Imagery rehearsal treatment for chronic nightmares.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 7677723 · doi:10.1016/0005-7967(95)00009-m
What was done
Fifty-eight chronic nightmare sufferers were randomly assigned to imagery rehearsal therapy (n = 39) or a wait-list control group (n = 19). The intervention taught participants in a waking state to modify a nightmare scenario and visualize the altered imagery. Outcomes assessed pre-treatment and at 3-month follow-up were nightmare frequency, self-rated distress, and subjective sleep quality.
What was found
Compared to wait-list controls, the treated group showed significant reductions in nightmares at 3-month follow-up: nightmare nights per week decreased by a mean of -2.0 (SD = 1.7, P = 0.0001), and the actual number of nightmares decreased by a mean of -4.2 (SD = 4.5, P = 0.0001). Treated subjects also had significant improvement in self-rated sleep quality compared to controls (P = 0.004), and nightmare reduction was significantly correlated with sleep improvement (r = 0.55, P = 0.0001).
Why it matters
This study provides early randomized evidence that chronic nightmares can be effectively treated with a brief, cognitive-behavioral imagery intervention.
Limits
The study had a small sample size (n = 58) with unbalanced group allocation, utilized an inactive wait-list rather than an active control, relied entirely on subjective self-report rather than objective sleep metrics, and followed participants for only 3 months.
Cited by
- supports Rewriting the ending of a recurring nightmare and reading it repeatedly before sleep alters the dream's content over a period of 7 to 10 days.