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Updated: Jun 18, 2025

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Published on: November 14, 2018
The Effectiveness of Imagery Rescripting Interventions for Military Veterans With Nightmares and Sleep Disturbances:
Marya Hicks1, Laura M Simonds1, Linda Morison1
1School of Psychology, University of Surrey, Guildford, UK.
Imagery rescripting (ImRs) interventions show promise for improving sleep quality in military veterans. While effective for sleep quality, evidence for reducing nightmare frequency requires further investigation in larger, diverse veteran samples.
Area of Science:
- Psychology
- Sleep Medicine
- Military Health
Background:
- Imagery rescripting (ImRs) interventions are recognized for enhancing sleep outcomes.
- Existing research predominantly features civilian populations, with limited focus on military veterans.
- Sleep disturbances and nightmares are prevalent issues affecting veteran well-being.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of ImRs interventions for military veterans.
- To assess the impact of ImRs on primary outcomes: nightmare frequency and sleep quality.
- To consolidate current evidence regarding ImRs in veteran populations.
Main Methods:
- Systematic literature search across multiple databases (CINAHL, MEDLINE, PsycArticles, PsycINFO, etc.) up to November 2021.
- Inclusion of randomized controlled trials, nonrandomized trials, and pre-post studies involving veterans with sleep issues.
- Methodological quality assessment using the Effective Public Health Practice Project (EPHPP) tool and meta-analysis using Stata.
Main Results:
- Meta-analysis of 15 studies (658 participants) indicated significant improvements in nightmare frequency and sleep quality from pre- to post-treatment.
- ImRs interventions demonstrated significantly greater improvements in sleep quality compared to control groups (Hedges' g = -0.65).
- No significant difference was found in nightmare frequency reduction between ImRs and control groups (Hedges' g = -0.10).
Conclusions:
- Imagery rescripting interventions show potential for improving sleep quality in military veterans.
- The current evidence base for reducing nightmare frequency in veterans via ImRs is limited.
- Findings should be interpreted cautiously due to the small number and methodological limitations of included studies; further research with larger samples is recommended.
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