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The thing is... when Dean wakes from the nightmares, he's not scared. He's not upset or angry or any of the things he knows he should be.
He's hungry.
Sometimes it's for food. Sometimes it's for sex. Sometimes it's for darker things.
Today, he wakes up horny as hell. He hasn't gotten laid in a while - Sammy being all worried means he's on a short leash - and it's starting to get to him.
He doesn't bother to worry about why dreams about killing make him wake up with a boner. It's less disturbing than when he wakes up craving steak.