Martraðir

Martraðir, the Icelandic term for nightmares, refer to distressing dreams that provoke strong fear, anxiety, or distress and are often remembered upon waking. They typically occur during rapid eye movement (REM) sleep and are more vivid and emotionally intense than ordinary dreams. Because of their disturbing content, martraðir can disrupt sleep and lead to difficulty returning to sleep after waking.

Prevalence and risk factors vary by age. In adults, frequent nightmares are estimated to affect about 2-8% of people, while the rate is higher among children. Risk factors include stress, exposure to trauma, anxiety or depressive disorders, sleep deprivation, and certain medications or substances (such as some antidepressants, beta-blockers, alcohol, or cannabis). Irregular sleep schedules and high sleep fragmentation can also contribute.

Causes and differential diagnosis. Martraðir can be triggered by acute stress, ongoing psychosocial difficulties, medical illnesses, or fever. They are distinct from sleep disturbances such as sleep terrors, which typically occur during non-REM sleep, involve sudden arousal and confusion, and often lack recall of the dream content. Nightmares may also be more common or distressing in conditions like post-traumatic stress disorder (PTSD) or other anxiety disorders.

Diagnosis and treatment. Diagnosis is usually clinical, based on patient history and reported dream content. Management focuses on reducing distress and improving sleep quality. Evidence-based approaches include imagery rehearsal therapy (IRT), cognitive-behavioral therapy for insomnia (CBT-I), and general sleep-hygiene measures. Treating underlying conditions, such as PTSD or depression, can reduce Nightmare frequency. In PTSD-related cases, pharmacological options like prazosin may be considered under medical supervision.

Prognosis and impact. Frequent martraðir can contribute to sleep fragmentation, daytime sleepiness, mood disturbances, and impaired functioning. With appropriate treatment and stress management, many individuals experience a reduction in frequency or distress over time.