire (par exemple, avoir de mauvaises notes, faire ses devoirs, être appelé en avant dans la classe) (Schredl et al., 2008b). Les facteurs stressants ponctuels, tels que la mort ou la maladie d'un proche, sont liés à la fréquence des cauchemars (Schredl et al., 2008b). ...
Few studies have been conducted on nightmares in children. This article presents a review of the literature on the prevalence, correlates and treatment of nightmares while highlighting key methodological issues. Studies indicate that almost half of children experience nightmares and that the presence of nightmares is related to different variables including anxiety, stress, behavioral problems and other sleep disorders. Finally, there is very little information on the treatment of nightmares in children, but promising results have been obtained with techniques based on imagery rehearsal therapy. Based on this review, future directions for research are suggested.
... They are more likely to appear in concomitance of inadequate sleep hygiene [81], for which insufficient quality of sleep represents an important factor, contributing to the development or maintaining of nightmares, bad dreams, or parasomnic episodes. In addition, they occur with higher probability as a consequence of stressful events, like exclusion from a group [105], parents' divorce [106], or loved people physically ill or passing away [105]. These findings partly support studies in adults that demonstrate a contribution of dreams to emotional regulation [89,107]. ...
... They are more likely to appear in concomitance of inadequate sleep hygiene [81], for which insufficient quality of sleep represents an important factor, contributing to the development or maintaining of nightmares, bad dreams, or parasomnic episodes. In addition, they occur with higher probability as a consequence of stressful events, like exclusion from a group [105], parents' divorce [106], or loved people physically ill or passing away [105]. These findings partly support studies in adults that demonstrate a contribution of dreams to emotional regulation [89,107]. ...
Sleep significantly changes across the lifespan, and several studies underline its crucial role in cognitive functioning. Similarly, mental activity during sleep tends to covary with age. This review aims to analyze the characteristics of dreaming and disturbing dreams at different age brackets. On the one hand, dreams may be considered an expression of brain maturation and cognitive development, showing relations with memory and visuo-spatial abilities. Some investigations reveal that specific electrophysiological patterns, such as frontal theta oscillations, underlie dreams during sleep, as well as episodic memories in the waking state, both in young and older adults. On the other hand, considering the role of dreaming in emotional processing and regulation, the available literature suggests that mental sleep activity could have a beneficial role when stressful events occur at different age ranges. We highlight that nightmares and bad dreams might represent an attempt to cope the adverse events, and the degrees of cognitive-brain maturation could impact on these mechanisms across the lifespan. Future investigations are necessary to clarify these relations. Clinical protocols could be designed to improve cognitive functioning and emotional regulation by modifying the dream contents or the ability to recall/non-recall them.
... When child reports of nightmares were examined as the criterion variable, none of the predictors examined emerged as significant-indicative that different factors serve to shape parent versus child report and recall of nightmares. For example, whereas anxiety and avoidant behaviors surrounding bedtime may contribute to parental reports, a broader range of predictors may be relevant for child report of nightmares, including general levels of stress (Schredl, Biemelt, Roos, Dunkel, & Harris, 2008) or nightmare distress (i.e., the extent to which nightmares have a negative waking effect). Level of distress evoked by nightmares, more so than their frequency, might also serve as a potent stimulus for child reports. ...
... Specifically, prior research shows females to be more emotionally reactive to stress than males (Rudolph, 2002;Rudolph & Hammen, 1999) and females with sleep problems experience increased levels of stress (i.e., higher cortisol) across the day and during stressful situations (Pesonen et al., 2012). In children, general levels of stress correlate with the occurrence of nightmares (Schredl et al., 2008). Our results are therefore consistent with previous findings revealing sex-based differences in nightmares (Hublin et al., 1999;Nielsen et al., 2000) and extend documented differences to anxious youth. ...
Frequency and predictors of nightmares among children 7-11 years old with generalized anxiety disorder (GAD; n = 42) and no diagnosis (n = 44) were examined using both prospective and retrospective child and parent reports. Both children with GAD and their parents reported significantly more nightmares than controls based on retrospective reports, but the groups did not differ when nightmares were assessed daily across a one-week prospective period. Females reported more nightmares than males according to prospective assessment only. Controlling for sex and group, child sleep anxiety and presleep somatic arousal predicted parent but not child report of nightmares. Results suggest both clinically anxious youth and their parents overestimate the occurrence of nightmares, yet factors influencing retrospective accounts appear to differ across informants.
... When child reports of nightmares were examined as the criterion variable, none of the predictors examined emerged as significant-indicative that different factors serve to shape parent versus child report and recall of nightmares. For example, whereas anxiety and avoidant behaviors surrounding bedtime may contribute to parental reports, a broader range of predictors may be relevant for child report of nightmares, including general levels of stress (Schredl, Biemelt, Roos, Dunkel, & Harris, 2008) or nightmare distress (i.e., the extent to which nightmares have a negative waking effect). Level of distress evoked by nightmares, more so than their frequency, might also serve as a potent stimulus for child reports. ...
... Specifically, prior research shows females to be more emotionally reactive to stress than males (Rudolph, 2002;Rudolph & Hammen, 1999) and females with sleep problems experience increased levels of stress (i.e., higher cortisol) across the day and during stressful situations (Pesonen et al., 2012). In children, general levels of stress correlate with the occurrence of nightmares (Schredl et al., 2008). Our results are therefore consistent with previous findings revealing sex-based differences in nightmares (Hublin et al., 1999;Nielsen et al., 2000) and extend documented differences to anxious youth. ...
Limited research has explored the presence of nightmares in children despite associations with psychiatric symptoms, anxiety in particular. Frequency and predictors of nightmares were therefore examined among 7 - 11 year old children with generalized anxiety disorder (n=42) and no diagnosis (n=44) using both prospective and retrospective child and parent reports. Both children with GAD and their parents reported significantly more nightmares than controls based on retrospective reports but the groups did not differ when nightmares were assessed daily across a one-week prospective period. Females reported more nightmares than males according to prospective assessment only. Controlling for sex and group, child sleep anxiety and pre-sleep somatic arousal predicted parent but not child report of nightmares. Results suggest both clinically-anxious youth and their parents overestimate the occurrence of nightmares yet factors influencing retrospective accounts appear to differ across informants.
... 19 Sandman et al. restricted the war generation to persons who were older than 18 years during the war, which seems arbitrary, especially in view of the findings that childhood trauma can increase nightmare frequency in adulthood, [20][21][22] and nightmare frequency in children has been associated with a loss of a close relative. 23 To the extent that data are available, Sandman et al. should be encouraged to analyze whether children who experienced all the stress during the war periods still show increased nightmare frequencies. ...
... As this was not found in the women aged 56 to 70, one might speculate that the peak reflects the stress of the women undergoing the changes related to menopause (e.g., hot flashes). These examples illustrate the possibility of using nightmare frequency as an indicator of stress (e.g., the effect of stress on children 23,[25][26][27][28] ). ...
... Up to 75% of children occasionally report nightmare, 73 whereas a frequent nightmare (at least once per week) affects 5% to 20% of children with the peak onset at 6-10 years of age 55,74,75 Boys and girls are equally affected by nightmare in school children with female preponderance emerging in young adolescents. 76,77 Albeit most of the nightmares can resolve as children age, about 30% of the children have persistent nightmare. ...
Sleep complaints are common among children. These include both night-time and daytime symptoms, such as trouble falling asleep, problems in maintaining sleep, snoring, and unusual events during sleep and daytime functioning impairment. However, sleep complaints in children are often overlooked and undertreated in clinical practice. Untreated sleep problems may further impact on children's development and will persist into adulthood in some cases. This review summarizes the common sleep complaints and disorders in school children, and provides an overview of the epidemiology, clinical features, consequences, and treatment of the sleep problems.
... Two studies in children indicate that nightmare frequency is stable over time [35,46], i.e., showing trait-like characteristics, and a familiar aggregation of nightmares was found by Li et al. [14], supporting the diathesis framework. In addition, trait anxiety and emotional problems [16,34,42] and stressors [30,31] are associated with heightened nightmare frequency in children. So far, the relatively small number of studies on nightmare etiology in children focusing on nightmare is in line with the findings in adults [13,27]. ...
Background and objectives
Occasional nightmares (distressing dreams that awaking the sleeper) and bad dreams (distressing dreams that do not awaking the sleeper) are very common in children and adolescents. About 5% of children experience frequent nightmares (once a week or more often) and the question arises as to what factors contribute to significant nightmare distress which is basic for diagnosing a nightmare disorder.
Materials and methods
A sample of 624 school-aged children (10–16 years; mean age 12.45 ± 1.33 years) completed a dream questionnaire and an anxiety inventory.
Results
About 11% of the participants reported frequent bad dreams; 3.5% reported frequent bedtime anxieties due to bad dreams. Similar to the findings in adults, distress due to bad dreams was not only related to bad dream frequency but also to trait anxiety—controlling for the direct effect of trait anxiety on bad dream frequency, i.e., bad dream frequency and trait anxiety contributed independently to bedtime anxiety due to bad dreams. In the exploratory part, the cultural background of the children’s parents showed only minor effects on bad dreams.
Conclusion
Similar to nightmare studies in adults, bad dream frequency and trait anxiety contributed independently to bad dream distress. Based on the current diagnostic criteria of the nightmare disorder, it would be interesting to have the opportunity to treat children with significant distress due to nightmares or bad dreams and study the long-term benefit—given that many adult nightmare sufferers reported that their nightmares started in childhood.
... Among these sleep problems, disturbing dreams (DDs; vivid dreams marked by intense negative emotions such as fear, anxiety, and anger) are frequently experienced by children (20)(21)(22)(23)(24). DDs may be associated with a wide range of psychosocial difficulties as they may signal problems with emotional regulation processes that normally occur during sleep as well as in dreams (for more details about this hypothesis, see (22,(25)(26)(27)(28). ...
Although frequent disturbing dreams, including bad dreams and nightmares, have been repeatedly associated with poor psychological well-being in adults, considerably less information exists on their psychosocial correlates in children. Recent empirical and theoretical contributions suggest that the association between disturbing dream frequency and psychosocial adaptation in children may differ as a function of children's negative emotionality. The current study assessed the moderating effect of very early negative emotionality (17 months of age) in the relation between disturbing dream frequency and psychosocial maladjustment (i.e., externalizing + internalizing behaviors) in a sample of 173 11-year-old children. Mixed-model analyses revealed that disturbing dream frequency was associated with some internalizing behaviors but that the association between disturbing dream frequency and most externalizing behaviors was moderated by early negative emotionality. The latter result indicates that the relation between disturbing dream frequency and externalizing behaviors was significant in 11-year-old children showing moderate negative emotionality early in life, but particularly strong in those children with high early negative emotionality. Whereas, a moderating effect of early negative emotionality was not found between disturbing dream frequency and internalizing behaviors, the findings highlight the more specific role of early emotional negativity as a developmental moderator for the link between disturbing dreams and externalizing behaviors in children. The results are discussed in light of recent models of disturbed dreaming production.
... For example, nightmare frequency has been related to neuroticism (7), Type-A personality (8), post-traumatic stress (9), and scores higher than controls on the hypochondriasis, depression, hysteria, paranoia, schizophrenia, and hypomania scales of the MMPI (10). Other researchers (3,11) also found that state stress and state anxiety better accounted for the experience of nightmares than trait personality measures. ...
Objective: To investigate the relationship between nightmares and a common,
nonpathological behavior, this study tested the relationship between nightmares and
night-sky watching.
Method: University students (N= 79) completed measures of night-sky watching frequency,
nightmare frequency, and the Noctcaelador Inventory, a measure of psychological
attachment to the night-sky. Data was analyzed using standard correlational procedures
Results: Nightmares were significantly positively related to night-sky watching frequency,
but not noctcaelador.
Conclusions: The results suggest a possible shared psychic structure for night-sky watchers
and nightmare experiencers. Future research is indicated to examine this structure further
and to more rigorously test the mood management hypothesis of night-sky watching.
... Research suggests that bad dreams are more prevalent than nightmares (Zadra & Donderi, 2000), though research examining the prevalence of bad dreams throughout the lifespan is lacking. It is estimated that 19% of children experience nightmares at least once per week (Schredl et al., 2008). Although nightmares are often viewed as a childhood sleep disorder, research suggests that nightmares may persist into adulthood, and are a function of age and sex. ...
Interest in the treatment of nightmares has greatly increased over the last several years as research has demonstrated the clinical significance of nightmare disorder. This paper provides an overview of nightmare disorder, its clinical relevance, and the leading treatments that are available. In particular, the paper defines nightmare disorder and then summarize the recent literature examining the clinical relevance of nightmare disorder, including its relation to post-traumatic stress disorder and other psychiatric conditions. The relation between nightmares and suicidality is also discussed. Recent findings on the treatment of nightmare with imagery rehearsal therapy and prazosin are then summarized. Lastly, the paper comments on potential future uses of nightmare treatment including using imagery rehearsal therapy or prazosin as a first-line intervention for post-traumatic stress disorder and using these treatments as an adjunctive therapy to reduce suicide risk in those at risk of suicide with nightmares.
... The etiology of nightmare is modeled by a disposition-stress model. Research indicates that genetic factors, (Hublin et al., 1999), as well as current stressors, (Schredl, 2003;Schredl et al., 2008), are related to nightmare frequency. Since stressors, for example negative live events, are also of importance in the etiology of primary insomnia (e.g., Harvey, 2002), it seems logical to hypothesize that these patients should experience nightmares more often than persons without insomnia. ...
The present study investigated the nightmare frequency of patients with insomnia. Patients reported more often nightmares, especially when overall dream recall frequency was statistically controlled. Moreover, nightmare frequency was related to the severity of insomnia complaints. It would be interesting to study whether specific techniques for treating nightmares (imagery rehearsal therapy) are beneficial for insomnia patients with nightmares.
... The "children" sample included the participants of three studies who, in the main, were fifth-grade school children, (Schredl & Sartorius, 2006;Schredl, Biemelt et al., 2008;Schredl, Anders et al., 2008). The young adult sample was taken from the Schredl, Wittmann, Ciric and Götz (2003) study. ...
Laboratory research indicated lower dream recall in children compared to young adults. However, the sample sizes of these studies are very small and the findings regarding home dream recall in larger studies are conflicting. The present study compared home dream recall frequency of 558 children (mean age about 10 yrs.) with a sample of young adults (mean age about 23 yrs) and found a marked lower dream recall frequency in children. Longitudinal studies with sufficient sample size are necessary to validate this cross-sectional finding.
Occasional nightmare in children is very common and mostly resolves with increasing age. However, approximately 30–40% of childhood nightmare may persist into adulthood and is associated with increased risk of psychopathology. This chapter presents an overview of nightmare disorder and describes the scope of the problem. The epidemiology and aetiology of childhood nightmare is reviewed. Clinical presentation and management of nightmare in children are summarised.
Objective/background:
Many studies have reported associations between disturbing dream occurrence and internalizing symptoms in adults, but the extent to which such associations also characterize adolescents remains unknown. The main goal of the present longitudinal study was to evaluate the strength and stability of the associations between disturbing dream frequency, suicidal ideation, and internalizing symptoms from ages 13 to 18.
Methods:
Participants (N = 434) drawn from two longitudinal birth cohort studies on child development in the province of Quebec, Canada, completed annual self-reports of disturbing dream frequency, suicidal ideation, and levels of depression and anxiety.
Results:
Two separate cross-lagged panel models for symptoms of depression and anxiety were conducted with both models showing similar results. In early adolescence, high levels of and higher change in disturbing dream frequency were associated with increased odds of reporting later suicidal ideation, whereas in mid to late adolescence, increased odds of reporting suicidal ideation at age 17 was associated with increased disturbing dream frequency at age 18. Across adolescence, increased levels of depression and anxiety were associated with increased odds of reporting later suicidal ideation and increased disturbing dream frequency.
Conclusions:
These findings support previous literature suggesting that disturbing dream frequency, depression, and anxiety, are risk factors for suicidal ideation throughout adolescence. The present longitudinal study allows for a refinement of our conceptualization of disturbing dream and their relation to suicide and internalizing symptoms throughout adolescence and suggests that the collection of information on disturbing dream and internalizing symptoms during early adolescence may help screen adolescents for suicide risk.
Nightmares are defined as disturbing mental experiences that generally occur during REM sleep and often result in awakening. The continuity hypothesis of dreaming would predict that media consumption arousing anxious feelings might increase nightmare frequency. Whereas there is some research on the effect of watching TV and playing computer games on dreams, research examining the relationship between reading and nightmares is scarce. The present study carried out in 3,535 children and adolescents showed that the preference for reading scary stories is positively related to nightmare frequency, whereas preferring fiction (novels and stories) is negatively related to nightmare frequency. To determine whether this is a causal effect, future studies should use experimental designs and test whether reading—even though it is not the most commonly used media form—can affect children in a negative way or whether reading specific books offering strategies for coping with nightmares can have beneficial effects on children.
History Nightmare reports can be found throughout history. It was assumed, for example, that demons or devils send nightmares to torment the more or less innocent sleeper. Sexual connotations like mythical creatures having intercourse with the dreamer (“succubus” for men, “incubus” for women) have been linked to nightmares. The picture of Johann Heinrich Füssli “Der Nachtmahr” painted in 1781 in different versions is widely known; a hairy beast is sitting on the chest of a beautiful woman causing the feeling of being choked. Having occasional nightmares is a very common experience; 70–90% of young adults have reported that they experienced a nightmare at least once in their lifetime. Nightmares are usually defined as frightening dreams that awaken the dreamer (DSM IV,). There are two problems, though, with this restricted definition. First, several researchers have demonstrated that very negatively toned dreams that do not wake the dreamer can be as disturbing as nightmares and have coined the term “bad dreams” for this class of dreams. On average, the emotional intensity of nightmares is higher than that of bad dreams, but there is a large overlap. Whether or not the sleeper is able to judge if the dream emotion was really the cause for waking is still an open question. Some characteristic dreams – like being chased and waking up just before the attacker grabs you, or falling dreams with waking up just before hitting the ground – are obvious examples of dreams that awaken the dreamer, but other dream themes may not be that clear.
Several large-scale studies showed that women tend to report nightmares more often than men. Despite this robust finding, empirically tested interpretations of these sex differences are lacking. Levin and Nielsen put forward the hypothesis that sex-specific socialization might be one of the risk factors for nightmare occurrence. The present findings of an online survey indicate that expressivity/femininity and instrumentality/masculinity were related to nightmare frequency and, thus, supported this hypothesis. Since the sex difference in nightmare frequency was not fully explained by these two variables, future studies should investigate other variables — in addition to sex-role orientation — like depressive symptoms, history of sexual and/or physical abuse, ruminative coping styles, and physiological measures of processing emotional stimuli within the brain.
A sample of 624 children (aged 10–16 yrs) reported their most recent anxiety ("bad") dream, rated how often they experience anxiety dreams, and indicated the most threatening theme occurring in these dreams, using a measure of trait anxiety. Three hypotheses were tested and confirmed. First, anxiety dreams occurred more frequently among Ss with high levels of general anxiety. Second, there was some evidence that anxiety dreams involving school examinations were associated with high levels of examination anxiety. Third, high levels of general anxiety were associated with anxiety dreams involving realistic dream aggressors (e.g., humans) rather than unrealistic ones (e.g., monsters). (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Ausgehend von der derzeit international als unzureichend einzuschätzenden epidemiologischen Datenlage zu Schlafstörungen bei Vorschul- und Schulkindern wurden im Rahmen der Kölner Kinderschlafstudie die Häufigkeiten von In- und Parasomniebeschwerden und deren Zusammenhang mit Schlafhygenievariablen, physikalischen und gesundheitlichen Belastungsfaktoren sowie komorbid auftretenden Verhaltensauffälligkeiten in einer repräsentativen Kohorte von Schulanfängern der Stadt Köln im Jahr 2002 untersucht. Im Elternurteil finden sich bei den Erstklässlern beachtenswert hohe Prävalenzen für Ein- und/oder Durchschlafstörungen (15%) sowie wiederkehrende Albträume (14%). Die Auftretenshäufigkeiten von Somnambulismus, Pavor nocturnus und Tagesmüdigkeit liegen deutlich darunter. Kinder, die einen stabilen Schlaf-Wach-Rhythmus aufweisen, zeigen gegenüber denen mit unregelmäßigen Aufsteh- und Zubettgehzeiten signifikant seltener Einschlafprobleme und Tagesmüdigkeit. Weiterhin werden wesentliche Zusammenhänge zwischen kindlichen Schlafproblemen und Umgebungsvariablen wie z. B. Licht- und Lärmbelästigung am Schlafplatz dargestellt. Im Hinblick auf die Komorbidität besteht bei den Kindern mit Insomnie- bzw. Parasomniebeschwerden ein zwei- bis dreifach erhöhtes Risiko für Hyperaktivität oder emotionale Probleme. Die Befunde sprechen für die Notwendigkeit einer stärkeren Berücksichtigung der diagnostischen Abklärung von Schlafstörungen und ggf. Interventionsplanung bei psychisch auffälligen und gesunden Kindern.(DIPF/Orig.) Epidemiological studies of sleep disturbances in preschool and school-aged children are underrepresented in international clinical research. Based on this fact we investigated the prevalence of insomnia and parasomnia in a representative sample of school-novices in Cologne in 2002 (Cologne Childrens Sleep Study). We have also considered the relationship between sleep problems on the one hand and sleep hygienic variables, physical and somatic healthy factors and behavioral problems on the other. A high prevalence of insomnia problems (15%) and repeated nightmares (14%) in children of this age were found in parents report. Thereas sleepwalking, night terrors and daytime sleepiness were reported less frequently. Children having a solid sleep-wake-schedule show significant less problems to fall into sleep and feel sleepy during the day. Moreover we focused the correlation between disturbed sleep and multiple influencing, as light irritating and noise. We found a two- to three times elevated risk for hyperactive and emotional problems for children with insomnia or parasomnia complaints with regard to the comorbidity of behavioural difficulties. These findings underline the necessity for diagnostic clarifying of sleep disturbances and intervention programs for behavioural disturbed and isolated sleep impaired children.(DIPF/Orig.)
Epidemiological, behavioral and etiological variables related to sleep disturbances were investigated in a survey of 1695 children in Grades 1 to 12 from 11 randomly selected schools. Sleep-walking, nightmares and sleep-talking were strongly associated with each other as well as to a family history of sleep-walking. Enuresis, however, was not related to the other sleep variables. Socioeconomic status of father was weakly related to enuresis and sleep-talking but not to sleep-walking or nightmares. Gender was not related to any of the sleep disturbances. The behavioral variables, physical activity, attention, emotional excitability, and feelings easily hurt showed a small association with the sleep disturbances. Parents most frequently attributed causes of sleep-walking and nightmares to over-tiredness and over-excitement. As well, parents' comments indicated that they tend to associate specific events such as illness or more often, frightening TV content with nightmares, but not sleepwalking.
Chronic nightmares occur frequently in patients with posttraumatic stress disorder (PTSD) but are not usually a primary target of treatment.
To determine if treating chronic nightmares with imagery rehearsal therapy (IRT) reduces the frequency of disturbing dreams, improves sleep quality, and decreases PTSD symptom severity.
Randomized controlled trial conducted from 1995 to 1999 among 168 women in New Mexico; 95% had moderate-to-severe PTSD, 97% had experienced rape or other sexual assault, 77% reported life-threatening sexual assault, and 58% reported repeated exposure to sexual abuse in childhood or adolescence.
Participants were randomized to receive treatment (n = 88) or to the wait-list control group (n = 80). The treatment group received IRT in 3 sessions; controls received no additional intervention, but continued any ongoing treatment.
Scores on the Nightmare Frequency Questionnaire (NFQ), Pittsburgh Sleep Quality Index (PSQI), PTSD Symptom Scale (PSS), and Clinician-Administered PTSD Scale (CAPS) at 3- and 6-month follow-up.
A total of 114 participants completed follow-up at 3 and/or 6 months. Comparing baseline to follow-up (n = 97-114), treatment significantly reduced nights per week with nightmares (Cohen d = 1.24; P<.001) and number of nightmares per week (Cohen d = 0.85; P<.001) on the NFQ and improved sleep (on the PSQI, Cohen d = 0.67; P<.001) and PTSD symptoms (on the PSS, Cohen d = 1.00; P<.001 and on the CAPS, Cohen d = 1.53; P<.001). Control participants showed small, nonsignificant improvements for the same measures (mean Cohen d = 0.21). In a 3-point analysis (n = 66-77), improvements occurred in the treatment group at 3-month follow-up (treatment vs control group, Cohen d = 1.15 vs 0.07 for nights per week with nightmares; 0.95 vs -0.06 for nightmares per week; 0.77 vs 0.31 on the PSQI, and 1.06 vs 0.31 on the PSS) and were sustained without further intervention or contact between 3 and 6 months. An intent-to-treat analysis (n = 168) confirmed significant differences between treatment and control groups for nightmares, sleep, and PTSD (all P<.02) with moderate effect sizes for treatment (mean Cohen d = 0.60) and small effect sizes for controls (mean Cohen d = 0.14). Posttraumatic stress symptoms decreased by at least 1 level of clinical severity in 65% of the treatment group compared with symptoms worsening or not changing in 69% of controls (chi(2)(1) = 12.80; P<.001).
Imagery rehearsal therapy is a brief, well-tolerated treatment that appears to decrease chronic nightmares, improve sleep quality, and decrease PTSD symptom severity.
The threat simulation theory of dreaming (TST) () states that dream consciousness is essentially an ancient biological defence mechanism, evolutionarily selected for its capacity to repeatedly simulate threatening events. Threat simulation during dreaming rehearses the cognitive mechanisms required for efficient threat perception and threat avoidance, leading to increased probability of reproductive success during human evolution. One hypothesis drawn from TST is that real threatening events encountered by the individual during wakefulness should lead to an increased activation of the system, a threat simulation response, and therefore, to an increased frequency and severity of threatening events in dreams. Consequently, children who live in an environment in which their physical and psychological well-being is constantly threatened should have a highly activated dream production and threat simulation system, whereas children living in a safe environment that is relatively free of such threat cues should have a weakly activated system. We tested this hypothesis by analysing the content of dream reports from severely traumatized and less traumatized Kurdish children and ordinary, non-traumatized Finnish children. Our results give support for most of the predictions drawn from TST. The severely traumatized children reported a significantly greater number of dreams and their dreams included a higher number of threatening dream events. The dream threats of traumatized children were also more severe in nature than the threats of less traumatized or non-traumatized children.
To (1) clarify the epidemiology of bad dreams in children and investigate risk and protective factors related to (2) the child's sleep, (3) parental sleep-enabling practices, and (4) the child's temperament.
Longitudinal with 6 time points from 5 months to 6 years.
Subjects' homes.
Representative sample of 987 children in the Province of Quebec.
None.
Longitudinal logistic regression analysis models with primary endpoints of presence or absence of parent-rated bad dreams at 29 months, 41 months, 50 months, 5 years, and 6 years and predictor variables of demographic characteristics, parent ratings of child's sleep characteristics, parental sleep-enabling practices (e.g., cosleeping), and child's psychological characteristics at 5 and 17 months (anxiousness, temperament). Mothers' ratings indicated lower than expected prevalence of frequent bad dreams (1.3% to 3.9%). Demographic correlates of bad dreams were high family income, absence of siblings at 29 months, and a non-immigrant mother. The best predictor at 41 and 50 months was the presence of bad dreams the preceding year, whereas at 5 and 6 years, it was their earlier presence at 29 months. Early protective factors were parental practices favoring emotional nurturance after night awakenings (29 and 41 months); early risk factors were sleep-onset emotional nurturance (29 months), difficult temperament (5 months), and anxiousness (17 months).
Bad dreams in preschoolers are less prevalent than thought but, when present, are trait-like in nature and associated with personality characteristics measured as early as 5 months. A stress-diathesis model may best account for the observed pattern of predictive factors.
The present study investigated the relationship between daytime symptomatology and nightmare frequency in school-aged children by eliciting daytime symptoms and nightmare frequency from children directly in addition to questionnaires completed by their parents.
A sample of 4,834 parents and 4,531 of their children (age range: 8-11 years) completed each a sleep questionnaire and the strengths and difficulties questionnaire (SDQ).
The results of the study clearly indicate that there is an underestimation of nightmare frequency in the parents' ratings compared to the children's data (effect size: d = 0.30) and the closeness between influencing factors and nightmare frequency is considerably higher for the data based on the children's responses; the proportion of explained variance was twice as high.
Therefore, it seems important for research and clinical practice to not to rely on parents' information but to ask the children about the occurrence of nightmares.
Investigated anxiety dreams in schoolchildren. Human Ss: 624 normal male and female children (median age 12.4 yrs). Ss were questioned regarding the experience of anxiety in their dreams. Gender differences in dream content were examined. Correlations between gender and anxiety were addressed. The hypothesis that gender socialization is reflected in dreams was discussed. Proposals for further research are given. Tests used: The Anxiety Questionnaire for Schoolchildren (W. Wieczerkowski et al., 1976) and Dreams Questionnaire for Children (Schredl and Pallmer, 1998). (English abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
some of the most terrifying dreams occur to children during the initial weeks after suffering a burn injury / addresses the subject of such dreams with an overview of children's [sleep, dreams and nightmares], an approach to clinical evaluation, a description of the pediatric burn unit setting, discussion of relevant studies, a developmental perspective with case examples, and enumeration of stressors experienced by burned children, and discussion of the implications for the psychology of trauma (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The present study investigated the relationship between nightmare frequency and both sleep and waking-life behavior in children
aged 6 to 11 years. The prevalence rate of nightmares was 41% and 5% experienced nightmares once a week or more often. In
the present sample, girls' nightmare frequency exceeded that of boys. The results indicate that parasomnias such as nightmares,
night terrors and sleepwalking often occurred together. With regard to personality, the findings support previous studies
in adolescents and adults which have shown a relationship between “thin boundaries” and nightmare frequency. As expected,
the occurrence of stressors (school problems, parental divorce) affected nightmare frequency. However, correlations were small
and inconsistent, so that future studies should be performed to elicit the temporal pattern of stress and nightmares.
Die vorliegende Studie untersuchte den Zusammenhang zwischen Alptraumhäufigkeit und Schlaf und Wachverhalten von Kindern zwischen
6 und 11 Jahren. Die Prävalenzrate von Alpträumen betrug 41% und 5% der Kinder erlebten Alpträume einmal pro Woche oder häufiger.
In der vorliegenden Stichprobe wurde für Mädchen eine höhere Alptraumrate angegeben als für Jungen. Die Ergebnisse legen nahe,
dass Parasomnien wie Alpträume, Pavor nocturnus und Schlafwandeln häufig zusammen auftreten. In Bezug auf die Persönlichkeit
sind die Ergebnisse in Einklang mit früheren Studien bei Jugendlichen und Erwachsenen, die einen Zusammenhang zwischen, ‘dünnen’
Grenzen und Alptraumhäufigkeit nachweisen konnten. Wie erwartet, beeinflusste das Auftreten von Stressoren (Schulprobleme,
elterliche Scheidung) die Alptraumhäufigkeit. Die Korrelationskoeflizienten waren jedoch niedrig und nicht konsistent, so
dass zukünftige Studien das zeitliche Muster des stressvorkommens und der Alpträume erfassen sollten.
The review of the relevant literature indicates that women tend to recall their dreams more often than men. However, the results of the two studies carried out in representative samples conflict with each other, i.e. one study did not find a substantial gender difference in dream recall. The present study included four representative German samples and confirmed earlier findings of significant gender differences in dream recall. These differences were not modulated by age or cohort effects. Despite the consistency of this finding, the factors underlying the gender difference in dream recall are still poorly understood.
Thirty-eight children playing or observing a soccer game were the victims of a lightning strike which killed one other child. Interviews with the children and their families documented a number of emotional effects of this disaster, chiefly situational adjustment reactions. The most common reactions involved anxiety, particularly at times of storms. However, the most severely upset children exhibited sleep disturbances, separation anxiety, and nocturnal enuresis. One of two side-flash victims experienced depression for several months; the other experienced no significant emotional upset. Both suffered medical complications and had no memory for the incident. While all children reached at follow-up were doing quite well, those who were most upset by the incident were more likely to refuse to play soccer during the follow-up interval. Stories told to pictures of lightning revealed projections of the children's emotional upset, various defensive reactions to the incident and an increased sense of subjective probability for lightning injuries.
Twenty-five normal schoolchildren were asked about their futures, expectations, the likelihood of any disasters, repeated terror dreams or death dreams, and their sense of dream prediction. Each child was asked for any particularly terrifying past episodes. Although there were a few isolated findings of limitation in life philosophy or death dreams without any connectable past fright or helplessness, the vast majority of positive findings in these normal children were directly related to past terror or psychic trauma.
A 4-year follow-up study of 25 school-bus kidnapping victims and one child who narrowly missed the experience revealed that every child exhibited posttraumatic effects. Symptom severity was related to the child's prior vulnerabilities, family pathology, and community bonding. Important new findings included pessimism about the future, belief in omens and prediction, memories of incorrect perceptions, thought suppression, shame, fear of reexperiencing traumatic anxiety, trauma-specific and mundane fears, posttraumatic play, behavioral reenactment, repetitions of psychophysiological disturbances that began with the kidnapping, repeated nightmares, and dreams of personal death. Brief treatment 5-13 months after the kidnapping did not prevent symptoms and signs 4 years later.
Twenty-three children involved in a school-bus kidnapping were studied from 5 to 13 months following the event. Each child suffered posttraumatic emotional sequelae. The author found that the children suffered from initial misperceptions, early fears of further trauma, hallucinations, and "omen" formation. Later they experienced posttraumatic symptoms consisting of posttraumatic play, reenactment, personality change, repeated dreams (including predictive dreams and those in which they died), fears of being kidnapped again, and "fear of the mundane." Differences between child and adult response to psychic trauma are discussed.
The present retrospective study investigated the often cited clinically relevant relationship between dreams and childhood memories. Indeed, the hypothesis was confirmed that high dream recallers remember more childhood memories than low dream recallers. Whether this is a pure cognitive relationship (memory) or could reflect general personality tendencies request further investigations. Additionally, the high incidence of childhood nightmares in a normal population was stressed.
Childhood nightmares are till today a very common phenomenon. The highest prevalence seems to be at about age six, decreasing strongly with age and no gender-specific differences in prevalence rates can be pinpointed for sure. The most frequently occurring nightmare themes are "Being chased", followed by dreams of "Falling" and those concerning, "Loss of close persons". As reasons for such dreams such factors as genetic influence, trait anxiety, traumatic experiences have been assumed, whereas a more comprehensive explanation model-which would take developmental issues into consideration-unfortunately does not yet exist. Numerous case studies have confirmed that childhood nightmares are easily treatable, especially where such children are encouraged to confront and cope with their anxiety. Further research such as longitudinal studies that would examine dream contents and children's waking-life experiences would be useful for a better overall understanding of the nightmare phenomenon and the causes behind their occurrence. In addition, it seems to be useful to inform parents, child caretakers, teachers and children about the simple methods in dealing with nightmares.
We quantified the genetic influences affecting the liability to nightmares, and the association between nightmares and psychiatric disorders in a community-based sample. In 1990, 1,298 monozygotic (MZ) and 2,419 dizygotic (DZ) twin pairs aged 33-60 years responded to a questionnaire study in the Finnish Twin Cohort. Structural equation modeling was used to estimate genetic and environmental components of variance in the liability to nightmares. Records on hospitalization and long-term antipsychotic medication were used to estimate the period prevalence of serious psychiatric disorders. Nightmares were reported more frequently in females both in childhood and as adults. The correlation between occurrence in childhood and as adults was 0.69 in males and 0.71 in females. Polychoric correlations of occurrence within the twin pairs were 0. 45 in MZ and 0.21 in DZ pairs in childhood, and as adults 0.39 and 0. 18, respectively. The best fitting genetic model was that specifying additive genetic and unshared environmental effects. The estimated proportion of genetic effects in childhood was in males 44% (95% confidence interval [CI] 35-52%) and in females 45% (95% CI 38-52%) of the phenotypic variance. As adults the values were in males 36% (95% CI 27-44%) and in females 38% (95% CI 31-45%). Nightmare frequency and psychiatric disorders were linearly associated. Among those with the most frequent nightmares odds ratios (95% CI) were 3. 67 (2.48-5.42) for childhood and 5.87 (4.08-8.45) for adults compared with those never having nightmares. Nightmares are quite a stable trait from childhood to middle age. There are persistent genetic effects on the disposition to nightmares both in childhood and adulthood. Nightmares are significantly associated with psychiatric disorders.
To determine whether a relationship exists between children's anxiety level and nightmare occurrence.
A total of 60 kindergarten, second and fourth grade school children and their parents completed questionnaires assessing nightmare occurrence and anxiety.
According to parental report, children who experience nightmares have significantly higher levels of anxiety than children who do not experience nightmares. The results also indicate a relationship between nightmare distress and trait anxiety.
These findings suggest that anxiety issues should be considered in children who are experiencing nightmares.
In a new approach, this study compared the effects of trait and state factors on nightmare frequency in a non-clinical sample. Although neuroticism and boundary thinness were related to nightmare frequency, regression analyses indicated that the trait measures did not add to the variance explained by the state measures. This finding supports the so-called continuity hypothesis of dreaming, i. e., nightmares reflect negative waking-life experiences. Second, the moderate relationship between nightmare frequency and poor sleep quality was partly explained by the day-time measures of neuroticism and stress, but it can be assumed that nightmares are an independent factor contributing to complaints of insomnia. Longitudinal studies measuring nightmare frequency and stress on a daily basis will shed light on the temporal relationship between daytime measures and the occurrence of nightmares. It will be also very interesting to study the relationship between stress and nightmare frequency in a sample who have undergone cognitive-behavioral treatment for nightmares.
Dream recall frequency varies widely between people as well as within individuals. To explore the relationship between dream recall frequency and trait variables such as personality dimensions, a measure of stable interindividual differences is necessary. In the present study (N = 198 patients with sleep disorders; 115 women, 83 men; M age = 45.8 +/- 15.3 yr.) a high retest reliability of the 7-point Dream Recall Frequency scale developed by Schredl in 2002a was found. If the participants' focus was not directed explicitly towards dream recall when the scale was presented within a general sleep questionnaire, the hitherto-reported increase of dream recall due to measuring dream recall frequency did not occur. In conclusion, the present scale is well suited for measuring interindividual differences in dream recall frequency reliably.
Childhood nightmares are a common phenomenon; the prevalence rates indicate that up to 5% of the children suffer from quite frequent nightmares. The etiology of nightmares is best explained by a vulnerability/stress model but one has to take cognitive avoidance as a maintaining factor into consideration. The therapeutic approach consisting of confrontation, coping and training is easily applied--even by non-professionals--and the efficacy has been demonstrated for adult nightmare sufferers.
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Die nächtliche Traumwelt: Einführung in die psychologische Traumforschung
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- E Hartmann
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Dreams and nightmares of burned children
- F J Stoddard
- D S Chedekal
- L Shakun
Stoddard FJ, Chedekal DS, Shakun L. Dreams and nightmares of
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Children's nightmares: what causes them? Dream Time: Association for the Study of
- J M King
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King JM, Townsend P, Johnson DL, Cuccia L. Children's
nightmares: what causes them? Dream Time: Association for the
Study of Dreams Newsletter 1998;15(1&2):16-17, 40.
Behandlung von Alpträumen
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