The Effectiveness of Imagery Rescripting Interventions for Military Veterans With Nightmares and Sleep Disturbances: A Systematic Review and Meta‐Analysis
Marya Hicks, Laura M. Simonds, Linda Morison
Clinical Psychology & Psychotherapy July 1, 2024 DOI: 10.1002/cpp.3025 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 658 |
| Population | Military veterans with sleep disturbances or nightmares |
| Intervention | Imagery rescripting |
| Topics | Dreaming |
| Keywords | Psycinfo Psychological intervention Meta-analysis Cinahl Medline Clinical psychology |
| Citations | 4 |
| Key findings | Imagery rescripting interventions significantly improved sleep quality but not nightmare frequency in military veterans compared to control groups. |
Abstract
Imagery rescripting (ImRs) interventions have been found effective in improving sleep outcomes, although research has mostly focused on civilian, rather than military, samples. The aim of this review was to estimate the overall effectiveness of ImRs interventions for military veterans on primary outcomes of nightmare frequency and sleep quality. A systematic search was conducted in CINAHL, MEDLINE, PsycArticles, PsycINFO, Psychology and Behavioural Sciences Collection and the PTSDpubs database and was completed on 1 November 2021. Randomised controlled trials, nonrandomised trials and pre-post studies of ImRs interventions in veterans with sleep disturbances or nightmares were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project (EPHPP) tool, and meta-analysis was performed using Stata. Nineteen articles from 15 empirical studies were included in the review, and data from the 15 studies (involving 658 participants) were included in the meta-analysis. Meta-analysis findings indicated that ImRs interventions are associated with significant positive changes from pretreatment to posttreatment for nightmare and sleep quality. Significantly greater improvements were found in ImRs interventions compared to control groups for sleep quality (Hedges' g = -0.65, 95% CI [-1.20, -0.10]) but not for nightmare frequency (Hedges' g = -0.10, 95% CI [-0.34, 0.14]). Overall, the meta-analysis included a relatively small number of studies with poor methodological quality and considerable heterogeneity; therefore, findings should be cautiously interpreted. Further research should focus on veteran participants with larger samples and from a broader range of sources to determine effectiveness more confidently.
Comparable studies
Other systematic reviews and meta-analyses on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Dreaming as mind wandering: evidence from functional neuroimaging and first-person content reports. | 2013 | Systematic review with meta-analytic comparison | |
| Lucid dreaming incidence: A quality effects meta-analysis of 50 years of research | 2016 | Meta-analysis | |
| The effectiveness of lucid dreaming therapy in patients with nightmares: A systematic review. Adults with chronic and recurring nightmares | 2023 | Systematic review | |
| The relationships between insomnia, nightmares, and dreams: A systematic review Individuals without a concomitant psychopathology, including those with insomnia or... | 2024 | Systematic review | |
| Psychosocial treatments for nightmares in adults and children: a systematic review | 2023 | Systematic review |
Citations in the library
Cited by 2
Cites 27
- Efficacy of a Cognitive‐Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD Journal of Clinical Psychology April 29, 2013
- A combined group treatment for nightmares and insomnia in combat veterans: A pilot study Journal of Traumatic Stress November 11, 2009
- Post-Traumatic Stress Disorder Nightmares and Sleep Disturbance in Iraq War Veterans: A Feasible and Promising Treatment Combination Journal of Aggression Maltreatment & Trauma July 23, 2009
- Telephone-guided imagery rehearsal therapy for nightmares: Efficacy and mediator of change. Journal of Sleep Research June 1, 2021
- Comparative efficacy of imagery rehearsal therapy and prazosin in the treatment of trauma-related nightmares in adults: A meta-analysis of randomized controlled trials. Sleep Medicine Reviews April 1, 2020
and 22 more in the library