Sleep disorders are usually targeted for treatment in and of themselves, even if a provider suspects that the difficulty may be caused by another mental health or medical problem. Treatment may include psychotherapy, sleep medications, or a combination of the two.
For insomnia and nightmare disorders, recommended treatment emphasizes the role of psychotherapy. For short periods of time, medications may also be useful. Used for too long, however, over-the-counter and prescription sleep medications can actually make the problem worse, a phenomenon known as "rebound insomnia."
Cognitive Behavioral Therapy for Insomnia (CBT-I)
Cognitive behavioral therapy is a form of psychotherapy commonly used to treat insomnia. CBT-I helps patients become more aware of the thoughts and behaviors that contribute to and perpetuate insomnia. Patients then learn how to change specific patterns of thought and behavior in order to create the psychological and physiological conditions that enable healthy, satisfying sleep.
Imagery Rehearsal Therapy (IRT)
Imagery rehearsal therapy is an evidence-based form of treatment that addresses nightmares as a learned sleep disorder that is the product of a damaged imagery system. IRT uses a process of selecting a nightmare, changing the nightmare into a new dream, and rehearsing the new dream. IRT helps patients learn about the human imagery system, how to monitor this system for themselves, to appreciate connections between daytime imagery and dreams, and to utilize the imagery rehearsal process to take control of their nightmares.