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NIGHTMARES: Is there an effective therapy?

The literature suggests that1 in 6 children with mental health problems also suffer from chronic nightmares. This prevalence is most likely underestimated while nightmares are rarely included in routine clinical screening. However, known to be a symptom of post-traumatic stress disorder, nightmares do not always disappear with the resolution of the mental health disorder and PTSD. There is therefore a need for therapy to specifically treat nightmares, regardless of the child’s comorbidities – and in adults too.

One of the lead authors, Dr. Tara Buck, a child and adolescent psychiatrist and associate professor of psychiatry at OU adds: “There is a lack of research on nightmares in children; a few studies have been carried out with adults. However, when children suffer from nightmares, they are afraid to fall asleep, they are tired and irritable, they develop behavioral problems, they experience difficulties at school, which has lifelong consequences.

The new therapy combines cognitive behavioral therapy (CBT), relaxation strategies, mindfulness, stress management and visualization to modify the structure of dreams could therefore be a valuable option for these children and adolescents.

The studythe first randomized clinical trial to test a therapy for nightmares in children, marks a step toward treating nightmares as a disorder in its own right, and not just a symptom of a mental health problem. OU psychologists and psychiatrists began by adapting a “sleep” therapy that includes

  • 5 weekly sessions aimed at raise awareness of the importance of sleep for health including mental health,
  • has anchor good habits sleep,
  • “rewrite” the nightmare into a pleasant dream.

At inclusion, young participants also receive by mail a box containing objects to use during therapy, including “protective glasses” which help to better understand the effects of lack of sleep, a pillowcase associated with a good sleep and markers to write or draw the things or situations they want to think about at bedtime.

Therapy thus combines TTC, relaxation strategies, mindfulness, stress management and visualization or reformulation, to modify the content of dreams. This latter technique makes it possible to

“change the channel and go back to sleep”.

The ultimate goal is to become the master of your dreams again.

The trial carried out with 46 young people aged 6 to 17, victims of chronic nightmares for at least 6 months and in some cases years, confirms that the therapy, developed step by step, ultimately allows:

  • a statistically significant reduction in nightmares;
  • a reduction in suicidal thoughts linked to nightmares;
  • an improvement in the quality of sleep and a reduction in the number of nighttime awakenings.

“We can talk about strategies for treating a child’s anxiety during a clinical examination, but it is only now that we are beginning to address the issue of nightmares which, however, can trap subjects in a vicious cycle: lack of sleep, anxiety disorders, distress, and chronic nightmares.”

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