Nightmare Disorder in Children and Adolescents

ICD-10 Code: F51.5

Nightmare disorder is part of a cluster of diagnoses called the sleep-wake disorders.  Sleep-wake disorders are a group of psychiatric conditions that include:

  • Insomnia Disorder
  • Hypersomnolence Disorder
  • Non-Rapid Eye Movement Sleep Arousal Disorder
  • Nightmare Disorder

These disorders are broadly characterized by disruptions in sleep and wakefulness.  Individuals with insomnia disorder have frequent difficulty falling asleep or staying asleep.  Individuals with hypersomnolence disorder feel excessively sleepy during the day, despite obtaining what for most people would be a full night of sleep.  Individuals with parasomnias such as non-rapid eye movement sleep arousal disorder and nightmare disorder experience unusual behaviors while sleeping, such as sleep walking, or vivid and disturbing dreams or night terrors.  

Some sleep-wake disorders, including insomnia disorder and hypersomnolence disorder, are associated with disturbances in the amount of time the individual spends asleep (too much or too little) or the times at which the individual sleeps (often outside of the desired sleeping window).  Other disorders, such as the parasomnias, are not associated with disturbances in the quantity or timing of sleep per se, but are instead associated with behavioral disturbances during sleep or frequent highly distressing dreams.

What is Nightmare Disorder?

Nightmare disorder is a psychiatric disorder that increases in prevalence throughout childhood and adolescence (up to 7% of children meet criteria for the disorder) and then decreases in prevalence in adulthood.  Nightmare disorder is characterized by repeated nightmares, which are extremely distressing, vivid, and well-remembered dreams.

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Understanding Nightmare Disorder

Nightmare disorder is more likely to cause severe distress than clinically significant impairment.  Nevertheless, impairment can occur if the nightmares lead to sleep avoidance or impaired concentration or efficiency during the day.  

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How is Nightmare Disorder Treated?

Published guidelines for the treatment of nightmares and other pediatric sleep disorders are available from the Agency for Healthcare Research and Quality.

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