Nightmare Disorder Diagnosis

(Also Known As: Nightmares Diagnosis, Dream Anxiety Disorder Diagnosis, Repeated Nightmares Diagnosis, Insomnia Diagnosis, Sleep Terror Disorder Diagnosis, Sleepwalking Disorder Diagnosis, Chronic Nightmare Disorder Diagnosis)

(Reviewed by: Paul Peterson, Licensed Therapist)

How is Nightmare Disorder Diagnosed?

Nightmare Disorder Diagnosis is usually made based on the criteria set forth by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) which should meet the following specific symptoms:

  • There is a repeated episode of awakening from a nap or major sleep with a detailed recall of the frightening dreams that usually involves threat to security, survival, and self-esteem. The awakening usually occurs on the second half of the sleep period.
  • The person usually has a vivid memory of the frightening dreams upon awakening with the person rapidly becoming oriented and alert, which is in contrast to the disorientation manifested in epilepsy and Sleep Terror Disorder.
  • The dream experience with the resulting sleep disturbance causes significant distress and impairment on the person’s social, occupational, and other important functioning.
  • The nightmares do not exclusively occur during the course of another mental disorder, such as delirium and Post Traumatic Stress Disorder, and are not due to the physiological effects of any medication.

Differential diagnosis is needed to identify distinction between Nightmare Disorders and Sleep Terror Disorder. Both conditions involve disturbed sleep and sleep arousal with the symptoms of anxiety and fear due to a nightmare. However in sleep terror disorder the patient is unresponsive, and during its episodes the person gets out of the bed, becomes active, and often screams and cries. Some would manifest violent kicking of the legs and flailing their arms while screaming in terror. They are also unable to recall what caused their terror. Persons with nightmare disorder are more subtle in that when they awake after a nightmare they have a clear memory of what the nightmare is all about and are more oriented.

The differential diagnosis for nightmare disorder also includes considering other conditions such as: 5

  • Post Traumatic Stress Disorder
    • Nightmare is one of its major symptoms in reliving their traumatic experience and the condition occurs with associated episodes of daytime anxiety and poor sleep.
  • Underlying organic brain disorder
    • Such as in cases of mental impairment and delirium
  • Withdrawal from medication
    • Nightmares are one of the body’s responses when there is a sudden and abrupt withdrawal of medication intake.
  • Recurrent febrile illness
    • High febrile state can predispose anyone to seizures, hallucinations, depression and nightmares.

Could You Have Nightmare Disorder?

Nightmare Disorder Topics

Related Conditions

Dyssomnia – Difficulty to Go to Sleep, Difficulty to Remain Sleeping, Sleep Disorder, Primary Sleep Disorder
Hypersomnia – Recurrent Episodes of Daytime Sleepiness, Sleep Disorder, Frequent Daytime Napping, Anxiety, Disturbed Sleep
Narcolepsy – Dyssomnia, Excessive Daytime Sleepiness, Daytime Drowsiness, Insomnia, Drooping Eyelids, Lack of Sleep, Sleep Awakening
Parasomnia NOS – Sleep Disorder, Abnormal Movements, Sleep Awakening, Abnormal Sleep Pattern, Dreaming, Disturbed Emotion and Behavior
Sleep Terror Disorder – Sleep Terror Disorder, Extreme Terror, Difficulty to Wake Up, Emotional Fear, Parasomnia
Sleepwalking Disorder – Somnambulism, Parasomnia, Engaging in Activities While in a State of Sleep