Understanding the connection between nightmare disorder and substance use is key to receiving adequate care and finding relief from symptoms.

Nightmare disorder is more than having bad dreams at night. Nightmare disorder is a pattern of disturbed sleep that makes falling asleep a scary and uncomfortable experience.

While there may be a connection between nightmare disorder and substance abuse, experts are still working to understand it. Understanding more about the relationship between nightmare disorder and substance abuse could allow people to find relief from their symptoms and help treatment professionals provide more effective treatments.

Effects of Drug Use on Nightmare Disorder

Any substance a person consumes can impact sleep and dreaming. Some can improve the quantity and quality of rest, while others trigger unwanted effects.

Prescription Drugs that Cause Nightmares

Some medications a doctor prescribes to manage one issue can increase the frequency or intensity of nightmares. Prescription drugs known to cause nightmares include:

  • Antidepressants. This class of medications has a reputation for producing nightmares, with Paxil being the primary culprit. Other antidepressants that can cause nightmares include Zoloft, Prozac and Viibryd.
  • Antihistamines. These over-the-counter and prescription medications can trigger vivid dreams and nightmares: Benadryl, Zyrtec, Claritin, Alegra and Unisom.
  • Blood pressure medications. Beta-blocker medications manage blood pressure, but they can also change the way the body reacts to certain brain chemicals, triggering nightmares. Blood pressure medicines with nightmare risks include Propranolol, Metoprolol, Atenolol and Labetalol.
  • Steroids. Drugs like prednisone and methylprednisolone can modify the brain’s response to serotonin, a chemical linked to sleep.
  • Cholesterol medication. Though it tends to only happen in rare cases, bad dreams and night terrors can be caused by cholesterol medications like Zocor, Pravachol and Lipitor.
  • Parkinson’s medication. A medication called Amantadine prescribed to people with Parkinson’s disease may produce intense dreams, frequently with sexual content.

Other Drugs that Cause Nightmares

Some legal and illicit drugs can also produce nightmares, but only when the substance leaves the body. If someone has become physically dependent on a substance, the withdrawal process can create sleep problems, including unpleasant and vivid dreams.

Drugs that can trigger nightmares during withdrawal include:

These drugs may spark new nightmares or intensify a pre-existing nightmare disorder. In either case, these substances should be avoided to reduce the risk of nightmares.

Statistics on Nightmare Disorder and Addiction

Though there is little information linking addiction to nightmare disorder explicitly, there is a significant amount of data connecting numerous sleep issues to substance abuse. Studies show:

  • About 15 percent of people have used illicit substances in the past year
  • About 65 percent of working adults have some sleep problems, with 44 percent having problems almost every night
  • As many as 72 percent of people in treatment for an alcohol use disorder reported sleeping concerns
  • Sleep problems may last for three years after drug use stops

Can Nightmare Disorder Lead to Drug Abuse?

Nightmare disorder can directly lead to drug abuse, and it is easy to see why. People who expect to have terrifying dreams while sleeping may be willing to employ extreme measures to improve or avoid sleep.

For example, someone with nightmares may think staying awake for longer periods will reduce their risk of nightmares and consume stimulants delay sleep. Unfortunately, this strategy is almost always unsuccessful and tends to increase the risk of nightmares in the long run, since nightmares are one of the most common symptoms of stimulant withdrawal.

Others may use alcohol or marijuana before bed to relax or induce sleepiness. Although these substances may make it easier to fall asleep, they can negatively impact the quality of sleep. Like stimulants, these substances can trigger nightmares during the withdrawal process.

Treating Nightmare Disorder and Co-Occurring Substance Use Disorders

Nightmare disorder and substance use disorders are problematic conditions. When they co-occur, the individual will need comprehensive treatment that addresses both conditions simultaneously.

If you or a loved one is using alcohol or other drugs and has frequent nightmares, it may be time to call The Recovery Village. When you call, a representative from The Recovery Village will offer information and guidance regarding treatment options to manage your co-occurring disorders. Reach out today to get started.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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Medically Reviewed By – Eric Patterson, LPC
Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more

American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013.

Aurora R.N., Zak R.S., Auerbach S.H., et al. “Best Practice Guide for the Treatment of[…]e Disorder in Adults.” Journal of Clinical Sleep Medicine, August 15, 2010. Accessed on April 10, 2019.

Mahfoud Y, Talih F, Streem D, Budur K. “Sleep Disorders in Substance Abusers: How Common are They?.” Psychiatry, September 2009. Accessed April 10, 2019.

Orrange, S. “7 Medications That Cause Nightmares and Disturbing Dreams.” GoodRx, June 4, 2018. Accessed April 10, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.