Recently published research from the University of Oklahoma and the University of Tulsa proposes a new model to explain why nightmares in children may persist over time and how therapies can be designed to break that cycle.
The study, published in border in sleepIntroduces the DARC-NESS model, a mnemonic for the factors that can keep a child stuck in long-term nightmares. At the heart of the model is “nightmare efficacy”, or the idea that children can learn skills to relieve nightmares and restore good sleep.
Lisa Cromer, Ph.D., professor of psychology at the University of Tulsa and volunteer child psychiatry faculty member at the OU School of Community Medicine in Tulsa. said, “The DARC-NESS model looks at the mechanisms that maintain nightmares, as well as the mechanisms that can break the cycle of nightmares.” “It’s a child’s response to a nightmare that causes chronic nightmares to occur, which means that if we can learn to respond to nightmares differently, we can interrupt that cycle. It’s empowering to understand that we can take steps to take control of our dreams.”
Rather than focusing solely on the content of the nightmare, the model encourages clinicians to consider broader factors, including how a child interprets the dream, anxiety about going to sleep, experiencing anxiety while sleeping, and coping after waking up.
That information can help guide an individualized treatment plan rather than a one-size-fits-all approach. For some children, treatment may focus on reducing bedtime anxiety. Others may benefit from improving sleep habits or participating in exposure-based therapy, such as describing, writing about, or drawing a nightmare and then working with a therapist to “rewrite” it.
“We believe we have created a way to understand why nightmares occur and how we can better treat them in children,” said OU Health child and adolescent psychiatrist Tara Buck, MD, associate professor at the OU School of Community Medicine in Tulsa. “What’s unique about the model is that it’s tailored to the patient’s needs, and it focuses on what the patient can control. We look for potential intervention points and target them collaboratively with patients and their families.”
Unlike insomnia, in which people fear that they will not sleep, children with chronic nightmares are afraid Desire Sleep According to Buck, helping children build confidence in their ability to deal with nightmares can have benefits far beyond sleep.
“Self-efficacy is at the heart of the model,” he said. “When children feel empowered to do something about nightmares, they begin to see how things are interconnected – because they are sleeping better, they have more energy, they go to school more consistently and their parents report better behavior.”
This model is designed for use by many practitioners, including therapists and pediatricians. For many years, health care providers either assumed that nightmares could not be treated or that they would go away if the underlying trauma or mental health condition was addressed. However, this is not always the case.
“We’ve worked with kids who have been receiving mental health treatment for a long time and their nightmares are still continuing,” Buck said. “A nightmare treatment model is needed to help children when their nightmares are frequent and distressing.”
