National Sleep Foundation

Chapter 6: Parasomnias

Treatment of Nightmares

Cognitive-behavioral therapy — including assertiveness training and outcome rehearsal — has been shown to be effective for the treatment of nightmare disorder not associated with an underlying medical or psychiatric disorder1 2.    Other treatments include eye movement desensitization and preprocessing and hypnosis3.

Treatment for disturbed dreaming depends upon an accurate identification of the underlying conditions or factors leading to the disturbed dreaming, such as anxiety, depression, Post-Traumatic Stress Disorder (PTSD), substance abuse, or use of certain prescription medications4.  (For example, nightmares that occur as a result of PTSD can be treated with prazosin.5)

References

  1. Schenck CH, Mahowald MW. Rapid eye movement sleep parasomnias. Neurol Clin. 2005;23:1107-1126.
  2. Nielson T, Zadra A, “Idiopathic Nightmares and Dream Disturbances Associated with Sleep-Wake Transitions,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 1106-1115.
  3. Nielson T, Zadra A, “Idiopathic Nightmares and Dream Disturbances Associated with Sleep-Wake Transitions,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 1106-1115.
  4. Nielson T, “Disturbed Dreaming as a Factor in Medical Conditions,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 1116-1127.
  5. Simon Kung S, Espinel Z, and Lapid MI, “Treatment of Nightmares With Prazosin: A Systematic Review,” Mayo Clin Proc. 2012 Sep; 87(9): 890–900. doi:  10.1016/j.mayocp.2012.05.015