Q. What triggers nightmares during sleep to an extent of screaming and violently jumping out of bed? Should one be worried when this happens multiple times?
On the face of it, yours is a nightmare question for us to deal with. Used in this way (the word), a nightmare event is one in which much distress is caused to the person on meeting a particular situation.
For example, a young man could describe his first meeting with a future father in law as a nightmare. What the young man wishes to say is that his encounter with the old man caused him great anguish, stress, fear and he had a racing heart before, during and after the encounter.
This, however, is not the nightmare scenario you wish us to shed light on. Yours would seem to be the kind of experience one goes into during REM (Rapid Eye Movement sleep). In fairness to the sleeping person, there are several stages of sleep, in which many different things happen to him.
Unknown to many people, “sleep is not just sleep”. It is during sleep that many functions of the body undergo restoration or repair.
If denied sleep, one is likely to get into a state of dysfunction and could even die! Just to make life a little more complex, not all stages of sleep are the same! During a night of sleep, the sleeper goes through five stages of sleep (1, 2, 3, 4 and REM sleep).
Each stage lasts 5-15 minutes and the cycles of sleep are repeated several times each night.
An average adult has 5-6 cycles of sleep stages every night. It sounds very complicated but is intended to show that a great deal goes on in one night of sleep.
In his 1899 book The Interpretation of Dreams Sigmund Freud (the psychoanalyst) focused on the relationship between dreams and the unconscious mind. Put another way, the dreams that one has was, to Freud, a gateway to the unconscious mind, as it represented the “secret” thoughts of the person.
All one needed to do, therefore, is to interpret the dreams of the person and the real wishes would become known to the patient and his therapist! If life was as easy at that!
Today, we know that many different conditions that afflict a person can lead to all manner of nightmares.
A recent case of a 35 year old accountant comes to mind. He came to us because he had the recurrent nightmare that his wife was about to cut off his penis.
The nightmare had gone on for six months and although it was sometimes slightly different in context, the general theme was essentially the same.
The wife, the knife, the struggle and the extreme fear were all constant. Some of the time, the event took place in their matrimonial bed, at others in hotels he had been to and one time he was on a beach in South Coast.
The nightmares (it turned out) had coincided with a time of some strain in his marriage. A recent promotion meant a great deal of regional travel, often with sales team members. At the same time, their second born child came along, and his wife developed what the doctors called, Post Natal Depression.
This condition made his wife become rather sad, miserable, clingy and irritable. She was sexually unresponsive and could not socialise. Home was dull and unhappy. The young man had found solace in alcohol and also that the women he travelled with were fun.
Following a number of sexual encounters with these girls, guilt had found its way into his heart. After all, before these two happy events (the promotion and the baby) life had been very good at home and his relationship with his wife had been very good!
During therapy, two things became clear. First of all, the nightmares were blamed on the increased use of alcohol. Secondly, was the poor sleep hygiene that had developed. During the trips out of town he stayed many hours from bed drinking and dancing with “the girls”.
When he got home, the baby was awake all night, because a depressed mother had issues attending to the baby. The anger and rejection by the wife led to the nightmare of the knife and the penis!
As you can see, the subject of nightmares can be interesting, complex and lead to many things one does not know about the state of sleep.