[Nightmares in patients with insomnia]

Studies show a high frequency of comorbidity of insomnia and nightmares, which aggravate and chronicle each other. The mechanisms of their mutual influence are different. Insomnia changes the nature of dreams, both indirectly through emotional hyperactivation characteristic of insomnia, and as a result of frequent awakenings. However, frequent recurring unpleasant and frightening dreams can themselves increase the frequency of nocturnal awakenings and worsen the quality of sleep. The comorbidity of insomnia and nightmares should be taken into account when choosing a therapeutic approach in this category of patients. Priority are drugs that do not cause nightmares as a side effect, as well as psychotherapy.