An expert consensus panel reviewed treatment manuals for cognitive behavioral therapies for nightmares (CBT-N) tested in randomized clinical trials with adults. The panel developed guidelines for standardized implementation and terminology of CBT-N, addressing patient symptom presentations appropriate for treatment and components such as session length, relaxation training, stimulus control, sleep efficiency training, sleep hygiene, nightmare exposure, nightmare rescripting, and imagery rehearsal of rescripted dreams. The recommendations aim to clarify confusion caused by unstandardized nomenclature and implementation nuances, and are intended to be revised as new research evidence emerges.
A small trial tested cognitive behavioral therapy for nightmares (CBT-N), adapted for people with narcolepsy, with or without targeted lucidity reactivation (TLR) to enhance lucid dreaming. Six adults who had frequent nightmares (at least 3 per week) received seven treatment sessions. Nightmare frequency dropped from an average of 8.38 per week to 2.25 per week, a large improvement. Nightmare severity and symptoms such as sleep paralysis, hallucinations, and dream enactment also improved. The three participants who received TLR all recalled dreams related to their rescripted nightmare. Participants reported reduced shame and anxiety about sleep and nightmares. The findings offer preliminary evidence that CBT-N and TLR may help manage narcolepsy-related nightmares.