Identifying Nightmare Disorder and Dream Anxiety

The International Classification of Sleep Disorders distinguishes more than 80 different disorders, which can be effectively treated. Problems with falling asleep or daytime sleepiness affect approximately 35 to 40% of the U.S. adult population. Individuals with BPD experience significantly greater instances of nightmares, increased levels of dream anxiety, and disturbed sleep.

Unfortunately, despite the high prevalence, sleep disorders remain poorly identified; less than 20% of individuals with insomnia or a related sleep disorder are correctly diagnosed and treated.

“What could be” (what are we aspiring to):
Disrupted sleep can severely impact your ability to manage your thoughts, moods, and behaviors. The goal of this video to help you not only identify possible sleep concerns, but also give you tips to manage it.

What is Dream Anxiety?
Anxiety or uneasiness about having an unpleasant dream which can be more or less disturbing than a nightmare. Dream anxiety is not in the DSM-5 but are characterized by feelings of uneasiness, distress, or apprehension upon waking. Anxiety dreams occur in rapid eye movement sleep and tend to involve incomplete tasks, embarrassment, falling, or being chased or pursued.

What is Nightmare Disorder?
• Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity and that generally occur during the second half of the major sleep episode.
• On awakening from the dysphoric dreams, the individual rapidly becomes oriented and alert.
• The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Daniel J. Fox, Ph.D., is a licensed psychologist in Texas, international speaker, and award winning author. He has been specializing in the treatment and assessment of individuals with personality disorders for over 15 years in the state and federal prison system, universities, and in private practice. His specialty areas include personality disorders, ethics, burnout prevention, and emotional intelligence.

He has published several articles in these areas and is the author of:

Thank you for your attention and I hope you enjoy my videos and find them helpful and subscribe. I always welcome topic suggestions and comments.

Citations:
Grove, J. L., Smith, T. W., Crowell, S. E., & Ellis, J. H. (2017). Preliminary evidence for emotion dysregulation as a mechanism underlying poor sleep quality in borderline personality disorder. Journal of Personality Disorders, 31: 542–552.

Semiz, et al., (2008). Nightmare disorder, dream anxiety, and subjective sleep quality in patients with borderline personality disorder. Psychiatry and Clinical Neurosciences, 62: 48–55.

[Ninaagabi]

A lot of my dreams have to do with real world problems or subconscious things that I’m holding in. I’ve already experience sleep paralysis and that was something I’ll never forget. It just really sucks because people have their dreams to escape and mine are usually based off work and home/ power struggle/ things were I have no voice, situations were I’m helpless.

[rpmfreak]

Just awoke from a night mare ten minutes ago" my heart rate is very high, I can't take this stuff anymore it's been over 30 years since I started having these night terrors" they seem to be getting worse, hell I'm setting here on a toilet crying my eyes out and I am a very big man. For some reason I am always dreaming about those people in my family who have already passed away. One time I was having a night terror and I actually experienced a heart attack! I awoke from the night mare and I was rushed to the hospital" and after a couple of EKGs" they told me that I certainly had already had a heart attack" and if I were to go home that I was going to die. Try to understand something like that happening when you are just 28 years old' sorry for bothering everyone with my problem.

[catstate]

i have bpd and am finishing my psych degree, and i had no idea that there was a connection between nightmares and bpd. i felt chills when you described the possible topics of bpd nightmares - falling, incomplete tasks, shame, and being chased - because those are ALWAYS somehow integrated into any dream or nightmare I've ever had.

and then the nightmare disorder! i would call those long, vivid dreams of trying to avoid danger "sleep comas" because even if i woke up, i would immediately be too anxious to /not/ finish the dream, and i would go back to sleep. i would end up actually waking up around 4pm - and the nightmare is usually still not resolved by then.

thank you so much for making this video! your descriptions were spot on and have helped me immensely

[Lidia.Bella.Italiana]

Nightmares, vivid distressing dreams, terrors, panic, since I was a kid and Sleep paralysis.
Dreaming of traumas and hidden meanings in my dreams of violence and losing things that mean something to me, fear of sleeping because I never knew when the evil shadow demon was coming in my sleep to kill me... BPD is recently my diagnosis... And I always knew these things weren't normal. This video made sense of my life.

[distressedkittyboy]

this is showing me a whole side of bpd and is explaining so much of what happens to me. i’ve been having nightmares for the past two weeks. can’t stop thinking about ‘screenshots’ from the dreams. thank you for your help!

[patriciaambrecht]

Wow! This is very informative and useful to know! I have had nightmares and night terrors since a little girl. I would have dreams of hands grabbing me:/ By the age of 15, four different adult men had molested me. I am now 63.  When I have had night terrors I am unable to speak and even when I try and scream no sound comes out. I'm thankful these bad dreams are not as frequent, but when my 12 year old grandson was living here,  he told me  that I had nightmares and he tried unsuccessfully to wake me up. He told me I sounded terrified:/

[allanaclarke]

Great video. Experiencing extreme nightmares which disturb me for days later. I know they're nightmares, but I feel tormented for days. I can waken & tell myself it's a nightmare. If I fall asleep again, I go back into the nightmare. Extremely unpleasant. I do have MDD, BPD with BP features & anxiety. I see a psychologist. Thanks again.

[helenachase]

Dr Fox you are a sweetheart ! I giggled when you used the emoji to apologise for mispronouncing a word.... I wake up a lot in the night so I keep these self help videos on 24/7 so any anxiety is quickly alleviated . Rock on Dr. Fox !

[amelialakewood]

I have dreams that people I love are dying next to me or that I must kill them. There are points in my dream where I realize it’s not real but no matter how hard I try the dream keeps going I assume it’s real. I often have to brutally kill other people to survive... it feels so real and terrifying. I am so scared to fall asleep

[ChixxxFTW]

This video helped me put feelings I've had for over 20 years into words.

[tawnyrenee]

Every time I’m experiencing something I swear he posts a video of exactly what I’m dealing with. I’ve been having nightmares lately that have been affecting my moods for the entire next day. I had a nightmare 3 days ago and have not been able to shake this feeling from this nightmare since. I feel strange and not like myself, I feel that I’m still in this dream. I don’t know how else to explain it but i feel very off or foreign. I’m not sure if this is related but I just want to feel normal again.

[christyj]

I had no idea my bpd could be the cause of these bad Dreams. It all makes a lot more sense. It's a shame that we deal with trauma as a child/teen and then we have to deal with more pain in our adult lives due to that trauma. I hope everyone can get help ❤️
Edit: This doesn't help with nightmares but ASMR has helped me fall asleep and go back to sleep after nightmares. Hope this helps someone

[msstephanie]

This happened to me and it was a nested dream. I kept waking up to find that I didn’t actually wake up and then tried to wake up again when I wasn’t actually waking up. This happened multiple times. When I tried to stop waking up, telling myself that someone would wake me up eventually, I had a pretty normal dream about a video game I used to play and then was woken up by my sister with a call from my parents. Somehow I knew it was real life, and not just another dream.

[jenniferholder]

What gets me is not knowing what was in a dream and what was real.

[amandal]

I deeply appreciate your videos. Each one has been so helpful for both my husband and I; they have allowed us to have wonderful conversations on handling my BPD. Thank you so very much for delivering the information in a clear and compassionate manner.

[CarmillaCarminecore.]

I just slept and I had a HORRIBLE nightmare, when I woke up (a few mins ago) I felt unreal (now) and it put me in sweat, I feel like crying

[shoxggz]

I been dreaming about my ex every single night for almost 2 years it’s driving me crazy 😓

[mrscookie]

Watching this after I woke up from a nightmare at 4 am. It has gotten to a point where I might wake up and immediately start crying and most of the time when I fall asleep again, the dream continues or I get one that's even worse. I often decide to just stay awake because the sleep that I would get would make me feel even more exhausted, so here I am, at 5 am.

[andrewprince]

My mom passed away about 6 months ago. I’ve been dealing with it alright (able to suppress a lot of the bad memories/thoughts) but my little brother on the other hand has been having nightmares about her every night. I hope I can use this knowledge to help him.

[XOXO-mbvh]

The shower is my so called 'portal'. Every night so many dreams. Reality starts to mesh with the dream state so the shower resets me a bit.