Wall Street Journal
4 Oct 11
by Melinda Beck
….A wide array of drugs can cause nightmares. The list includes certain antidepressants, antibiotics, beta blockers, blood-pressure medications, statins for lowering cholesterol and drugs for Alzheimer's and Parkinson's diseases. Some drugs tend to cause bad dreams when they are first taken; others bring nightmares when they're stopped. Alcohol, over-the-counter antihistamines and some dietary supplements have the same effect.
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Although the mechanisms aren't completely understood, sleep experts think drugs cause nightmares because they interfere with so-called sleep architecture—the stages of light, deep and rapid-eye-movement, or REM, sleep that people typically rotate through three or four times a night. The REM stages, during which the most vivid dreams occur, normally get longer toward morning. But some medications delay or decrease REM, and some create a "REM rebound" effect when people stop taking them, making the REM stage unusually long or intense.
"Whenever REM sleep is altered, that leads to nightmares," says Naresh Dewan, a professor of sleep medicine at Creighton University in Omaha, Neb.
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Sleep experts say medications particularly apt to bring troubling dreams are those that affect neurotransmitters, the brain's chemical messengers that influence sleep cycles, among other things. That includes most antidepressants, as well as antihistamines and anticholinergic drugs used to treat a broad range of conditions, from overactive bladder to bronchial spasms. Sleeping pills can also disrupt sleep cycles and cause nightmares.
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It isn't clear why disrupted REM sleep tends to bring nightmares rather than more pleasant dreams.
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Ms. [Alesandra] Rain, 54, was so disturbed by the dreams and the long list of drugs she was taking that she quit them cold turkey and started a nonprofit organization, Point of Return, in Westlake Village, Calif., to help others wean themselves off of multiple prescription drugs. "I haven't had a nightmare in nine years," she says.
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Some chronic nightmare sufferers find relief with Image Rehearsal Therapy, a technique pioneered in the 1990s in which patients write out their typical nightmare, then imagine a new, benign ending for it.
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Patients practice visualizing the new dream several times a day for several weeks. Even if that particular dream never recurs, the nightmares typically end. "Once people believe they have control over their nightmare, that's when they start to get better," says Dr. Harris…..
http://online.wsj.com/article/health_journal.html
