DARC-NESS: a mastery-based cognitive-behavioral model for treating chronic nightmares in youth
Frontiers in Sleep February 27, 2026 Lisa DeMarni Cromer, Emily Kaier Cromwell, Lauren Prince et al.
A new theoretical model called DARC-NESS explains how nightmares persist by highlighting nightmare self-efficacy as a central mechanism. The model identifies seven interacting components: Dream (nightmare) content, Appraisals, Resources for regulation, Conditioned arousal, Nightmare Efficacy, Sleep hygiene and patterns, and Sleep quality and quantity. These factors perpetuate nightmares through a vicious cycle. The model provides the basis for cognitive behavioral therapy for children's nightmares and suggests treatment strategies for each component. A case illustration shows how interventions can break the cycle. Flexible clinical applications help clinicians select and sequence modular treatment elements tailored to individual cases.