scholarly journals 1222 Does Creativity & “Dose” Enhance Outcomes in Imagery Rehearsal Therapy? A Case of Successful IRT

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A467-A467
Author(s):  
Alicia J Roth ◽  
Michelle Drerup
Keyword(s):  
Sleep Quality ◽  
Verbal Memory ◽  
Self Efficacy ◽  
Guided Imagery ◽  
Average Intensity ◽  
Mild Depression ◽  
Written Narratives ◽  
Imagery Rehearsal Therapy ◽  
Nightmare Disorder ◽  
Imagery Rehearsal

Abstract Introduction Imagery Rehearsal Therapy (IRT) is an efficacious treatment for Nightmare Disorder. In IRT, patients practice pleasant guided imagery techniques, then use these skills to re-script recurring nightmares, which lowers the frequency and intensity of overall nightmare activity. However, the most efficacious methods and dosage of guided imagery and nightmare re-scripting is undetermined. Report of Case The patient was a 70-year-old male with Nightmare Disorder. Patient denied any precipitating event or trauma associated with nightmare onset. He has a longstanding history of depression and OSA (uses CPAP). He was taking Seroquel, which reduced severity of nightmares but not frequency. Trials of other medications for nightmares had failed (including prazosin, Depakote, and trazodone). Patient presented as highly distressed, exhibited distrust towards medical providers, and was skeptical about the effectiveness of IRT. Despite his skepticism, patient self-initiated very detailed and media-enhanced methods for pleasant guided imagery and nightmare re-scripting, including written narratives, voice recordings, and created a movie of his re-scripted nightmare with pictures set to music. He listened to the recordings 2-3x/day. Themes of nightmares included lack of mastery over problems; patient’s re-scripted dreams put him back in control of frightening scenarios. Nightmare logs at baseline showed sleep quality=1.9/5; average=2.0 nightmares/night; average intensity= 6.2/10. At week 15 of treatment, sleep quality=3/5; nightmares/night average=0.25; average intensity=6/10. Sleep disturbance also improved (ISI=18-moderately severe clinical insomnia to 11-subthreshold insomnia); mood was stable (PHQ=5-mild depression). Conclusion Previous studies have suggested that IRT increases patients’ sense of mastery or perceived self-efficacy over nightmares (Rousseau et al., 2018). Additionally, higher verbal memory in persons with trauma-related nightmares has been shown to improve nightmare frequency and severity in IRT (Scott et al., 2017). In this case study, self-efficacy may have been activated by the highly detailed and media-enhanced imagery the patient created. Further empirical research on the mechanisms for enhancing IRT is warranted.

scholarly journals Comparative Meta-Analysis of Prazosin and Imagery Rehearsal Therapy for Nightmare Frequency, Sleep Quality, and Posttraumatic Stress

2015 ◽  
Vol 11 (01) ◽  
pp. 11-22 ◽  
Author(s):  
Gilbert Seda ◽  
Maria M. Sanchez-Ortuno ◽  
Carolyn H. Welsh ◽  
Ann C. Halbower ◽  
Jack D. Edinger
Keyword(s):  
Sleep Quality ◽  
Posttraumatic Stress ◽  
Meta Analysis ◽  
Imagery Rehearsal Therapy ◽  
Imagery Rehearsal

Treating your worst nightmare: a case-series of imagery rehearsal therapy for nightmares in individuals experiencing psychotic symptoms

2015 ◽  
Vol 8 ◽  
Author(s):  
Bryony Sheaves ◽  
Juliana Onwumere ◽  
Nadine Keen ◽  
Elizabeth Kuipers
Keyword(s):  
Working Memory ◽  
Sleep Quality ◽  
Emotional Response ◽  
Case Series ◽  
Small Sample ◽  
Psychotic Symptoms ◽  
Imagery Rehearsal Therapy ◽  
Affective Symptoms ◽  
Additional Control ◽  
Imagery Rehearsal

AbstractPrevious research has indicated that nightmares might be a common problem for people with psychotic symptoms. Furthermore, more distressing nightmares have been associated with higher levels of delusional severity, depression, anxiety, stress and working memory. However no known research has investigated the use of nightmare treatments in those with symptoms of psychosis. This study aimed to assess the acceptability and feasibility of using imagery rehearsal (IR) therapy as a treatment of nightmares for those presenting with co-morbid psychotic symptoms. Six participants presenting with frequent distressing nightmares and psychotic symptoms were recruited. Five participants attended 4–6 sessions of IR. Measures of nightmares, sleep quality, psychotic and affective symptoms were completed at baseline and immediately following the intervention. It was feasible to adapt IR for those experiencing psychotic symptoms. Descriptive improvements were noted on measures of nightmare-related distress, vividness and intensity. Positive post-session feedback endorsed the acceptability of IR. Nightmare frequency did not reduce following IR; however, participants described a change in emotional response. IR was an acceptable and feasible intervention for this small sample. A larger study powered to detect group changes, with an additional control is warranted to test the efficacy of the intervention for those with psychosis.

Long Term Reduction of Nightmares with Imagery Rehearsal Treatment

1996 ◽  
Vol 24 (2) ◽  
pp. 135-148 ◽  
Author(s):  
Barry Krakow ◽  
Robert Kellner ◽  
Dorothy Pathak ◽  
Lori Lambert
Keyword(s):  
Sleep Quality ◽  
Sleep Disorder ◽  
Cognitive Behavioral ◽  
Behavioral Method ◽  
Nightmare Disorder ◽  
Primary Sleep Disorder ◽  
Imagery Rehearsal

An eighteen month follow-up of chronic nightmare sufferers treated with imagery rehearsal, a cognitive-behavioral method, demonstrated significant and clinically meaningful decreases in nightmare frequency. Sixty-eight percent of subjects decreased their nightmares below criteria for a “Chronic Nightmare Disorder”. Significant improvement was also noted for sleep quality and daytime anxiety. The findings support the theory that nightmares may be clinically conceptualized as a primary sleep disorder in some chronic sufferers.

scholarly journals 1104 Increasing Accessibility of Nightmare Treatment Via Mobile Health

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A420-A420
Author(s):  
K J Speed ◽  
M Nadorff ◽  
T Bishop ◽  
M Stearns ◽  
W Pigeon
Keyword(s):  
College Students ◽  
Mobile Health ◽  
Repeated Measures ◽  
Smartphone Application ◽  
Ptsd Symptoms ◽  
Waitlist Control ◽  
Imagery Rehearsal Therapy ◽  
Main Effect ◽  
Nightmare Disorder ◽  
Imagery Rehearsal

Abstract Introduction Nightmares have been tied to a myriad of adverse mental health outcomes and are known to persist after treatment of other concerns such as posttraumatic stress, depression, and anxiety. When reaching clinical levels, nightmare disorder is known to effect 2-6% of the general population, Although many treatments exist for nightmare disorder and posttraumatic nightmares, Imagery Rehearsal Therapy has consistently been cited as the first line treatment. Mobile health (mHealth) technology has emerged as a viable platform from which to deliver sleep medicine interventions. Methods We assessed the efficacy of an Imagery Rehearsal Therapy-based mobile application (Dream EZ) developed by the National Center for Telehealth and Technology. College students (n = 99) were recruited in a two-part online study and randomized to the treatment condition or waitlist control. Repeated measures analysis of variance were used to assess the efficacy of smartphone-based mHealth application treatment (Dream EZ) in reduction of psychological symptoms (nightmare distress, PTSD symptoms, and suicide risk) as compared to waitlist control. Results Findings support the use of Dream EZ for nightmares distress reduction (main effect: p =.004, d = .57; interaction: p =.049, d = .41). Results regarding effectiveness of Dream EZ in relation to reduction of PTSD symptoms (main effect: p = .415, d = .17; interaction: p =.262, d = .23) showed no significant interactions between PTSD symptoms and treatment group assignment. In relation to changes in suicidality (main effect: p =.007, d = .57; interaction: p =.758, d = .07), findings were nonsignificant. Conclusion Use of nightmare-focused treatment through a mHealth smartphone application may be a viable avenue for promoting management of nightmare distress in college students. These findings present an opportunity to explore further options for increasing accessibility of sleep-focused treatment options in a challenging and fast-paced population. Support No support to disclose.

Chronische Alpträume: Wirksamkeit eines deutschsprachigen Manuals zur angeleiteten Selbsthilfe mit Imagery Rehearsal Therapy

2012 ◽  
Vol 41 (4) ◽  
pp. 249-257 ◽  
Author(s):  
Tana Kröner ◽  
Kathrin Hansen ◽  
Regina Steil
Keyword(s):  
Face To Face ◽  
Imagery Rehearsal Therapy ◽  
Imagery Rehearsal

Theoretischer Hintergrund: Chronische Alpträume stellen eine weit verbreitete Schlafstörung dar, welche einen hohen Leidensdruck hervorruft. Als besonders wirksam in der Behandlung gilt die Imagery Rehearsal Therapy (IRT). Selbsthilfeprogramme stellen hierbei eine effektive, ökonomische Behandlungsoption dar. Fragestellung: Die vorliegende Pilotstudie untersucht die Wirksamkeit einer neuen, IRT-basierten, angeleiteten Selbsthilfe. Methode: 10 Patienten mit chronischen Alpträumen wurden im Rahmen von 4 face-to-face-Sitzungen vor Intervention (T1) sowie 4 Wochen (T2) und 3 Monate (T3) danach hinsichtlich Alptraumhäufigkeit sowie verschiedener psychosozialer Parameter untersucht. Ergebnisse: Die Alptraumhäufigkeit reduzierte sich innerhalb von 4 Wochen signifikant (T1-T2; Effektstärke: 1,0). Dieser Effekt blieb über 3 Monate stabil (T1-T3; Effektstärke: 1,26). Zudem reduzierten sich signifikant Depressions-, Angst- und Anspannungsparameter sowie das Stresserleben. Schlussfolgerung: Das deutschsprachige Selbsthilfemanual könnte eine wirksame Behandlungsmöglichkeit zur Reduktion von Alpträumen darstellen.

Rem-Tracker

Schlaf ◽  
2018 ◽  
Vol 07 (02) ◽  
pp. 76-80
Author(s):  
Friedrich Gauger ◽  
Gerhart Schroff ◽  
Wilhelm Stork
Keyword(s):  
Imagery Rehearsal Therapy ◽  
Imagery Rehearsal

Die Behandlung von Albträumen erfolgt bislang meist psychotherapeutisch. Ein in der Praxis bewährtes Verfahren ist die Imagery Rehearsal Therapy (IRT). Untersuchungen zeigen, dass die Effektivität der IRT erhöht werden kann, wenn der Patient die Fähigkeit zum Klarträumen erlangt. Die gängige Technologie zur Klartrauminduktion kann bislang nur in entsprechend qualifizierten Schlaflaboren eingesetzt werden.Der REM-TRACKER bietet erstmals die Möglichkeit der Klartrauminduktion mittels einer einfach handhabbaren Technologie, die auch im häuslichen Umfeld eingesetzt werden kann.

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