Distressing dreams related to a traumatic experience, often vivid and realistic, that can disrupt sleep and leave the person feeling frightened or distressed on waking. Nightmares are a recognised symptom of PTSD and acute stress reactions and are common in both survivors and co-survivors following cardiac arrest. For survivors, nightmares may incorporate distorted versions of the ICU experience, of being unable to breathe, or of medical procedures. For co-survivors, they often replay the moment of collapse or the resuscitation. Nightmares tend to be most intense in the weeks immediately following the event and often reduce over time, though for some people they persist. Image Rehearsal Therapy (IRT) — a technique involving consciously rewriting the nightmare while awake — is an evidence-based treatment specifically for trauma-related nightmares.
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