New PTSD Sleep Clinic Opens in New Mexico

A new PTSD Sleep Clinic is opening today in Albuquerque, N.M. The clinic will target the sleep problems that plague people who have post-traumatic stress disorder.

The clinic is directed by AASM member Dr. Barry Krakow. He is the founder of the Maimonides International Nightmare Treatment Center.

Krakow notes that antidepressant medications may not be the best option for people who have PTSD. And many people with PTSD also have obstructive sleep apnea. This can make their PTSD symptoms even worse.



The AASM reports that recurring nightmares tend to be most disturbing aspect of PTSD. In these dreams the event may be relived in a way that seems shockingly real.

Krakow says that treating sleep problems can greatly reduce PTSD symptoms. Daytime fatigue and sleepiness decrease, and energy levels increase. This provides a boost for the coping skills and motivation needed to tackle the problems related to PTSD.

His clinic uses a variety of techniques to treat PTSD. These include cognitive behavioral therapy, imagery rehearsal therapy and sleep-related emotion-focused therapy.

Last year the Sleep Education Blog reported that imagery rehearsal therapy is helping some people change their nightmares. Yoga also is being used to help soldiers who have PTSD. And a recent study showed that old fear memories can be “updated” to prevent the return of fear.

Read more about PTSD and nightmares.

Changing Nightmares: Imagery Rehearsal Therapy

“Your Health” columnist Kim Painter reports in USA Today that imagery rehearsal therapy is helping some people change their nightmares.

This method is just one form of cognitive behavioral therapy. A variety of CBT techniques have been used to reduce nightmare frequency.

One method is to record your nightmares in a diary. Relaxation exercises also may be helpful. Exposure techniques involve “reliving” a nightmare in your imagination during the daytime.

Cognitive-restructuring techniques involve changing a nightmare. One technique is lucid dreaming treatment; you change the nightmare as it occurs during sleep.

Imagery rehearsal therapy involves changing the nightmare while awake; you “rehearse” the new version in your mind during the day.

The first step is to write down a recent nightmare. Then you change the nightmare. Usually you change it to a more positive version.

You write down this new version. Then you rehearse it in your mind daily; you imagine the imagery of the changed nightmare.

In 2008 a review in the Journal of Clinical Sleep Medicine noted that CBT has become the treatment of choice for nightmares. It reported that imagery rehearsal therapy and exposure are effective at reducing nightmares; the methods also reduce other sleep complaints and mental distress.

The authors noted that the drug prazosin also may be effective at reducing nightmares. But it appears that treatment requires ongoing use of the drug; nightmares may return after drug withdrawal.

One of the review’s co-authors was sleep specialist Dr. Barry Krakow. He is founder of the Maimonides International Nightmare Treatment Center in Albuquerque, N.M.

In 1992 Krakow and colleagues at the University of New Mexico published a study of imagery rehearsal therapy in the journal Sleep. They found that the therapy reduced nightmare frequency by 72 percent.

Nightmare rehearsal was first reported as an effective treatment option in a 1978 case study. The method was adapted into an imagery rehearsal technique at the University of New Mexico; the first case studies were reported in 1991.

In June the Sleep Education Blog reported that imagery rehearsal therapy also can be helpful for children with nightmares. Learn more about dreams and nightmares on SleepEducation.com. Get help for nightmare disorder at an AASM-accredited sleep center near you.

Image by Cornelia Kopp

Treating Nightmares in Children with Imagery Rehearsal Therapy

Imagery rehearsal therapy is an effective way to treat adults with nightmare disorder. A new study from Canada shows that it also can be helpful for children.

The small study involved 11 boys and nine girls between 9 and 11 years of age. Each child had a moderate or severe nightmare problem; they had one nightmare or more per week for at least six months. None of the children had post-traumatic stress disorder.

Eleven children were put on a waiting list; nine of the children were treated with imagery rehearsal therapy. This is a way to train your brain to change your nightmares into a new set of images.

Results show that imagery rehearsal therapy reduced the frequency of nightmares. This effect lasted during a nine-month follow-up period. Nightmares became so rare that the researchers were unable to measure post-nightmare distress.

The AASM reports that children tend to begin having nightmares between the ages of three and six. The frequency of these disturbing dreams usually peaks between the ages of six and 10.

Learn more about nightmares and children.

Treating Nightmares with Imagery Rehearsal Therapy

It’s bad enough to have your sleep disrupted by a nightmare. It’s even worse when recurring episodes of disturbing dreams turn into a nightmare disorder.

This is a common problem for soldiers and other people who have post-traumatic stress disorder. Their dreams often replay a disturbing event in a way that seems shockingly real.

But the Pittsburgh Post-Gazette reports that treatment can help break the cycle of recurring nightmares. This can help your sleep, and your daytime life, return to normal.

One of the most effective treatments for nightmares is “imagery rehearsal therapy.” According to the article, it is effective in more than 90 percent of people who try it.

“You train your brain to have a new set of images,” sleep researcher Anne Germain told the Post-Gazette.

Germain also said that the high blood pressure medication prazosin is another treatment option. The drug is effective at eliminating nightmares.

Get help for nightmare disorder at an AASM-accredited sleep center near you.

Learn more about dreams and nightmares on SleepEducation.com.

Image by Vanessa C