Best practice guide for the treatment of nightmare disorder in adults

R. Nisha Aurora, Rochelle S. Zak, Sanford H. Auerbach, Kenneth R. Casey, Susmita Chowdhuri, Anoop Karippot, Rama K. Maganti, Kannan Ramar, David A. Kristo, Sabin R. Bista, Carin I. Lamm, Timothy I. Morgenthaler, Sharon L. Tracy

Research output: Contribution to journalReview article

155 Citations (Scopus)

Abstract

Prazosin is recommended for treatment of Posttraumatic Stress Disorder (PTSD)-associated nightmares. Level A Image Rehearsal Therapy (IRT) is recommended for treatment of nightmare disorder. Level A Systematic Desensitization and Progressive Deep Muscle Relaxation training are suggested for treatment of idiopathic nightmares. Level B Venlafaxine is not suggested for treatment of PTSD-associated nightmares. Level B Clonidine may be considered for treatment of PTSD-associated nightmares. Level C The following medications may be considered for treatment of PTSD-associated nightmares, but the data are low grade and sparse: trazodone, atypical antipsychotic medications, topiramate, low dose Cortisol, fluvoxamine, triazolam and nitrazepam, phenelzine, gabapentin, cyproheptadine, and tricyclic antidepressants. Nefazodone is not recommended as first line therapy for nightmare disorder because of the increased risk of hepatotoxicity. Level C The following behavioral therapies may be considered for treatment of PTSD-associated nightmares based on low-grade evidence: Exposure, Relaxation, and Rescripting Therapy (ERRT); Sleep Dynamic Therapy; Hypnosis; Eye-Movement Desensitization and Reprocessing (EMDR); and the Testimony Method. Level C The following behavioral therapies may be considered for treatment of nightmare disorder based on low-grade evidence: Lucid Dreaming Therapy and Self-Exposure Therapy. Level C No recommendation is made regarding clonazepam and individual psychotherapy because of sparse data.

Original languageEnglish (US)
Pages (from-to)389-401
Number of pages13
JournalJournal of Clinical Sleep Medicine
Volume6
Issue number4
StatePublished - Aug 15 2010

Fingerprint

Practice Guidelines
Post-Traumatic Stress Disorders
Therapeutics
Eye Movement Desensitization Reprocessing
Autogenic Training
Phenelzine
Nitrazepam
Implosive Therapy
Triazolam
Trazodone
Cyproheptadine
Relaxation Therapy
Fluvoxamine
Clonazepam
Hypnosis
Tricyclic Antidepressive Agents
Prazosin
Clonidine
Psychotherapy
Antipsychotic Agents

Keywords

  • Aripiprazole
  • Clonazepam
  • Clonidine
  • Cognitive behavioral therapy
  • Cortisol
  • Cyproheptadine
  • Exposure relaxation and rescripting therapy
  • Fluvoxamine
  • Gabapentin
  • Hypnosis
  • Imagery rehearsal therapy
  • Lucid dreaming therapy
  • Nefazodone
  • Nightmare disorder
  • Nightmares
  • Nitrazepam
  • Olanzapine
  • Phenelzine
  • Prazosin
  • Progressive deep muscle training
  • Psychotherapy
  • Risperidone
  • Self-exposure therapy
  • Sleep dynamic therapy
  • Systematic desensitization
  • Testimony method
  • Topiramate
  • Trazodone
  • Triazolam
  • Tricyclics
  • Venlafaxine

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Cite this

Aurora, R. N., Zak, R. S., Auerbach, S. H., Casey, K. R., Chowdhuri, S., Karippot, A., ... Tracy, S. L. (2010). Best practice guide for the treatment of nightmare disorder in adults. Journal of Clinical Sleep Medicine, 6(4), 389-401.

Best practice guide for the treatment of nightmare disorder in adults. / Aurora, R. Nisha; Zak, Rochelle S.; Auerbach, Sanford H.; Casey, Kenneth R.; Chowdhuri, Susmita; Karippot, Anoop; Maganti, Rama K.; Ramar, Kannan; Kristo, David A.; Bista, Sabin R.; Lamm, Carin I.; Morgenthaler, Timothy I.; Tracy, Sharon L.

In: Journal of Clinical Sleep Medicine, Vol. 6, No. 4, 15.08.2010, p. 389-401.

Research output: Contribution to journalReview article

Aurora, RN, Zak, RS, Auerbach, SH, Casey, KR, Chowdhuri, S, Karippot, A, Maganti, RK, Ramar, K, Kristo, DA, Bista, SR, Lamm, CI, Morgenthaler, TI & Tracy, SL 2010, 'Best practice guide for the treatment of nightmare disorder in adults', Journal of Clinical Sleep Medicine, vol. 6, no. 4, pp. 389-401.
Aurora RN, Zak RS, Auerbach SH, Casey KR, Chowdhuri S, Karippot A et al. Best practice guide for the treatment of nightmare disorder in adults. Journal of Clinical Sleep Medicine. 2010 Aug 15;6(4):389-401.
Aurora, R. Nisha ; Zak, Rochelle S. ; Auerbach, Sanford H. ; Casey, Kenneth R. ; Chowdhuri, Susmita ; Karippot, Anoop ; Maganti, Rama K. ; Ramar, Kannan ; Kristo, David A. ; Bista, Sabin R. ; Lamm, Carin I. ; Morgenthaler, Timothy I. ; Tracy, Sharon L. / Best practice guide for the treatment of nightmare disorder in adults. In: Journal of Clinical Sleep Medicine. 2010 ; Vol. 6, No. 4. pp. 389-401.
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N2 - Prazosin is recommended for treatment of Posttraumatic Stress Disorder (PTSD)-associated nightmares. Level A Image Rehearsal Therapy (IRT) is recommended for treatment of nightmare disorder. Level A Systematic Desensitization and Progressive Deep Muscle Relaxation training are suggested for treatment of idiopathic nightmares. Level B Venlafaxine is not suggested for treatment of PTSD-associated nightmares. Level B Clonidine may be considered for treatment of PTSD-associated nightmares. Level C The following medications may be considered for treatment of PTSD-associated nightmares, but the data are low grade and sparse: trazodone, atypical antipsychotic medications, topiramate, low dose Cortisol, fluvoxamine, triazolam and nitrazepam, phenelzine, gabapentin, cyproheptadine, and tricyclic antidepressants. Nefazodone is not recommended as first line therapy for nightmare disorder because of the increased risk of hepatotoxicity. Level C The following behavioral therapies may be considered for treatment of PTSD-associated nightmares based on low-grade evidence: Exposure, Relaxation, and Rescripting Therapy (ERRT); Sleep Dynamic Therapy; Hypnosis; Eye-Movement Desensitization and Reprocessing (EMDR); and the Testimony Method. Level C The following behavioral therapies may be considered for treatment of nightmare disorder based on low-grade evidence: Lucid Dreaming Therapy and Self-Exposure Therapy. Level C No recommendation is made regarding clonazepam and individual psychotherapy because of sparse data.

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