Management of Nightmare Disorder in Adults

Erin D. Callen, PharmD, BCPS; Tiffany L. Kessler, PharmD, BCPS; Krista G. Brooks, PharmD; Tom W. Davis, MD


US Pharmacist. 2018;43(11):21-26. 

In This Article

Nonpharmacologic Treatment

The only treatment strategy with enough evidence to be recommended in the AASM's position paper is behavioral intervention with imagery-rehearsal therapy (IRT).[3] IRT is based on the theory that nightmares are a learned behavior and can be replaced by a less disruptive behavior that will not ultimately affect sleep or daytime functioning. Patients are asked to recall the nightmare, write it down, alter its content to a positive outcome, and rehearse the rescripted dream for 10 to 20 minutes each day. Additional treatments that may be used for both PTSD-associated nightmares and nightmare disorder include cognitive behavioral therapy and exposure, relaxation, and rescripting therapies. Other behavioral strategies include hypnosis, lucid-dreaming therapy, eye-movement desensitization and reprocessing, and progressive deep-muscle relaxation techniques.[3]