Nightmares

How common are nightmares and why treat them?

Nearly 1 in 20 adults in the United States suffer from nightmares or disturbing dreams, and nearly twice as many children and adolescents experience frequent nightmares. Nightmares are scary, disturbing, and bothersome. They can lead to insomnia and daytime consequences such as depression, anxiety and difficulties with memory, irritability, attention and concentration. Most nightmare sufferers cannot imagine that their nightmares are a treatable problem, resulting in few people actively seeking treatment for them. 

What is Imagery Rehearsal Therapy (IRT)?

IRT is an evidence-based, non-drug approach to nightmare treatment. Contrary to older beliefs about nightmares, in IRT, patients do not discuss the experience that may have started the nightmares or even the content of their dreams. Instead, patients focus on changing the imagery. Patients are taught ways to re-write the dream (even only a scene) and then to practice imagining the new dream during the daytime.

Research has shown that IRT is effective with a wide range of patients, from those who suffer from distressing dreams on a regular basis to those who have nightmares related to Post-Traumatic Stress Disorder (PTSD). Although nightmares are very common in childhood and generally do not require treatment, some children begin to fear going to sleep due to nightmares. This then can create daytime problems such as hyperactivity, increased napping, and attention/concentration problems. IRT has been shown to help here as well. 

How effective is IRT?

Clinical studies have shown IRT is effective for the treatment of nightmares. Some patients report improved daytime mood and functioning as a result of successful treatment of their nightmare disorder.

How long does IRT take?

Although each person's situation is unique, on average 3-4 sessions are usually required for many people to begin seeing improvement in nightmare frequency and distress. Follow-up recommendations are made to make sure that the results are maintained. Some BSM providers even offer groups for IRT.