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Transdiagnostic cognitive behavioral therapy for nightmares and parasomnias.

Norah Vincent, Dale A Dirkse, Eleni Giannouli, Amanda McQuarrie

Journal of Clinical Sleep Medicine March 1, 2023 DOI: 10.5664/jcsm.10374 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Pilot study Peer reviewed
Sample size 19
Population Adult sleep clinic outpatients with a DSM-5 parasomnia disorder
Intervention Transdiagnostic cognitive behavioral therapy for parasomnias (CBTp)
Duration 6-week program
Topics Dreaming
Keywords Humans Parasomnias Polysomnography Pilot projects Dreams Adult Cognitive behavioral therapy Cognitive behavioral treatment
Registration NCT04633668
Key findings Relative to a self-monitoring control, transdiagnostic cognitive behavioral therapy for parasomnias significantly improved parasomnia frequency, severity, nocturnal activity, and sleep efficiency, with trends toward reduced sleep-onset latency and better work and social adjustment. All treated participants rated themselves as improved. The authors conclude that such cognitive behavioral interventions are effective in lessening parasomnias and warrant further investigation.

Abstract

Study

Objectives: This pilot study determined whether transdiagnostic cognitive behavioral therapy for parasomnias (CBTp) reduces parasomnia and activity levels during sleep in a sample of adult sleep clinic outpatients. A secondary objective was to assess whether treatment produces improvements in daytime fatigue/sleepiness, perceived cognition, mood, and depression/anxiety/stress, as well as functional impairment in work and leisure activities.

Methods: This was a randomized controlled trial with CBTp and self-monitoring control conditions. Participants were 19 adults with a DSM 5 parasomnia disorder who received individual CBTp virtually from their homes. CBTp consisted of psychoeducation, sleep hygiene and safety instructions, relaxation training, parasomnia techniques, and relapse prevention in a 6-week manualized, structured program.

Results: Using a repeated measures analysis of variance model, and relative to a self-monitoring control condition, results showed that CBTp produced statistically significant improvements in parasomnia frequency, severity, nocturnal activity, and sleep efficiency. There was a trend toward reduced sleep-onset latency and improved work and social adjustment. Of treated participants, 100% rated themselves as improved at study conclusion.

Conclusions: Implications of these findings are that cognitive behavioral interventions for parasomnias are effective in lessening parasomnias. More investigation into this type of treatment is warranted. Clinical

Trial Registration: Registry: ClinicalTrials.gov; Name: Impact of Cognitive Behavioral Therapy on Parasomnias; URL: https://clinicaltrials.gov/ct2/show/NCT04633668; Identifier: NCT04633668. Citation: Vincent N, Dirkse D, Giannouli E, McQuarrie A. Transdiagnostic cognitive behavioral therapy for nightmares and parasomnias. J Clin Sleep Med. 2023;19(3):499-509.

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

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