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Anxiety, not Halloween, may be the cause of your nightmares

The fall brings many of our favorite things: piles of brightly colored leaves, apple cider with donuts, and cooler temperatures that allow us to turn off our air conditioners finally! But for many, the spooky season of Halloween time only highlights the nightmares that interfere with sleep and quality of life. Today we examine the relationship between anxiety and the nighttime disturbances of nightmares and night sweats.

Nightmares and anxiety

If you have frequent nightmares, you have parasomnia — a type of sleep disorder that includes unwanted disturbances while you're falling asleep, during sleep or when you're waking up. Nightmares and bad dreams are overlapping and common forms of parasomnia. Nightmares can be thought of as “vivid, disturbing, or frightening dreams that cause a startled awakening (Levin & Nielsen, 2007)", and bad dreams are “very disturbing dreams which, though being unpleasant, do not cause the dreamer to awaken” (Robert & Zadra, 2008).

An anxiety dream falls under this umbrella as well; it is any dream that causes stress or distress. You might feel panicked or nervous during the dream, but often these feelings continue even when you wake up or worse, linger on during your day.

Although nightmares often inspire feelings of terror more intense than general anxiety, these also count as anxiety dreams, since anxiety during the day can make nightmares more likely. Nightmares can be triggered by many factors outside of anxiety including trauma (such as an accident or other events), irregular sleep cycles/schedule, some medications, substance abuse and/or withdrawal, and other medical conditions such as depression, heart disease or cancer.

However, the primary cause of nightmares is stress or anxiety. Sometimes, the ordinary stresses of daily life, such as a conflict at work or school can trigger a nightmare. A major life change, such as a move or the death of a loved one, can have the same effect. Experiencing anxiety is associated with a greater risk of nightmares.

How does anxiety trigger nightmares?

As you might already know, your brain remains active while you sleep. The brain uses this time to carry out critical functions required to refresh your body and optimize your brain function during your waking hours. Part of this process that happens when you sleep includes encoding experiences and sensations into memory and organizing all that data, much like a filing system.

It follows, then, that if your recent thoughts and feelings cause stress and fear, your dreams will likely follow a similar pattern. Not everyone living with anxiety will have bad dreams, but research does suggest anxiety can play a significant part in nighttime distress.

In a 2014 study, those who met criteria for generalized anxiety disorder had more bad dreams than participants who didn’t have anxiety. Bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. The study also showed that bad dreams led to greater daytime feelings of anxiety and depression and lower quality of life. In short, anxiety, and nightmares can feed into each other, creating an unpleasant cycle.

Night sweats and anxiety

Night sweats are something you probably recognize if you are experiencing them, but clinically it is defined as being flushed, very hot, and sweating for no apparent reason. This can happen when trying to rest, go to sleep, or when waking up, even though the room temperature is normal or cool. There may be a medical reason for your night sweats your body fighting off a virus or bacteria. What's more, night sweats can be caused by perimenopause, menopause, the aftereffects of menopause, or by other hormonal problems. Night sweats can come and go infrequently, occur on a regular basis, or go on every night for what seems to be indefinitely.

Anxiety night sweats may precede, accompany, or follow an escalation of other anxiety sensations and symptoms (things like nervousness, anxiety, fear, and elevated stress) or occur with no obvious trigger.  It can also come in waves, where it’s strong one moment and eases off the next.

Why does anxiety cause night sweats?

In short, an over-active mind causes the physical symptoms associated with night sweats. Your stress response in your head causes a physical response in your body including changing your body’s metabolism, respiration, and perspiration. This response is why the heart beats harder and faster, breathing becomes shorter and shallower, and we sweat.

Experiencing night sweats is a common consequence of a stressed or anxious mind, and an indication of how the body can mismanage itself based on our mental state. When the nervous system is healthy, it manages these systems and functions normally and invisibly for the most part. But when the nervous system becomes hyper-stimulated on a regular basis, the body is more apt to move from “thinking to feeling” in a shorter time span – a type of muscle memory if you will. Nightmares and the stress responses they trigger can also be a cause, or part of the circle of night sweats.

What to do if you are experiencing nightmares or night sweats on a regular basis

It’s always wise to seek support if your symptoms begin affecting your work, relationships, or overall quality of life. The best way to combat the negative effects of anxiety is to prevent them in the first place! Dr. Sambunaris suggests changing your sleep habits first:

If you have tried all of these suggestions, and you still find that your sleep disturbances are affecting your quality of life, it’s time to talk to a physician like Dr. Sambunaris who specializes in anxiety disorders. Recurrent or long-lasting stress and anxiety could be a sign of a more serious mental health issue that will not go away on its own. Make an appointment to get a clear diagnosis of what is keeping you up at night by calling 770-817-9200.



Angelo Sambunaris, M.D.

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