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Trauma-related nightmares: A Comprehensive and Integrative review.
Dorone Feingold1, Jean-Baptiste Roseau2, Charles Verdonk3
1Université Paris Cité, VIFASOM (Vigilance Fatigue Sleep and Public Health), Paris, 75006, France.
Sleep Medicine Reviews
|March 26, 2026
Summary
Trauma-related nightmares (TRNs) are complex and require integrated approaches for understanding and treatment. This review proposes a new framework to clarify their classification and management.
Area of Science:
- Neuroscience
- Psychiatry
- Sleep Medicine
Background:
- Trauma-related nightmares (TRNs) present diagnostic challenges, blurring lines between pathology, sleep, and memory.
- Their clinical impact and frequency necessitate a clearer conceptual framework.
Purpose of the Study:
- To resolve conceptual inconsistencies surrounding TRNs.
- To introduce a novel typology and integrative framework for understanding TRNs.
Main Methods:
- Review of clinical, phenomenological, and physiological dimensions of TRNs.
- Integration of patient narratives with objective sleep and autonomic markers.
- Examination of ecological studies and proposed DIA-TRNs model.
Main Results:
- TRNs are conceptualized within a vulnerability cycle involving triggers, dysregulation, and sleep fragmentation.
- A typology based on trauma replication, content, frequency, and distress is introduced.
- The DIA-TRNs model offers a dynamic view of TRN evolution: Disruption, Integration, Adaptation.
Conclusions:
- TRNs require an integrative, multidimensional approach beyond symptomatic treatment.
- The proposed framework clarifies TRN status and guides therapeutic strategies.
- Understanding TRNs as dynamic processes is crucial for effective intervention.
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