Long-term effectiveness of cognitive-behavioural self-help intervention for nightmares.

Two cognitive-behavioural self-help interventions for nightmares, imagery rehearsal and exposure, produced effects that were almost completely sustained 42 weeks after treatment ended. The initial improvements in nightmare measures persisted with effect sizes between 0.50 and 0.70. No differences in effectiveness were found between the two interventions. These long-term results suggest that nightmares can be effectively treated with targeted self-help approaches, and an internet-delivered intervention may serve as a good first step in a stepped-care model.

Study at a glance

Abstract

Nightmares are a prevalent disorder leading to daily impairments. Two cognitive-behavioural self-help interventions--imagery rehearsal and exposure--recently showed short-term efficacy compared to a waiting-list and a group that recorded their nightmares. This paper reports the long-term results of the imagery rehearsal (n=103) and exposure (n=95) interventions. Participants were assigned randomly to a condition after completing baseline measurements; they received a 6-week self-help intervention and completed questionnaires 4, 16 and 42 weeks after end of treatment. Initial effects on nightmare measures were almost completely sustained after 42 weeks (d=0.50-0.70); no differences were found between exposure and imagery rehearsal therapy. These results suggest that nightmares should be targeted specifically and that an internet-delivered self-help intervention seems to be a good first option in a stepped-care model.