The dream experience or the sleep disturbance resulting from the awakenings causes significant distress. The patient repeatedly awakens with detailed recall of long, frightening dreams. These usually occur in the second half of the sleep or nap period and concern threats to security, self-esteem or survival. The patient quickly becomes alert and oriented upon awakening. The symptoms are directly caused by a general medical condition or substance use, including medications and drugs of abuse.
Some disorders have similar or even the same symptoms.
The frequency of episodes is variable both within and among individuals. In many cases three or more nightmares per week are reported. Children frequently outgrow the disorder. If it begins in adulthood, however, the disorder often persists for decades. The disorder is reported to be particularly common in people with frequent physical and mental health problems.