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Treatment of nightmares and night terrors depends on the age of the patient and the cause of the sleep disturbance.

The frequency of nightmares and night terrors decreases in most children as they age. Because nightmares rarely indicate an underlying disorder in children, most respond well to reassurance and support. Children are rarely treated with medication.

To reassure children, parents or guardians may want to:

• Minimize the child’s exposure to frightening images, such as violence on television and in video games
  
  
• Read, talk and relax with children
  
  
• Ensure that bedtime is safe and comfortable for children
  
  
• Help the child imagine a happy ending to nightmares if they occur frequently
  
  
• Encourage older children to keep a dream journal

Patients experiencing night terrors should never be awoken because they are not rational and may lash out at the person awakening them.

Adults who experience occasional nightmares may also respond well to reassurance and support. However, adults who experience chronic nightmares that disrupt daytime functioning may require therapy. Behavior therapy, which may consist of group or individual counseling with a mental health professional, has proven especially beneficial.

Therapy may be required for patients whose nightmares are associated with post-traumatic stress disorder (PTSD), a psychiatric illness that occurs after a traumatic event in which the threat of injury or death was present. Some types of therapy used to treat patients with PTSD include:

• Cognitive restructuring. Therapy technique during which a patient identifies negative, irrational beliefs and replaces them with truthful, rational statements.
  
  
• Exposure therapy. Involves exposing patients to prolonged and repeated images of trauma until the images no longer cause severe anxiety.

Some patients with PTSD are treated with antidepressant medications. Patients should be aware that a physician may need to adjust the dosage or change medications to achieve the best results with minimal side effects. In addition, the U.S. Food and Drug Administration (FDA) has advised that antidepressants may increase the risk of suicidal thinking in some patients and all people being treated with them – especially children - should be monitored closely for unusual changes in behavior.

Patients with REM sleep behavior disorder may be treated with benzodiazepines (medications that slow down the central nervous system) or antidepressants.