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Are there any effective treatments for posttraumatic nightmares?
Nightmare symptoms often get better with standard PTSD treatment. If nightmares persist, there are treatments that can reduce how often they occur.
One treatment is Imagery Rehearsal Therapy (IRT). In IRT, the person who is having nightmares, while awake, changes how the nightmare ends so that it no longer upsets them. Then the person replays over and over in their minds the new dream with the non-scary ending. Research shows that this type of treatment can reduce how often nightmares occur.
Also, treatment for breathing problems that occur during sleep may reduce the nightmares that follow trauma. High levels of sleep-disordered breathing have been seen in trauma survivors. In one study, patients given a treatment to improve their breathing during sleep no longer had violent, scary dreams.
Little research exists on the use of medicines to treat nightmares from trauma. The medicine with the most promise is prazosin. Two studies have found that prazosin reduces nightmare symptoms. More research on prazosin is under way.