Expanding Self-Help Imagery Rehearsal Therapy for Nightmares with Sleep Hygiene and Lucid Dreaming: A Waiting-List Controlled Trial

Nightmares are a common disorder with serious consequences. Recently, the cognitive behavioral interventions Imagery Rehearsal Therapy (IRT) and exposure proved effective in a self-help format. The aim of the current study was to compare the following self-help formats to a waiting-list: IRT; IRT with sleep hygiene; and IRT with sleep hygiene and a lucid dreaming section. Two-hundred-seventy-eight participants were included and randomized into a condition. Follow-up measurements were 4, 16, and 42 weeks after treatment completion. Seventy-three participants completed all questionnaires and 49 returned the nightmare diaries. Contrary to our expectations, the original IRT was more effective than the two other intervention conditions. Moreover, IRT was the only intervention that convincingly proved itself compared to the waiting-list condition. However, these data should be interpreted with caution due to the low power and high dropout. Yet it seems that in a self-help format, IRT and exposure (which was validated previously) are the treatments of choice for nightmares.