Postal self-exposure treatment of recurrent nightmares. Randomised controlled trial.
BACKGROUND
Many nightmare sufferers do not consult a health care professional. Though behavior and cognitive therapy can help, they have not been tested as a self-treatment method at home using a manual.


METHODS
One hundred and seventy adults with primary nightmares were randomised to four weeks' self-exposure or self-relaxation at home using manuals posted to them, or to a waiting-list as a control group for four weeks. Individuals recorded nightmare frequency and intensity in four-week diaries.


RESULTS
At one- and six-month follow-up, the self-rated nightmare frequency fell more significantly in exposure subjects than relaxation or waiting-list subjects. The self-exposure group had the most drop-outs but remained superior in an over-cautious intent-to-treat analysis. The individuals' partners confirmed the superiority of self-exposure to self-relaxation at one- and six-month follow-up.


CONCLUSIONS
Recurrent nightmare sufferers improved more with self-exposure manuals than with self-relaxation manuals or by being on a waiting-list. Self-exposure may be needed for longer than four weeks in order to reduce nightmare intensity as well as frequency. Despite a high drop-out rate, some sufferers of other conditions may benefit from self-treatment manuals.
Burgess
M
M
Chronic Fatigue Research Unit, New Medical School, London.
Gill
M
M
Marks
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D004325:Dreams; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010349:Patient Compliance; D011613:Psychotherapy / Q000379:methods*; D012648:Self Care; D016896:Treatment Outcome