Med thumb man nightmare

At an annual checkup, any responsible patient would inform their doctor of a new or persistent health issue, be it a nagging sinus infection, chronic nerve pain or feelings of anxiety. But even the most conscientious patients gloss over a common, relevant experience: nightmares. 

According to a new study, which appears in the current issue of the Journal of Clinical Sleep Medicine, patients heavily underreport nightmares, and doctors — even those working at sleep clinics — rarely ask about them. As a result, nightmares go largely untreated, despite the availability of two treatment methods.

For one, nightmares are both symptomatic and predictive of PTSD. People who get them prior to undergoing trauma are statistically more likely to develop PTSD afterward. What's more, nightmares are also linked to insomnia, mood disorders, schizophrenia and suicidal thoughts.

In the current study, a psychology team lead by Michael Nadorff at Mississippi State University analyzed two groups of participants: 809 volunteers recruited through Amazon Turk, a crowdsourcing service, and 747 American college students. Researchers used standardized questionnaires to identify participants who experienced nightmares that are intense, frequent and disruptive enough to constitute clinical significance.

Among Amazon Turk recruits, only 38 percent of people with clinical-level nightmares mentioned their terrors to healthcare professionals, including therapists and doctors. That number fell to just 11 percent among college-aged participants.

In both groups, only a minority of people affected by nightmares believed there was any available treatment. But there are, in fact, two established treatments: “Imagery Rehearsal Therapy” and  a drug called prazosin (aka Minipress), the latter of which works by inhibiting adrenaline.

The moral of the story? Talk to your doctor about your nightmares. They may be more telling than you think.