Endorsement of: "Position paper for the treatment of nightmare disorder in adults: An American Academy of Sleep Medicine position paper" by the World Sleep Society.
F Provini, Birgit Högl, Alex Iranzo, C Kushida, J-Y Lee, G Shukla, Ambra Stefani, Y K Wing, R Malkani
Sleep Medicine January 2, 2025 DOI: 10.1016/j.sleep.2025.01.001 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Dreaming |
| Key findings | The authors argue that nightmare disorder is common in adults (2–6%) and highly prevalent in PTSD (88%), military and veteran populations (31%), and isolated REM sleep behavior disorder (93%), and that despite many available treatments, direct evidence is limited and key questions about definition, assessment, comorbidity, outcome measurement, subpopulations, and healthcare integration remain unanswered. |
Abstract
According to the ICSD-3TR, nightmare disorder is characterized by extended, extremely dysphoric, and well-remembered dreams that usually involve threats to survival, security, or physical integrity. The dream experience causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Nightmare disorder occurs in 2–6% of adults. Nightmares are present in 88 % of patients with post-traumatic stress disorder (PTSD), in 31 % of active-duty military populations and war veterans, and in 93 % of patients with isolated REM sleep behavior disorder (RBD). Nightmares can also occur in the setting of other sleep disorders including severe obstructive sleep apnea, periodic limb movement disorder, non-REM parasomnias and narcolepsy. However, for many available treatment options for nightmare disorder, direct evidence is limited, and numerous research questions remain unanswered. Concerns in therapeutic studies include the etiology and definition of nightmares, their assessment methodologies, the high comorbidities of nightmares with other sleep disorders (especially insomnia, RBD, narcolepsy, and obstructive sleep apnea) and PTSD, outcome measures to assess improvement, the heterogeneous subpopulations (adults, children, military veterans and refugees), and the integration of nightmare treatments into different healthcare systems.
Comparable studies
Other narrative reviews on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The cognitive neuroscience of lucid dreaming | 2019 | Review | |
| Sleep and dreaming are for important matters | 2013 | Review | |
| Nightmare Disorder and Isolated Sleep Paralysis | 2020 | Review | |
| My Dream, My Rules: Can Lucid Dreaming Treat Nightmares? | 2019 | Review | |
| Dream Recall: State or Trait Variable? Part I: Model, Theories, Methodology and Trait Factors | 1996 | Review |
Citations in the library
Cites 18
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- Nightmare Disorder and Isolated Sleep Paralysis Neurotherapeutics November 23, 2020
- Posttraumatic sleep disturbances in veterans: A pilot randomized controlled trial of cognitive behavioral therapy for insomnia and imagery rehearsal therapy. Journal of Clinical Psychology November 1, 2023
- The Effects of Pharmacological Treatment of Nightmares: A Systematic Literature Review and Meta-Analysis of Placebo-Controlled, Randomized Clinical Trials. International Journal of Environmental Research and Public Health December 31, 2022
- Enhancing imagery rehearsal therapy for nightmares with targeted memory reactivation. Current Biology November 21, 2022
and 13 more in the library