Treatment for Chronic Nightmares
Most people with chronic nightmares and disturbing dreams are unaware so many other individuals suffer the same problem. At minimum, no less than 4% of the adult population and a much greater proportion of children and adolescents regularly report problems with bad dreams or what’s called a “chronic nightmare disorder” in clinical terms.
Adding to this individual lack of awareness, there are at least two other aspects about chronic nightmare disorder that fly very low under the radar, both for the nightmare sufferers and their healthcare professionals, including mental health doctors and therapists.
First, an extremely small proportion of individuals—patients or providers—recognize bad dreams can actually be treated. Surprisingly, even though the right kind of therapy almost always decreases or eliminates nightmares, most patients or professionals are taken by surprise when told such treatment exists.
The second and possibly more remarkable news is nightmares generally respond to six different types of therapy, and only one involves the use of a medication known as Prazosin. Among the other five, only two involve psychotherapy techniques, including emotion-focused therapies and psychodynamic psychotherapies. The remaining three include what is generally described as: dream interpretation therapy or dream therapy for short; a relatively newer cognitive-imagery program known as Imagery Rehearsal Therapy (IRT), which is now considered the top treatment choice for chronic nightmares even for those suffering from trauma-related disturbing dreams; and, finally, believe it or not, emerging evidence indicates a CPAP device significantly decreases the frequency of chronic nightmares.
Perhaps more astonishing, it does not necessarily matter how you developed the problem of nightmares or what causes the nightmares to persist to gain benefit from this diverse array of therapeutic options; although, some techniques appear more suitable than others depending on the circumstances, patterns, and physiology of the individual’s overall sleep quality.
We’ll be developing this topic in more detail at the next Discussion group on Thursday, November 4th at 8 pm Eastern.
In the meantime, if you want to learn more about IRT, we have two resources available at the main website, including an instruction video and an audio workbook series: https://barrykrakowmd.com/products-for-sleep-patients-and-sleep-professionals/