Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013


Purpose of Review

Post-traumatic nightmares (PTN) are a common and enduring problem for individuals with post-traumatic stress disorder (PTSD) and other clinical presentations. PTN cause significant distress, are associated with large costs, and are an independent risk factor for suicide. Pharmacological and non-pharmacological treatment options for PTN exist. A previous review in this journal demonstrated that Prazosin, an alpha blocker, was a preferred pharmacological treatment for PTN and imagery rescripting therapy (IRT) was a preferred non-pharmacological treatment. Since that time, new and important research findings create the need for an updated review.

Recent Findings

Based on the results of a recent study in the New England Journal of Medicine, Prazosin has been downgraded by both the American Academy of Sleep Medicine (AASM) and the Veterans Health Administration/Department of Defense (VA/DoD) for PTN. In Canada, Nabilone, a synthetic cannabinoid, appears to be promising. Few recent studies have been published on non-pharmacological interventions for PTN; however, recent data is available with regard to using IRT on an inpatient setting, with German combat veterans, and through the use of virtual technology. Recent evidence supports the use of exposure, relaxation, and rescripting therapy (ERRT) with children and individuals with comorbid bipolar disorder and PTN.


Prazosin is no longer considered a first-line pharmacological intervention for PTN by AASM and VA/DoD. However, in the absence of a suitable alternative, it will likely remain the preferred option of prescribers. IRT and ERRT remain preferred non-pharmacological treatments of PTN. Combining cognitive behavior therapy for insomnia (CBT-I) with IRT or ERRT may lead to improved outcomes.

This is a preview of subscription content, access via your institution.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    Cushway D, Sewell R. Therapy with dreams and nightmares. 2nd ed. London: Sage; 2013.

    Google Scholar 

  2. 2.

    Freud S. The interpretation of dreams. Harmondsworth: Penguin; 1899/1976.

    Google Scholar 

  3. 3.

    American Academy of Sleep Medicine, European Sleep Research Society, the Japanese Society of Sleep Research, the Latin American Sleep Society. International Classification of Sleep Disorders. Westchester, IL: American Academy of Sleep Medicine; 2001.

  4. 4.

    Herman JL. Trauma and recovery: the aftermath of violence—from domestic abuse to political terror. Hachette: Basic Books; 1992.

    Google Scholar 

  5. 5.

    Nielsen T. The stress acceleration hypothesis of nightmares. Front Neurol. 2017;8:201.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington DC: American Psychiatric Pub; 2013.

    Google Scholar 

  7. 7.

    Creamer JL, Brock MS, Matsangas P, Motamedi V, Mysliwiec V. Nightmares in United States military personnel with sleep disturbances. J Clin Sleep Med. 2018;14(03):419–26.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Seda G, Sanchez-Ortuno MM, Welsh CH, Halbower AC, Edinger JD. Comparative meta-analysis of prazosin and imagery rehearsal therapy for nightmare frequency, sleep quality, and posttraumatic stress. J Clin Sleep Med. 2015;11(1):11.

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Writer BW, Meyer EG, Schillerstrom JE. Prazosin for military combat-related PTSD nightmares: a critical review. J Neuropsychiatry Clin Neurosci. 2014;26(1):24–33.

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Colvonen PJ, Straus LD, Stepnowsky C, McCarthy MJ, Goldstein LA, Norman SB. Recent advancements in treating sleep disorders in co-occurring PTSD. Curr Psychiatry Rep. 2018;20(7):48.

    Article  PubMed  Google Scholar 

  11. 11.

    •• Ho FY, Chan CS, Tang KN. Cognitive-behavioral therapy for sleep disturbances in treating posttraumatic stress disorder symptoms: a meta-analysis of randomized controlled trials. Clin Psychol Rev. 2016;43:90–102 This article is the most comprehensive article available regarding RCTs for PTSD symptoms that includes posttraumatic nightmares.

    Article  PubMed  Google Scholar 

  12. 12.

    Larsen SE, Fleming CJ, Resick PA. Residual symptoms following empirically supported treatment for PTSD. Psychol Trauma Theory Res Pract Policy. 2018.

  13. 13.

    Collen JF, Williams SG, Lettieri CJ. Doomed to repeat history: the burden of trauma-related nightmares in military personnel. J Clin Sleep Med. 2018;14(03):303–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Phelps AJ, Varker T, Metcalf O, Dell L. What are effective psychological interventions for veterans with sleep disturbances? A rapid evidence assessment. Mil Med. 2017;182(1–2):e1541–50.

    Article  PubMed  Google Scholar 

  15. 15.

    • Escamilla M, LaVoy M, Moore BA, Krakow B. Management of post-traumatic nightmares: a review of pharmacologic and nonpharmacologic treatments since 2010. Curr Psychiatry Rep. 2012;14(5):529–35 This article reviews the literature between 2010 and 2013 for both pharmacological and non-pharmacological treatments for posttraumatic nightmares.

    Article  PubMed  Google Scholar 

  16. 16.

    Sandman N, Valli K, Kronholm E, Vartiainen E, Laatikainen T, Paunio T. Nightmares as predictors of suicide: an extension study including war veterans. Sci Rep. 2017;7:1–7.

    Article  CAS  Google Scholar 

  17. 17.

    Titus CE, Speed KJ, Cartwright PM, Drapeau CW, Heo Y, Nadorff MR. What role do nightmares play in suicide? A brief exploration. Curr Opin Psychol. 2018;22:59–62.

    Article  PubMed  Google Scholar 

  18. 18.

    • Ellis TE, Rufino KA, Nadorff MR. Treatment of nightmares in psychiatric inpatients with imagery rehearsal therapy: an open trial and case series. Behav Sleep Med. 2017. This article reviews Imagery Rehearsal Therapy in an inpatient setting, which expands the data supporting its use with different populations.

  19. 19.

    Phelps AJ, Kanaan RA, Worsnop C, Redston S, Ralph N, Forbes D. An ambulatory polysomnography study of the post-traumatic nightmares of post-traumatic stress disorder. Sleep. 2018;41(1):zsx188.

    Article  Google Scholar 

  20. 20.

    Mysliwiec V, O'Reilly B, Polchinski J, Kwon HP, Germain A, Roth BJ. Trauma associated sleep disorder: a proposed parasomnia encompassing disruptive nocturnal behaviors, nightmares, and REM without atonia in trauma survivors. J Cl Sleep Med. 2014;10(10):1143–8.

    Google Scholar 

  21. 21.

    Rachakonda TD, Balba NM, Lim MM. Trauma-associated sleep disturbances: a distinct sleep disorder? Curr Sleep Med Rep. 2018;4:143–8.

    Article  Google Scholar 

  22. 22.

    Detweiler MB. Risperidone for night terrors and sleepwalking in an adult: a case report. J Pharm Technol. 2013;29(3):143–8.

    Article  Google Scholar 

  23. 23.

    Mazarakis T. A case of adult night terrors. Tzu Chi Med J. 2014;26(3):138–40.

    Article  Google Scholar 

  24. 24.

    Burstein A. Treatment of post-traumatic stress disorder with imipramine. Psychosomatics. 1984;25(9):681–7.

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Thünker J, Pietrowsky R. Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD. Behav Res Ther. 2012;50(9):558–64.

    Article  PubMed  Google Scholar 

  26. 26.

    Department of Veterans Affairs, Department of Defense. VA/DoD clinical practice guidelines for the management of posttraumatic stress disorder and acute stress disorder. 2017. Accessed 26 Jun 2018

  27. 27.

    •• Raskind MA, Peskind ER, Chow B, Harris C, Davis-Karim A, Holmes HA, et al. Trial of prazosin for post-traumatic stress disorder in military veterans. N Engl J Med. 2018;378(6):507–17 This results of this study influenced prazosin’s downgrade in the Clinical Practice Guidelines for the Management of Posttraumatic Stress Disorder from the Department of Veterans Affairs and the Department of Defense and the American Academy of Sleep Medicine.

    CAS  Article  PubMed  Google Scholar 

  28. 28.

    Morgenthaler TI, Auerbach S, Casey KR, Kristo D, Maganti R, Ramar K, et al. Position paper for the treatment of nightmare disorder in adults: an American Academy of sleep medicine position paper. J Clin Sleep Med. 2018;14(6):1041–55.

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Aurora RN, Zak RS, Auerback SH, Casey KR, Chopwduri S, Krippot A, et al. Best practice guide for the treatment of nightmare disorder in adults. J Clin Sleep Med. 2010;6(4):389–401.

    PubMed  PubMed Central  Google Scholar 

  30. 30.

    Nappi CM, Drummond SP, Hall JM. Treating nightmares and insomnia in posttraumatic stress disorder: a review of current evidence. Neuropharmacology. 2012;62(2):576–85.

    CAS  Article  PubMed  Google Scholar 

  31. 31.

    Ahmadpanah M, Sabzeiee P, Hosseini SM, Torabian S, Haghighi M, Jahangard L, et al. Comparing the effect of prazosin and hydroxyzine on sleep quality in patients suffering from posttraumatic stress disorder. Neuropsychobiology. 2014;69(4):235–42.

    CAS  Article  PubMed  Google Scholar 

  32. 32.

    Germain A, Richardson R, Moul DE, Mammen O, Haas G, Forman SD, et al. (2012). Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US military veterans. J Psychosom Res. 2012;72(2):89–96.

    Article  PubMed  Google Scholar 

  33. 33.

    Raskind MA, Peskind ER, Kanter ED, Petrie EC, Radant A. Thompson CE,, et al. reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study. PsychiatryOnline. 2003;160(2):371–3.

    Google Scholar 

  34. 34.

    Raskind MA, Peskind ER, Hoff DJ, Hart KL, Holmes HA. Warren D,, et al. a parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with posttraumatic stress disorder. Biol Psychiatry. 2007;61:928–34.

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Taylor FB, Martin P, Thompson C, Williams J, Mellman TA, Gross C, et al. Prazosin effects on objective sleep measures and clinical symptoms in civilian trauma posttraumatic stress disorder: a placebo-controlled study. Biol Psychiatry. 2008;63(6):629–32.

    CAS  Article  PubMed  Google Scholar 

  36. 36.

    Johnson KG, Rosen J. Re-emergence of posttraumatic stress disorder nightmares with nursing home admission: treatment with prazosin. J Am Med Dir Assoc. 2013;14(2):130–1.

    Article  PubMed  Google Scholar 

  37. 37.

    Keeshin BR, Ding Q, Presson AP, Berkowitz SJ, Strawn JR. Use of Prazosin for pediatric PTSD-associated nightmares and sleep disturbances: a retrospective chart review. Neurol Ther. 2017;6(2):247–57.

    Article  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Koola MM, Varghese SP, Fawcett JA. High-dose prazosin for the treatment of post-traumatic stress disorder. Therap Adv Psychopharmacol. 2013;4(1):43–7.

    Article  Google Scholar 

  39. 39.

    Oluwabusi OO, Sedky K, Bennett DS. Prazosin treatment of nightmares and sleep disturbances associated with posttraumatic stress disorder: two adolescent cases. J Child Adolesc Psychopharmacol. 2012;22(5):399–402.

    CAS  Article  PubMed  Google Scholar 

  40. 40.

    Raskind MA, Dobie DJ, Kanter ED, Petrie EC, Thompson CE, Peskind ER. The alpha1-adrenergic antagonist prazosin ameliorates combat trauma nightmares in veterans with posttraumatic stress disorder. J Clin Psychiatry. 2000;61(2):129–34.

    CAS  Article  PubMed  Google Scholar 

  41. 41.

    Ressler KJ. Alpha-adrenergic receptors in PTSD—failure or time for precision medicine? N Engl J Med. 2018;378:575–6.

    Article  PubMed  Google Scholar 

  42. 42.

    Nirmalani-Gandhy A, Sanchez D, Catalano G. Terazosin for the treatment of trauma-related nightmares. Cl Neuropharmacology. 2015;38(3):109–11.

    Google Scholar 

  43. 43.

    Salviati M, Pallagrosi M, Valeriani G, Carlone C, Todini L, Biondi M. On the role of noradrenergic system in PTSD and related sleep disturbances. The use of terazosin in PTSD related nightmares: a case report. Clin Ter. 2013;164(2):133–7.

    CAS  PubMed  Google Scholar 

  44. 44.

    Sethi R, Vasudeva S. Doxazosin for the treatment of nightmares. Prim Care Companion CNS Disord. 2012.

  45. 45.

    Smith C, Koola MM. Evidence for using doxazosin in the treatment of posttraumatic stress disorder. Psychiatr Ann. 2016;46(9):553–5.

    Article  PubMed  PubMed Central  Google Scholar 

  46. 46.

    Alao A, Selvarajah J, Razi S. The use of clonidine in the treatment of nightmares among patients with co-morbid PTSD and traumatic brain injury. Int J Psychiatry Med. 2012;44(2):165–9.

    Article  PubMed  Google Scholar 

  47. 47.

    Kinzie JD, Leung P. Clonidine in Cambodian patients with posttraumatic stress disorder. J Nerv Ment Dis. 1989;177(9):546–50.

    CAS  Article  PubMed  Google Scholar 

  48. 48.

    Kinzie JD, Sack RL, Riley CM. The polysomnographic effects of clondine on sleep disorders in posttraumatic stress disorder. J Nerv Ment Dis. 1994;182(10):585.

    CAS  Article  PubMed  Google Scholar 

  49. 49.

    Jakovljevic M, Sagud M, Mihaljevic-Peles A. Olanzapine in the treatment-resistant, combat-related PTSD—a series of case reports. Acta Psychiatr Scand. 2003;107(5):394–6.

    CAS  Article  PubMed  Google Scholar 

  50. 50.

    David D, De Faria L, Mellman TA. Adjunctive risperidone treatment and sleep symptoms in combat veterans with chronic PTSD. Depress Anxiety 2006;23(8):489–491.

    CAS  Article  PubMed  Google Scholar 

  51. 51.

    Khachiyants N, Ali R, Kovesdy CP, Detweiler JG, Kim KY, Detweiler MB. Effectiveness of risperidone for the treatment of nightmares in veterans with posttraumatic stress disorder. J Clin Psychopharmacol. 2010;30(6):735–7.

    Article  PubMed  Google Scholar 

  52. 52.

    Stanovic JK, James KA, VanDevere CA. The effectiveness of risperidone on acute stress symptoms in adult burn patients: a preliminary retrospective pilot study. J Burn Care Rehab 2001. 2001;22(3):210–3.

    CAS  Article  Google Scholar 

  53. 53.

    Lambert MT. Aripiprazole in the management of post-traumatic stress disorder symptoms in returning global war on terrorism veterans. Inter Clin Psychopharmacol. 2006;21(3):185–7.

    Article  Google Scholar 

  54. 54.

    Brophy MH. Cyproheptadine for combat nightmares in post-traumatic stress disorder and dream anxiety disorder. Mil Med. 1991;156(2):100–1.

    CAS  Article  PubMed  Google Scholar 

  55. 55.

    Clark RD, Canive JM, Calais LA, Qualls C, Brugger RD, Vosburgh TB. Cyproheptadine treatment of nightmares associated with posttraumatic stress disorder. J Clin Psychopharmacol. 1999;19(5):486–7.

    CAS  Article  PubMed  Google Scholar 

  56. 56.

    Gupta S, Popli A, Bathurst E, Hennig L, Droney T, Keller P. Efficacy of cyproheptadine for nightmares associated with posttraumatic stress disorder. Compr Psychiatry. 1998;39(3):160–4.

    CAS  Article  PubMed  Google Scholar 

  57. 57.

    De Boer M, Op den Velde W, Falger PJ, Hovens JE, De Groen JH, Van Duijn H. Fluvoxamine treatment for chronic PTSD: A pilot study. Psychother Psychosom. 1992;57(4):158–63.

    Article  PubMed  Google Scholar 

  58. 58.

    Neylan TC, Metzler TJ, Schoenfeld FB, Weiss DS, Lenoci M, Best SR, et al. Fluvoxamine and sleep disturbances in posttraumatic stress disorder. J Trauma Stress. 2001;14(3):461–7.

    CAS  Article  PubMed  Google Scholar 

  59. 59.

    Hamner M, Brodrick P, Labbate L. Gabapentin in PTSD: a retrospective, clinical series of adjunctive therapy. Ann Clin Psychiatry. 2001;13(3):141–6.

    CAS  Article  PubMed  Google Scholar 

  60. 60.

    Fraser GA. The use of a synthetic cannabinoid in the management of treatment-resistant nightmares in posttraumatic stress disorder (PTSD). CNS Neurosci Therap. 2009;15(1):84–8.

    Article  Google Scholar 

  61. 61.

    Jetly R, Heber A, Fraser G, Boisvert D. The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: a preliminary randomized, double-blind, placebo-controlled cross-over design study. Psychoneuroendocrinology. 2015;51:585–8.

    CAS  Article  PubMed  Google Scholar 

  62. 62.

    Alderman CP, McCarthy LC, Condon JT, Marwood AC, Fuller JR. Topiramate in combat-related posttraumatic stress disorder. Ann Pharmacother. 2009;43(4):635–41.

    CAS  Article  PubMed  Google Scholar 

  63. 63.

    Berlant JL. Prospective open-label study of add-on and monotherapy topiramate in civilians with chronic nonhallucinatory posttraumatic stress disorder. BMC Psychiatry. 2004;4(1):1–6.

    Article  CAS  Google Scholar 

  64. 64.

    Berlant J, Van Kammen DP. Open-label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder. J Clin Psychiatry. 2002;63(1):15–20.

    CAS  Article  PubMed  Google Scholar 

  65. 65.

    Tucker P, Trautman RP, Wyatt DB, Thompson J, Wu S, Capece JA, et al. Efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder. J Clin Psychiatry. 2007;68(02):201–6.

    CAS  Article  PubMed  Google Scholar 

  66. 66.

    Yeh MS, Mari JJ, Costa MC, Andreoli SB, Bressan RA, Mello MF. A double-blind randomized controlled trial to study the efficacy of topiramate in a civilian sample of PTSD. CNS Neurosci Ther. 2010;17(5):305–10.

    Article  CAS  PubMed  Google Scholar 

  67. 67.

    Hogben GL, Cornfield RB. Treatment of traumatic war neurosis with Phenelzine. Arch Gen Psychiatry. 1981;38(4):440.

    CAS  Article  PubMed  Google Scholar 

  68. 68.

    Lerer B, Bleich A, Kotler M, Garb R, Hertzber M, Levin B. Posttraumatic stress disorder in Israeli combat veterans. Arch Gen Psychiatry. 1987;44(11):976.

    CAS  Article  PubMed  Google Scholar 

  69. 69.

    Warner MD, Dorn MR, Peabody CA. Survey on the usefulness of Trazodone in patients with PTSD with insomnia or nightmares. Pharmacopsychiatry. 2001;34(4):128–31.

    CAS  Article  PubMed  Google Scholar 

  70. 70.

    Davidson JR, Weisler RH, Malik ML, Connor KM. Treatment of posttraumatic stress disorder with nefazodone. Int Clin Psychopharmacol. 1998;13(3):111–4.

    CAS  Article  PubMed  Google Scholar 

  71. 71.

    Gillin JC, Smith-Vaniz A, Schnierow B, Rapaport MH, Kelsoe J, Raimo E, et al. An open-label, 12-week clinical and sleep eeg study of nefazodone in chronic combat-related posttraumatic stress disorder. J Clin Psychiatry. 2001;62(10):789–96.

    CAS  Article  PubMed  Google Scholar 

  72. 72.

    Neylan TC, Lenoci M, Maglione ML, Rosenlicht NZ, Leykin Y, Metzler TJ, et al. The effect of nefazodone on subjective and objective sleep quality in posttraumatic stress disorder. J Clin Psychiatry. 2003;64(4):445–50.

    CAS  Article  PubMed  Google Scholar 

  73. 73.

    Boehnlein JK, Kinzie JD, Ben R, Fleck J. One-year follow-up study of posttraumatic stress disorder among survivors of Cambodian concentration camps. Amer J Psychiatry. 1985;142(8):956–9.

    CAS  Article  Google Scholar 

  74. 74.

    Cates ME, Bishop MH, Davis LL, Lowe JS, Woolley TW. Clonazepam for treatment of sleep disturbances associated with combat-related posttraumatic stress disorder. Ann Pharmacother. 2004;38(9):1395–9.

    CAS  Article  PubMed  Google Scholar 

  75. 75.

    Stein DJ, Pedersen R, Rothbaum BO, Baldwin DS, Ahmed S, Musgnung J, et al. Onset of activity and time to response on individual CAPS-SX17 items in patients treated for post-traumatic stress disorder with venlafaxine ER: a pooled analysis. Int J Neuropsychopharmacol. 2005;12(01):23.

    Article  CAS  Google Scholar 

  76. 76.

    Moore BA, Krakow B. Imagery rehearsal therapy: an emerging treatment for posttraumatic nightmares in veterans. Psychol Trauma. 2010;2(3):232–8.

    Article  Google Scholar 

  77. 77.

    Rousseau A, Belleville G. The mechanisms of action underlying the efficacy of psychological nightmare treatments: a systematic review and thematic analysis of discussed hypotheses. Sleep Med Rev. 2018;39:122–33.

    Article  PubMed  Google Scholar 

  78. 78.

    Krakow B, Zadra A. Clinical management of chronic nightmares: imagery rehearsal therapy. Behav Sleep Med. 2006;4(1):45–70.

    Article  PubMed  Google Scholar 

  79. 79.

    Alliger-Horn C, Zimmermann P, Herr K, Danker-Hopfe H, Willmund G. Adapted, inpatient nightmare therapy involving imagery rehearsal therapy (IRT) for chronically war-traumatized German soldiers with PTSD. Z Psychiatr Psychol Psychother. 2017;65(4):251–60.

    Google Scholar 

  80. 80.

    Sheaves B, Onwumere J, Keen N, Kuipers E. Treating your worst nightmare: a case-series of imagery rehearsal therapy for nightmares in individuals experiencing psychotic symptoms. Cog Behav Therap. 2015;8.

  81. 81.

    Gieselmann A, Böckermann M, Sorbi M, Pietrowsky R. The effects of an internet-based imagery rehearsal intervention: a randomized controlled trial. Psychother Psychosom. 2017;86(4):231–40.

    Article  PubMed  Google Scholar 

  82. 82.

    Margolies S, Rybarczyk B, Vrana S, Leszczyszyn D, Lynch J. Efficacy of a cognitive-behavioral treatment for insomnia and nightmares in Afghanistan and Iraq veterans with PTSD. J Clin Psychol. 2013;69(10):1026–42.

    Article  PubMed  Google Scholar 

  83. 83.

    Balliett N, Davis J, Miller K. Efficacy of a brief treatment for nightmares and sleep disturbances for veterans. Psychol Trauma. 2015;7(6):507–15.

    Article  PubMed  Google Scholar 

  84. 84.

    Miller K, Davis J, Rhudy J. Pilot study: brief posttrauma nightmare treatment for persons with bipolar disorder. Dreaming. 2018;28(2):150–61.

    Article  Google Scholar 

  85. 85.

    Fernandez S, DeMarni CL, Borntrager C, Swopes R, Hanson R, Davis J. A case series: cognitive-behavioral treatment (exposure, relaxation, and rescripting therapy) of trauma-related nightmares experienced by children. Clin Case Stud. 2013;12(1):39–59.

    Article  Google Scholar 

  86. 86.

    Pruiksma K, Cranston C, Rhudy J, Micol R, Davis J. Randomized controlled trial to dismantle exposure, relaxation, and rescripting therapy (ERRT) for trauma-related nightmares. Psychol Trauma. 2018;10(1):67–75.

    Article  PubMed  Google Scholar 

  87. 87.

    Colvonen PJ, Drummond SP, Angkaw AC, Norman SB. Cognitive behavioral therapy for insomnia integrated with prolonged exposure: rationale and pilot study. Psychol Trauma Under Rev.

  88. 88.

    Waltman SH, Sokol L, Beck AT. Cognitive behavior therapy treatment Fidelity in clinical trials: review of recommendations. Curr Psychiatr Rev. 2017;13(4):311–5.

    Article  Google Scholar 

  89. 89.

    Defense Health Agency. Dream EZ. Accessed 26 Jun 2018.

  90. 90.

    Friedman MJ, Marmar CR, Baker DG, Sikes CR, Farfel GM. Randomized, doubleblind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting. J Clin Psychiatry. 2007;68:711–20.

    CAS  Article  PubMed  Google Scholar 

  91. 91.

    Schnurr PP, Friedman MJ, Foy DW, Shea MT, Hsieh FY, Lavori PW, et al. Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a Department of Veterans Affairs cooperative study. Arch Gen Psychiatry. 2003;60:481–9.

    Article  PubMed  Google Scholar 

  92. 92.

    Krystal JH, Cramer JA, Krol WF, Kirk GF, Rosenheck RA. Naltrexone in the treatment of alcohol dependence. N Engl J Med. 2001;345:1734–9.

    CAS  Article  PubMed  Google Scholar 

  93. 93.

    Rosenheck RA, Krystal JH, Lew R, Barnett PG, Fiore L. Valley D,, et al. long-acting risperidone and oral antipsychotics in unstable schizophrenia. N Engl J Med. 2011;364:842–51.

    CAS  Article  PubMed  Google Scholar 

  94. 94.

    Meichenbaum D, Lilienfeld SO. How to spot hype in the field of psychotherapy: a 19-item checklist. Prof Psychol Res and Pr. 2018;49(1):22–30.

    Article  Google Scholar 

  95. 95.

    Waltman SH, Creed TA, Beck AT. Are the effects of cognitive behavior therapy for depression falling? Review and critique of the evidence. Clin Psychol. 2016;23(2):113–22.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Scott H. Waltman.

Ethics declarations

Conflict of Interest

Scott H. Waltman worked as a consultant and CBT trainer for the Academy of Cognitive Therapy.

David Shearer declares no potential conflicts of interest.

Bret A. Moore reports he is a CME content reviewer for the Neuroscience Education Institute and Series Editor for Routledge Press book series titled “Clinical Topics in Psychology and Psychiatry.”

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Sleep Disorders

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Waltman, S.H., Shearer, D. & Moore, B.A. Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013. Curr Psychiatry Rep 20, 108 (2018).

Download citation


  • Nightmares
  • Trauma
  • Traumatic
  • PTSD
  • Trauma nightmare
  • Prazosin
  • Imagery rehearsal therapy