Only about five percent of adults have a clinical problem with nightmares, in that the dreams are so frequent and/or severe that they seek help. "It's really a question of how much distress it's causing," Nielsen says. If the nightmares are regularly disturbing your sleep, then you should probably visit a sleep clinic, where specialists can diagnose if your only problem is nightmares, or if you have something more serious, like sleep apnea.
"Sleep deprivation is like having a loan out from the bank," says Mingrone. "You've got to pay the sleep debt back."
For some, relief may come not from a sleep clinic, but from a psychologist's office. "The best way to avoid nightmares is to deal with any underlying anxiety problems," Nielsen says. The deep dark secret; the car crash that scarred you; the wicked aunt-turned witch—if these stressors are seeping into your dreams and disrupting precious REM sleep, it may be worth hashing it out consciously, with a specialist.
At the end of the day, or rather, at the end of the scary night, most people don't need or want treatment for nightmares. In fact, many don't mind them. "Often people come in and say [their nightmares] are a source of creativity or they're quite interested in them." Nielsen says. "They don't want to lose them."