In an uncontrolled pilot study, five veterans from recent wars with combat-related PTSD were trained in transcendental meditation and followed for 12 weeks. All participants improved on the primary PTSD symptom measure, with an average score reduction of 31.4 points. Significant improvements were also seen in clinician-rated severity, quality of life, and a self-reported PTSD checklist. The findings suggest that TM may help alleviate PTSD symptoms and improve quality of life in this small group, but larger, placebo-controlled studies are needed to confirm efficacy.
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.
Among 54 military veterans with posttraumatic stress disorder (PTSD) and recurrent nightmares, over half reported experiencing lucid dreaming—awareness during a dream that one is dreaming. Nearly all of those individuals specifically reported lucidity in nightmares. The lucid nightmare profile featured high awareness of dreaming but low control over dream content. Veterans described feeling stuck and anxious, and they tried unsuccessfully to awaken from these lucid nightmares. The findings suggest that lucid nightmares occur commonly in veterans with PTSD, with a profile similar to that previously reported for lucid dreaming experiences generally in this group.
The nightmares of 48 male U.S. Vietnam war veterans with combat-related PTSD were predominantly replays of actual combat events involving death, violence, and fear for one's life. In Imagery Rehearsal therapy, rescripted dreams that addressed or resolved the nightmare theme were linked to reduced sleep disturbance, but including violent details in the rescripted dream predicted poorer treatment outcome in nightmare frequency (B = 5.69, SE = 1.14). Experiencing olfactory sensations in nightmares, a possible marker of nightmare intensity, also predicted poorer treatment response (B = 2.95, SE = 1.06). The therapy may be most effective when rescripted dreams resolve the nightmare theme and exclude violent content.