Sleep Specialists Assess Treatments for Nightmares in Adults
Psychiatric News September 21, 2018 Lynne Lamberg
The American Academy of Sleep Medicine recommends image rehearsal therapy (IRT) as first-line treatment for PTSD-associated nightmares and nightmare disorder in adults. IRT involves imagining a more positive outcome for a nightmare's storyline and rehearsing the new scenario mentally 10 to 20 minutes a day. Nine randomized controlled trials enrolling nearly 800 subjects found IRT effective in reducing nightmare frequency and distress. Other interventions that may be used include various behavioral therapies and medications such as olanzapine, prazosin, and gabapentin. Clonazepam and venlafaxine are not recommended for nightmare disorder because studies found no benefits.