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Answer from: NiceGuy1
Nightmare mode is only available on new games (once you finish the game and beat Kaos on Easy, Medium or Hard). Select to start a new game - I recommend a different save slot, so you can return to your regular game later - then you can set the difficulty to Nightmare before you start the game. Once you set the game to Nightmare, you can't change the difficulty on that save game. Note that once you beat Kaos on Nightmare, there's a bit of an Easter Egg, special for Nightmare mode, so don't skip everything.