Dear doctor; Do nightmares signify some underlying problem in health? I have recently been having one too many. Mannie, 22. Dear Mannie, A nightmare is dream that can evoke strong emotional response like fear, terror, extreme sadness or severe anxiety. They are very vivid dreams which make one sit up in fear from sleep. There may be associated sweating, dryness of mouth, pounding of heart among other symptoms. One mostly has vivid memory of it the next day. Nightmares are more common in children but do occur in adults as well. They mostly occur in rapid eye movement phase of sleep and hence, occur after midnight. A nightmare can occur due to any stressful event in one’s life or during the day time or anxiety related to any issue in coming days. Taking a heavy meal or late meal keeps body metabolism active even during sleep and can cause nightmares. Use of alcohol and other abusive substances, use of strong coffee can disturb sleep and induce night mare. It can also be caused by wearing tight or uncomfortable night clothes, obstructive sleep apnea which can occur due to obesity and or high blood pressure. Watching exciting or scary movies before sleeping may disturb sleep and induce a nightmare. Nightmares do not indicate health related problems but occur due to any problem currently or fear of some anticipated problem. Recurrent night mares may disturb sleep precipitating health problems like high blood pressure or insomnia and related problems. To have a sound sleep, one should learn to relax both physically as well as mentally. Avoid taking heavy meals at night, use of alcohol or coffee before going to sleep. Bed clothes and night clothes should be loose, comfortable and preferably of cotton. Regular physical exercise and taking a balanced diet helps to improve over all health and also obtain sound sleep without nightmares.