Abstract
Nightmares are defined as repeated occurrences of extremely dysphoric and well-remembered dreams that usually involve subjective threats to survival, security, or physical integrity. Generally, they occur during rapid eye movement sleep (REMS) and lead to awakenings with distress and insufficient overnight sleep. Nightmares may occur spontaneously (idiopathic) or as recurrent nightmares. Recurrent nightmares cause significant distress and impairment in occupational and social functioning, as have been commonly observed in post-traumatic stress disorder, depression and anxiety. By contrast, during lucid dreaming (LD), subjects get insight they are dreaming and may even control the content of their dreams. These features may open a way to help those who suffer from nightmare disorder through re-significations of the dream scene, i.e., knowing that they are dreaming and having control over their dream content. Thus, lucid dreamers might be able to render nightmares normal dreams, thereby assuring a restoring sleep. The aim of the present study is to review the existing literature of the use of LD as an auxiliary tool for treatment of nightmares. We conducted a careful literature search for eligible studies on the use of LD treatment for nightmares. We observed that whereas LD may be a feasible aid in the treatment of patients with nightmares through minimizing their frequency, intensity and psychological distress, the available literature is still scarce and does not provide consistent results. We conclude therefore that more research is clearly warranted for a better estimation of the effective conductance and therapeutic outcome of LD treatment in clinical practice.
Highlights
According to the International Classification of Sleep Disorders, 3rd Edition (American Academy of Sleep Medicine, 2014), nightmare disorder represents repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve threats to survival, security, or physical integrity
Whereas approximately 2–8% of the general population suffers from idiopathic nightmares, nightmares are a core feature of post-traumatic stress disorder (PTSD), with up to 80% of individuals with PTSD reporting disturbing and suicidal dreams with some degree of resemblance to the actual traumatic event (Hasler and Germain, 2009; American Academy of Sleep Medicine, 2014)
We found 10 original research articles dealing with lucid dreaming therapy (LDT) as a therapeutic approach for nightmares (Table 1)
Summary
According to the International Classification of Sleep Disorders, 3rd Edition (American Academy of Sleep Medicine, 2014), nightmare disorder represents repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve threats to survival, security, or physical integrity. Nightmares may occur occasionally in almost half of adults, but they may become recurrent, that is, repeated, especially in post-traumatic stress disorder (PTSD) (Hartmann, 1984; Aurora et al, 2010; Morgenthaler et al, 2018), anxiety (Haynes and Mooney, 1975; Levin, 1998; Nielsen et al, 2000; Zadra and Donderi, 2000; Tanskanen et al, 2001) and depression (Germain and Nielsen, 2003; Agargun et al, 2007). An important etiological distinction made is the difference between idiopathic and posttraumatic nightmares Idiopathic nightmares are those with unknown etiology and unrelated to other disorders (American Academy of Sleep Medicine, 2014; Robert and Zadra, 2014). Whereas approximately 2–8% of the general population suffers from idiopathic nightmares, nightmares are a core feature of PTSD, with up to 80% of individuals with PTSD reporting disturbing and suicidal dreams with some degree of resemblance to the actual traumatic event (Hasler and Germain, 2009; American Academy of Sleep Medicine, 2014)
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