Cognitive-behavioral self-help treatment for nightmares: a randomized controlled trial.
Jaap Lancee, Victor I. Spoormaker, Jan Van den Bout
Psychotherapy and Psychosomatics 2010 DOI: 10.1159/000320894 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 399 |
| Population | Dutch adults with nightmares recruited through a nightmare website |
| Interventions | Imagery rehearsal therapy Exposure Recording (keeping a diary) |
| Duration | 6-week self-help treatment, 11-week follow-up from baseline |
| Topics | Dreaming |
| Key findings | Imagery rehearsal therapy and exposure to nightmare imagery are equally effective in reducing nightmare complaints, with both outperforming a waiting list. |
Abstract
Several cognitive-behavioral techniques are effective in reducing nightmare frequency, but the therapeutic factor (e.g. cognitive restructuring, systematic desensitization) remains unclear. The aim of this study was to compare the nightmare treatments imagery rehearsal therapy (IRT), exposure, and recording (keeping a diary)--in a self-help format--with a waiting list. Participants were recruited through a Dutch nightmare website. After completion of the baseline questionnaires, 399 participants were randomly assigned to a condition, received a 6-week self-help treatment (or were placed on the waiting list), and filled out the post-treatment measurements 11 weeks after baseline. Compared to the waiting list, IRT and exposure were effective in ameliorating nightmare frequency and distress, subjective sleep quality, anxiety (after imagery rehearsal), and depression (after exposure; Δd = 0.25-0.56). Compared to recording, IRT reduced nightmare frequency while exposure reduced nightmare distress (Δd = 0.20-0.30; p < 0.05). The recording condition was more effective compared to the waiting list in ameliorating nightmare frequency, nightmare distress, and subjective sleep quality (Δd = 0.19-0.28; p < 0.05). IRT had a more rapid reduction on the diary compared to exposure and recording. IRT and exposure appear equally effective in ameliorating nightmare complaints. Exposure to nightmare imagery may function as the crucial therapeutic factor; however, cognitive restructuring may be a useful addition to increase immediate effects.
Comparable studies
Other randomized controlled trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Efficacy of a Cognitive‐Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD Combat veterans of Operation Enduring Freedom and/or Operation Iraqi Freedom (mean age... | 2013 | Randomized controlled trial | n = 40 |
| Lucid Dreaming Treatment for Nightmares: A Pilot Study Chronic nightmare sufferers | 2006 | Randomized controlled trial | n = 23 |
| Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study Participants spending three consecutive nights in a sleep laboratory | 2013 | Randomized controlled trial | n = 19 |
| Pre-sleep treatment with galantamine stimulates lucid dreaming: A double-blind, placebo-controlled, crossover study Adults with high dream recall and an interest in lucid dreaming | 2018 | Randomized crossover trial | n = 121 |
| Studies with lucid dreaming as add-on therapy to Gestalt therapy Adults with nightmares (ICD-10: F51.5) at least twice a week | 2015 | Randomized controlled trial | n = 32 |
Citations in the library
Cited by 29
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- Psychosocial treatments for nightmares in adults and children: a systematic review BMC Psychiatry April 21, 2023
- Interest in telephone nightmare counselling in patients with sleep-related breathing disorders Somnologie: Schlafforschung und Schlafmedizin August 3, 2020
- Parasomnias I Oxford University Press eBooks May 22, 2025
- Status of Imagery Rehearsal Therapy and Other Interventions for Nightmare Treatment in PTSD. Current Psychiatry Reports November 1, 2025
and 24 more in the library
Cites 6
- The relationship of nightmare frequency and nightmare distress to well‐being Journal of Sleep Research May 26, 2004
- A systematic review of cognitive-behavioral treatment for nightmares: toward a well-established treatment. Journal of Clinical Sleep Medicine October 1, 2008
- Dreaming in posttraumatic stress disorder: A critical review of phenomenology, psychophysiology and treatment. Psychotherapy and Psychosomatics 2007
- Nightmares: from anxiety symptom to sleep disorder. Sleep Medicine Reviews February 1, 2006
- Clinical management of chronic nightmares: imagery rehearsal therapy. Behavioral Sleep Medicine 2006
and 1 more in the library