The perceptions of nightmare sufferers regarding the functions, causes, and consequences of their nightmares, and their coping strategies

Abstract

The administration of treatments for nightmares, and more broadly, clinical work with patients reporting dysphoric dreams as a concomitant psychological difficulty, could be improved based on a better understanding of the experience of nightmare sufferers. The objective of this study was to explore the perceptions of nightmare sufferers regarding the functions, causes, and consequences of their nightmares, as well as their strategies for coping with nightmares. Twenty university students with frequent nightmares took part in an individual semi‑structured interview constructed by the research team. The interviews were recorded and transcribed verbatim. Verbatim were analysed using a content analysis method. Four major findings emerge from this study. Firstly, the main perceived causes of nightmares, including one’s occupational and social life, support the hypothesis that dreams reflect waking concerns. Secondly, nightmares tend to decrease sleep quality and to provoke sleep fragmentation, which may be aggravated by sleep avoidance and voluntary awakening from lucid nightmares. In turn, the fatigue that results from a disturbed sleep can negatively affect concentration, daily functioning and mood. Thirdly, nightmares can impact emotions upon awakening and during the day, directly and indirectly, through various mechanisms. Fourthly, nightmares are frequently perceived as a source of personal insight: half of the participants believe that their dreams can reveal information about themselves, searching for the signification of nightmares is one of the most common coping strategies, and many participants experienced a reflection or realization following a nightmare. A model is proposed to integrate the findings and explain how the nightmare problem might perpetuate itself.