POSTAL SELF-EXPOSURE TREATMENT OF RECURRENT NIGHTMARES - RANDOMIZED CONTROLLED TRIAL

Background Many nightmare sufferers do not consult a health care profe ssional. Though behaviour and cognitive therapy can help, they have no t been tested as a self-treatment method at home using a manual. Metho d One hundred and seventy adults with primary nightmares were randomis ed to four weeks' self-exposure or self-relaxation at home using manua ls posted to them, or to a waiting-list as a control group for four we eks. Individuals recorded nightmare frequency and intensity in four-we ek diaries. Results Atone-and six-month follow-up, the self-rated nigh tmare frequency fell more significantly in exposure subjects than rela xation or wailing-list subjects. The self-exposure group had the most drop-outs but remained superior in an over-cautious intent-to-treat an alysis. The individuals' partners confirmed the superiority of self-ex posure 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 or other conditions may benefit from self-treatment m anuals.