Format

Send to

Choose Destination
J Clin Sleep Med. 2019 May 15;15(5):757-767. doi: 10.5664/jcsm.7770.

Randomized Controlled Trial of Imagery Rehearsal for Posttraumatic Nightmares in Combat Veterans.

Author information

1
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.
2
Yale University and National Center for PTSD, New Haven, Connecticut.
3
Phoenix Australia Centre for Posttraumatic Mental Health, Melbourne, Australia.
4
University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.

Abstract

STUDY OBJECTIVES:

To examine the efficacy of imagery rehearsal (IR) combined with cognitive behavioral therapy for insomnia (CBT-I) compared to CBT-I alone for treating recurrent nightmares in military veterans with posttraumatic stress disorder (PTSD).

METHODS:

In this randomized controlled study, 108 male and female United States veterans of the Iraq and Afghanistan conflicts with current, severe PTSD and recurrent, deployment-related nightmares were randomized to six sessions of IR + CBT-I (n = 55) or CBT-I (n = 53). Primary outcomes were measured with the Nightmare Frequency Questionnaire (NFQ) and Nightmare Distress Questionnaire (NDQ).

RESULTS:

Improvement with treatment was significant (29% with reduction in nightmare frequency and 22% with remission). Overall, IR + CBT-I was not superior to CBT-I (NFQ: -0.12; 95% confidence interval = -0.87 to 0.63; likelihood ratio chi square = 4.7(3), P = .2); NDQ: 1.5, 95% confidence interval = -1.4 to 4.4; likelihood ratio chi square = 7.3, P = .06).

CONCLUSIONS:

Combining IR with CBT-I conferred no advantage overall. Further research is essential to examine the possibly greater benefit of adding IR to CBT-I for some subgroups of veterans with PTSD.

CLINICAL TRIAL REGISTRATION:

Registry: ClinicalTrials.gov; Title: Cognitive Behavioral Therapy (CBT) for Nightmares in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans; Identifier: NCT00691626; URL: https://clinicaltrials.gov/ct2/show/NCT00691626.

KEYWORDS:

cognitive behavioral therapy; insomnia; nightmares; posttraumatic stress disorder

PMID:
31053215
PMCID:
PMC6510682
[Available on 2020-05-15]
DOI:
10.5664/jcsm.7770

Supplemental Content

Full text links

Icon for American Academy of Sleep Medicine
Loading ...
Support Center