Nightmares—dreams that are frightening and/or threatening—are one of the primary symptoms of PTSD. People who have experienced a traumatic event often relive the trauma for months or even years through nightmares, flashbacks, and scary memories.

While nearly everyone has nightmares every once in a while, trauma survivors experience them more often—and people with posttraumatic stress disorder have them even more frequently. It’s estimated that about 3 to 5 percent of adults in the general public have nightmares, and between 52 and 96 percent of people with PTSD have bad dreams regularly. People who have another mental health condition, such as panic disorder, in addition to posttraumatic stress disorder are more likely to experience nightmares than people with PTSD alone.

About Trauma-induced Nightmares

Nightmares that develop after a trauma often include the same frightening elements that were involved in the event. For example, following a hurricane, survivors may have nightmares about trying to escape high winds or flood waters. People with PTSD experience nightmares that replay the events of the trauma more often than survivors who do not develop posttraumatic stress disorder.

Research shows that posttraumatic nightmares occur earlier in the night and during different stages of sleep than other bad dreams. Following a traumatic event, nightmares also involve body movements (e.g., thrashing, kicking, punching) more often.

Treatment for Posttraumatic Nightmares

Standard treatment for posttraumatic stress disorder typically reduces the frequency and severity of nightmares. If posttraumatic nightmares persist in spite of treatment, imagery rehearsal therapy (IRT) may be effective. This treatment involves changing the parts of the nightmare that are upsetting—for example, how the dream ends—while awake and then replaying the new scenario over and over in the mind.

Trauma survivors have higher-than-normal rates of sleep breathing disorders like sleep apnea. Studies show that treating sleep disorders and improving breathing during sleep decreases posttraumatic nightmares.

More research is needed to determine if medications can be used to treat nightmares after a traumatic event. Prazosin (used to treat high blood pressure, benign prostatic hyperplasia [BPH, enlarged prostate], congestive heart failure, and other conditions) is a promising drug that is being studied. Talk to your health care provider or mental health professional if you experience frequent nightmares following a trauma.

Source: U.S. Department of Veterans Affairs

Publication Review By: the Editorial Staff at

Published: 29 May 2014

Last Modified: 29 May 2014