A recent study by Northwestern Medicine has explored a novel approach to treating nightmares associated with narcolepsy. The research combined cognitive behavioral therapy (CBT) and lucid dreaming techniques in a small clinical trial, showing promising results.
"We had them imagine what they’d like to dream instead of their nightmare, almost like they’re writing a movie script," explained Jennifer Mundt, the study's corresponding author and assistant professor at Northwestern University Feinberg School of Medicine.
The study involved six patients and reported reductions in both the severity and frequency of nightmares. These findings were published on October 23 in the Journal of Sleep Research.
Narcolepsy, a chronic neurological disorder affecting sleep regulation, often includes vivid and distressing nightmares for 30-40% of patients. Despite their prevalence, these nightmares have been largely overlooked in research and clinical practice. "Narcolepsy-related dreams have been an overlooked symptom within narcolepsy," Mundt noted.
Mundt emphasized the importance of treatment: "Many of them don’t know anything can be done, and treatment can completely transform their sleep."
This study is reportedly the first to apply CBT specifically to narcolepsy-related nightmares. Participants received weekly telehealth sessions focused on educating them about nightmares and improving sleep habits. They also practiced rescripting their nightmares into preferred dreams.
Half of the participants underwent an additional procedure involving targeted lucidity reactivation (TLR) during naps. This technique aims to induce lucid dreaming by using sound cues associated with rescripted dreams during REM sleep.
"This research highlights a new orientation to sleep," said Ken Paller, director of the Cognitive Neuroscience Program at Northwestern.
Post-treatment assessments showed that all participants experienced less severe and frequent nightmares. For four out of six participants, nightmare severity fell below the threshold for nightmare disorder.
Participants reported feeling less anxious about their nightmares after treatment. "It’s empowering for them," Mundt stated. "They’re so surprised this works."
The pilot study was titled “Treating narcolepsy-related nightmares with cognitive behavioral therapy and targeted lucidity reactivation: A pilot study” and received funding from the Northwestern University Center for Circadian and Sleep Medicine.