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[Practice guide for the management of nightmare disorders]
1Psychiatre, spécialiste des troubles du sommeil et de la vigilance, vice-présidente du réseau Morphée, Paris, France.
La Revue Du Praticien
|February 11, 2022
Summary
Nightmare disorder, characterized by recurrent nightmares, significantly impacts well-being. Imagery rehearsal therapy (IRT) is a recommended psychotherapy for managing nightmares, including those related to post-traumatic stress disorder.
Area of Science:
- Neurology
- Sleep Medicine
- Psychiatry
Background:
- Nightmares are common parasomnias occurring during REM sleep, affecting all ages.
- Recurrent nightmares, or nightmare disorder, represent a distinct clinical entity causing significant distress.
- Distinguishing nightmares from other parasomnias like night terrors and REM sleep behavior disorder is crucial for appropriate management.
Purpose of the Study:
- To provide a practice guide for the management of nightmare disorder.
- To outline the differential diagnosis of nightmares and associated conditions.
- To recommend effective therapeutic strategies for recurrent nightmares.
Main Methods:
- Clinical assessment focusing on psychopathology and comorbid sleep disorders (e.g., narcolepsy, sleep apnea).
- Evaluation for iatrogenic, toxic, or rare nocturnal epilepsy origins.
- Review of psychotherapeutic interventions for nightmare disorder.
Main Results:
- Nightmares are often associated with stress, trauma, and high anxiety levels.
- Comorbid sleep disorders and other medical conditions can precipitate nightmares.
- Imagery rehearsal therapy (IRT) demonstrates effectiveness for both idiopathic and trauma-related nightmares.
Conclusions:
- Recurrent nightmares require a comprehensive clinical assessment to identify underlying causes.
- Psychotherapy, particularly IRT, is the primary and effective treatment for nightmare disorder.
- Effective management of nightmares can significantly alleviate patient suffering and improve quality of life.
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