Why do I have nightmares while sleeping, yet my mind feels very alert and conscious? It's terrifying—what should I do?

Experiencing nightmares while sleeping, along with mental alertness and a sense of terror, may be caused by physiological factors, or could result from pathological conditions such as neurasthenia or autonomic nervous system dysfunction. These symptoms can be improved through general treatments or medication. Specific analyses are as follows:

1. Physiological Causes

If the sleeping environment is noisy, it may affect sleep quality and lead to the aforementioned symptoms. Usually, these issues gradually improve once the environment is optimized.

2. Pathological Causes

1) Neurasthenia

Neurasthenia is a psychological disorder resulting from prolonged stress and high pressure. If a person suffers from this condition, the nervous system may remain in a constant state of tension, leading to the symptoms described. For this condition, patients are advised to take appropriate medications under a doctor's guidance, such as diazepam tablets, clonazepam tablets, or buspirone hydrochloride tablets.

2) Autonomic Nervous System Dysfunction

Contributing factors for autonomic nervous system dysfunction include psychosocial stress and genetic predisposition. This condition may trigger sleep disorders, manifesting as the symptoms mentioned above. In such cases, patients may follow medical advice to use medications like oryzanol tablets, Anshen Bunao liquid, or Yangxue Qingnao granules to alleviate symptoms.

In addition to the above causes, these symptoms might also be due to heart disease, sleep apnea syndrome, Parkinson’s disease, or other conditions. If significant discomfort occurs, patients should promptly seek medical attention at a reputable hospital to avoid adverse effects on health.