Psychosocial treatments for nightmares in adults and children: a systematic review
Peter Gill, Emily Fraser, Thong Thai Diep Tran, Gabriel de Sena Collier, Andrew Jago, Joe Losinno, Michael Ganci
BMC Psychiatry April 21, 2023 DOI: 10.1186/s12888-023-04703-1 (opens in new tab) via OpenAlex
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Interventions | trauma-focused Cognitive Behavioural Therapy Image Rehearsal Therapy |
| Topics | Anxiety Dreaming |
| Keywords | Psychosocial Distress Psychological intervention Clinical psychology |
| Citations | 21 |
| Key findings | Exposure and image rehearsal treatments are strongly effective for reducing nightmare frequency, severity, and distress across multiple populations. |
Abstract
Background: As nightmares may be a risk factor for, or symptom of, multiple psychological disorders, some researchers suggest that nightmares should be screened, diagnosed, and treated. Treatments for nightmares include trauma-focused Cognitive Behavioural Therapy and Image Rehearsal Therapy, and pharmacological interventions such as prazosin and nitrazepam. As recent research has put into question our current understanding of treatment efficacy, there is a need to systematically review findings related to the effectiveness of nightmare treatments to inform best practice. The current review assessed the efficacy of psychosocial treatments of nightmare in all cohorts.
Methods: A systematic search of four databases for peer reviewed journal articles from 2000 onwards produced 69 (35 RCTs, 34 non-RCTs) eligible articles that underwent narrative synthesis.
Results: The results provide strong evidence for exposure and image rehearsal treatments for the reduction of nightmare frequency, severity, and distress, in civilian, military, idiopathic, and posttraumatic stress disorder (PTSD) cohorts. There is emerging evidence that self-guided and brief treatment modalities offer efficient and effective treatment options. There is an urgent need for clinical trials of treatment effectiveness in children.
Conclusions: The results suggest that treatments for nightmares are most effective when they facilitate a sense of control or mastery by directly targeting the nightmare content and/or the client's emotional responses to the nightmare content.
Trial Registration: A review protocol was registered with PROSPERO (CRD42020204861).