After a nightmare, the first job is to tell your body the danger is over. Remind yourself it was a dream, look around and touch something real, and breathe slowly until your heart rate settles. If you're still wide awake after 10 to 15 minutes, get out of bed for a short while and go back when you feel sleepy.
Occasional nightmares are normal and usually nothing to worry about. Frequent ones are treatable. Below: a step-by-step plan for the next few minutes, why nightmares happen, how to have fewer of them, and when it's time to talk to a doctor.
What counts as a nightmare
A nightmare is a frightening dream that wakes you up (Mayo Clinic). A disturbing dream that doesn't wake you is technically a bad dream. Nightmares are usually vivid and realistic, often involve physical danger, and most people remember them clearly when they wake (AASM Sleep Education).
They're common. The American Academy of Sleep Medicine (AASM) estimates that 50% to 85% of adults have an occasional nightmare, while 2% to 8% of people have nightmares that cause real sleep problems.
Most nightmares happen during REM sleep, the dream-heavy stage. REM periods get longer as the night goes on, so nightmares are most likely in the last third of the night (AASM Sleep Education). That's why nightmares tend to wake people in the early morning hours.
What to do right after a nightmare: 7 steps
These steps come mostly from guidance by the U.S. Department of Veterans Affairs and a public health service in Western Australia, both written for people who deal with frequent nightmares. They work just as well after a one-off.
1. Remind yourself it was a dream
Say it plainly, even out loud: it wasn't real, you're safe, it's over. VA guidance suggests reminding yourself the nightmare wasn't real life (Make the Connection, VA), and the Western Australia guide adds a blunt fact worth repeating: a dream can't hurt you (North Metropolitan Health Service).
2. Ground yourself in the room
Your brain is still half in the dream. Pull it back with your senses: touch the sheets or the nightstand and describe them to yourself, count objects in the room, or walk through the steps of something routine, like making coffee (Make the Connection, VA).
3. Slow your breathing
Take slow, deep breaths to release the physical tension. If your heart is pounding, that's a normal stress response, and it will come down. Picturing your muscles loosening as you breathe out can help (North Metropolitan Health Service).
4. Release the tension in your body
Without getting up, stretch, roll your head gently, or clench your fists and let go a few times (Make the Connection, VA). It gives the adrenaline somewhere to go.
5. Turn on a low light if you need it
There's no rule against it. The Western Australia guide suggests keeping a lamp within reach so you can switch it on right away, and even checking the locks if that helps you feel safe. A drink of water or splashing your face can also break the spell. A small lamp is enough; you don't need the overhead light.
6. Get up if you can't settle
If you can't fall back asleep within 10 or 15 minutes, get out of bed for a short time (Make the Connection, VA). Do something calm in low light: read, listen to quiet music or audio. Go back to bed when you feel sleepy. Our guide on what to do when you can't sleep walks through this in detail.
7. Skip the phone, the workout and the drink
The VA advises avoiding screens, strenuous activity, and alcohol or drugs that a doctor hasn't prescribed. It also notes that sleeping pills or alcohol don't reduce how often nightmares happen over time (Make the Connection, VA). Scrolling news or social media at 4 a.m. is the opposite of what your brain needs.
Where calm audio and ASMR fit
Some people settle faster with something soft to listen to after a nightmare: quiet music, rain, a podcast, or ASMR. The Western Australia guide lists listening to relaxing music among the things you can do to shift focus. No study has tested ASMR for nightmares, so there's no evidence it prevents them or treats them.
What research does show is that most ASMR viewers use it to relax (98%) and to help them sleep (82%), according to a survey of 475 people recruited from ASMR communities, with no control group (Barratt & Davis, 2015). In a lab study, people who experience ASMR saw their heart rate drop by about 3.4 beats per minute on average while watching ASMR videos (Poerio et al., 2018). Small effects, but in the right direction for winding down.
If you want to try it after a bad dream:
- Pick a calm voice or no voice. Soft-spoken ASMR is a gentle, ordinary-sounding voice, which some people find more reassuring than close whispering. No-talking ASMR gives you sounds with nothing to follow.
- Avoid anything unpredictable or eerie. Skip roleplays with dark themes or sudden sound changes. On Tingly Room you can also hide triggers you don't like.
- Choose before you lie down, then put the screen face down with the volume low, so you're not staring at a bright screen.
- Set a sleep timer so the audio stops once you drift off.
If audio keeps you more alert, turn it off. The goal is to feel safe and sleepy again, not to find the perfect video.
Why nightmares happen
Often there's no clear reason. But several things make them more likely, according to Mayo Clinic and the AASM:
- Stress and anxiety, including big life changes like a move, a new job or a loss (Mayo Clinic). A Cleveland Clinic sleep psychologist describes unresolved daytime problems spilling over into nightmares (Cleveland Clinic, 2024).
- Trauma and PTSD. Repeated nightmares with the same content are common after severe stress or trauma (AASM Sleep Education).
- Too little sleep or an irregular schedule. Sleep deprivation, schedule changes, insomnia and being overtired all raise the odds (Mayo Clinic).
- Medications, including some antidepressants, blood pressure drugs, beta blockers, Parkinson's medications and smoking-cessation drugs. Don't stop a prescription on your own; talk to your doctor.
- Alcohol, drugs and withdrawal. Mayo lists heavy drinking, drug use and withdrawal as triggers. Cleveland Clinic notes that alcohol can fuel intense dreams and nightmares as your sleep is broken up through the night (Cleveland Clinic).
- Quitting cannabis. Disturbing dreams and nightmares are among the most common symptoms of cannabis withdrawal (Cleveland Clinic). Across 11 studies, about a third of people in withdrawal reported strange dreams (Gates et al., 2016). If that's you, see vivid dreams after quitting weed.
- What you watch or read before bed. Scary movies, upsetting news or a tense conversation late in the evening may show up in your dreams (Cleveland Clinic, 2024).
How to stop nightmares from coming back
You can't fully prevent nightmares, but you can lower the odds.
- Keep a regular sleep and wake time. Mayo Clinic says a consistent schedule and bedtime routine can help (Mayo Clinic).
- Wind down with something quiet. Reading, a warm shower, deep breathing or relaxation exercises in the last hour before bed.
- Go easy on alcohol, especially in the evening.
- Watch the late-night content. Save the horror movie or the doomscroll for earlier.
- Deal with stress in the daytime. Talk it through, write it down, or get help from a professional if it's piling up.
- Rewrite the ending. Mayo suggests writing the nightmare down or talking about it, then imagining a different, non-threatening ending. That's the core of the main treatment below.
Imagery rehearsal therapy: the recommended treatment
Imagery rehearsal therapy (IRT) is simple to describe. While awake, you write down a recurring nightmare, change the story so it's no longer frightening, and rehearse the new version in your mind regularly (AASM, 2018).
In its 2018 position paper, the AASM rated IRT the only "recommended" treatment, for both nightmare disorder and nightmares linked to PTSD (Morgenthaler et al., 2018). Other options, such as cognitive behavioral therapy, relaxation, exposure-based therapies and the blood pressure drug prazosin, were rated "may be used," meaning the evidence was less clear. The panel advised against clonazepam and venlafaxine for nightmare disorder.
Two honest caveats. The paper was a position statement based on expert review, not a full clinical guideline, and the authors called for more randomized trials. And while you can try rewriting a dream ending on your own, IRT works best with a therapist or sleep specialist, especially if your nightmares are tied to trauma.
When to see a doctor
Occasional nightmares usually aren't a concern. See a healthcare professional if your nightmares (Mayo Clinic):
- Happen often and keep going over time
- Regularly disrupt your sleep
- Make you afraid to go to sleep
- Make daytime life harder, through sleepiness, mood or concentration
When nightmares happen often enough to cause distress and wreck your sleep, that's called nightmare disorder. A doctor may ask you to keep a sleep diary for two weeks, and may refer you to a behavioral sleep medicine specialist (AASM Sleep Education).
If your nightmares replay something that happened to you, or started after a traumatic event, ask about PTSD and mental health support. PTSD treatment works (Make the Connection, VA). Nightmares are also linked to depression, anxiety and, in some people, suicidal thoughts (Mayo Clinic).
If you're in crisis or thinking about harming yourself, call or text 988 for the 988 Suicide & Crisis Lifeline. Veterans can dial 988 and press 1 for the Veterans Crisis Line, or text 838255 (Make the Connection, VA).
