A single 30-minute telephone counseling session that included information on nightmare causes and a shortened version of imagery rehearsal therapy (IRT), followed by 8 weeks of self-practice, significantly reduced both nightmare frequency and distress in 28 participants drawn from a student group and a sleep-laboratory patient group. Effect sizes were very high compared to waiting-list control groups in similar studies. The approach may offer a low-threshold intervention for nightmare sufferers who rarely seek help.
About 20% of 1,125 patients at a sleep center expressed interest in learning more about nightmare causes and treatments, including those who had never sought help before. The findings suggest that nightmares are underdiagnosed and undertreated even in specialized settings, and that health care professionals should routinely ask about nightmares and consider offering internet-based self-help programs as an initial step.