Study Objectives: Despite the considerable prevalence of the nightmare disorder and its burden on the patient, nightmares are underdiagnosed and undertreated, even in sleep centers. Methods: A total of 1,125 patients in a sleep center undergoing routine diagnostic procedures for their sleep disorders completed a questionnaire about nightmares. Results: About 20% of the sample indicated an interest in more information about nightmare etiology and nightmare therapy-even patients who had never sought professional help previously. Conclusions: From a clinical viewpoint, health care professionals should be encouraged to ask about nightmares and, as a first step, internet-based selfhelp programs should be implemented for this patient group. Keywords: nightmare disorder, imagery rehearsal therapy Citation: Schredl M, Dehmlow L, Schmitt J. Interest in information about nightmares in patients with sleep disorders. J Clin Sleep Med 2016;12(7):973-977.
I NTRO DUCTI O NNightmares are defined as extended, extremely dysphoric, and well-remembered dreams that usually involve threat to survival, security, or physical integrity.1 Nightmares are experienced occasionally by many persons during their lifetime, 2 i.e., for the clinical context, it is important to differentiate between nightmares that occur rarely and the presence of a nightmare disorder (which includes the criteria that nightmares cause clinically significant distress and/or impairment in social, occupational, or other important areas of functioning).1 The nightmare disorder prevalence in the general population is estimated to be about 5%, 3 and about 30% in a patient group with various mental disorders. 4 The etiology of nightmares is best explained by a disposition-stress model 5 and effective treatment strategies, like Imagery Rehearsal Therapy, are available.6 Nightmares are also of special importance in a clinical context because nightmares are an independent predictor of suicidal ideation and suicide.
7-9Despite the considerable prevalence of the nightmare disorder 3 and its burden on the patient, 10 nightmares have been rarely diagnosed and treated, even in sleep clinics: Krakow reported that 16.3% of sleep-disordered patients (n = 718) also have a salient nightmare condition that normally would not have been diagnosed if they had not specifically asked for it as part of this research project.11 Comparable results were reported by Schredl et al., 12 who found that 13.4% of the patients undergoing diagnostic procedures for various reasons in a sleep laboratory (n = 4,001) reported nightmares at least once a week, whereas a diagnosis of a nightmare disorder was given to only 1.6% of the sample. On the other hand, nightmare sufferers also rarely seek help for their problem on their own initiative. [13][14][15][16] In an online study of nightmare sufferers (n = 335), only 29.6% of the respondents reported that they had asked a health care provider for help.13 Even lower figures were reported for persons of a representative sample having nightmares at least once...