After the victim's first attempt to sleep, it incurs a -2 penalty on all WIS based skill checks. This penalty persists as long as the Symphonic Nightmare maintains its hold on the target. This spell affects all creatures that sleep or enter sleep-like trances, although creatures without the need to sleep are effectively immune.

In addition, the creature's sleep is now haunted. It can no longer gain complete rest from sleeping or resting. The target does not regain hit points or heal ability damage naturally, nor is it able to prepare spells if doing so requires a full night's rest.

The creature is, however, now immune to the 'dream' and 'nightmare' spells, as well as to other effects that cause nightmares (such as a night hag's dream haunting ability).

The caster may lift the effects of this curse at will, but it is otherwise difficult to remove a Symphonic Nightmare before its duration expires. A Remove Curse cast at a higher caster level than the Symphonic Nightmare spell removes it, as does a successful Break Enchantment. Otherwise, a Wish or Miracle is required to lift the curse.

Focus: A small statue of an opened skull within which is arranged a miniature orchestra. The quality of this component must be extraordinary, and carries a value of 1,000gp.