Dreams hold particular relevance in mental
health work with American Indians (AIs). Nightmares
are a common sequelae of trauma and a frequent
defi ning feature of post-traumatic stress disorder
(PTSD). Despite mounting evidence of the prevalence
of trauma and PTSD among AIs and the important
cultural role of dreams, no work to date has directly
examined nightmares in trauma. Drawing from
epidemiological and clinical sources, data are presented
about nightmares among Northern Plains AI veterans.
Nightmares are common among these veterans: 97%
of combat veterans with PTSD report nightmares.
These rates are higher than rates among other veteran
populations. The frequency of nightmares and sleep
disturbances increases with trauma and PTSD severity
in this population. Qualitative materials, in the form
of a brief cultural overview and a case presentation, are
included to illustrate clinical and cultural contexts of
nightmares in the Northern Plains. Clinicians working
with this population should be aware of the high
frequency and cultural context of nightmares for AI
veterans. In order to improve culturally appropriate
care, further research is needed to better understand
the frequency, meaning, and context of nightmares in
trauma and PTSD for AI populations.