Nightmares and lucid dreams are closely related because unpleasant dreams may trigger uninvited lucidity. For people who suffer from recurring nightmares, which cause sleep problems and increased anxiety, lucid dreaming may prove to be a useful tool. This tool offers control of the dream content, including threatening circumstances within the dream. Lucid dreams may lead to a reduced frequency of nightmares, less frightening nightmares, and alleviate some of the suffering repeated nightmares can cause (Revonsuo, 2010).
A nightmare is defined by the DSM-IV (The Diagnostic and Statistical Manual of Mental Disorders) as a very frightening dream that usually results in waking up with a negative effect on various aspects of waking life (American Psychiatric Association, 2000). Studies have investigated the effects of lucid dream therapy in reducing the frequency of nightmares. The two main elements of this treatment are learning to use cues that help in achieving lucidity during nightmares and learning what dreamers can do after they achieve lucidity. Participants in these studies learned several methods for creating lucidity and how to identify characteristics in a nightmare as a dream. The participants then chose a certain feature or characteristic of the dream that they tried to change when they are lucid, so that the nightmare takes a different course with an alternative (and less scary) ending. These studies show that lucid dreaming is an effective treatment in reducing the frequency and intensity of nightmares and improving sleep quality. In these experiments, several participants showed a decrease in the frequency of nightmares (Spoormaker & van den Bout, 2006; Spoormaker, van den Bout & Meijer, 2003; Zadra & Pihl, 1997). Furthermore, certain treatments contributed to improving the subjective quality of sleep (Spoormaker et al., 2003). Another study found that participants who failed to become lucid experienced fewer nightmares as well. Thus, the researchers concluded that the very knowledge of the potential to control the nightmare has an important and decisive role in helping with this phenomenon.
In a study conducted in Germany in 2006, a group of subjects, who received an explanation about lucid dreams, were asked to mentally imagine and rehearse a different version of the nightmare they were experiencing, while directed to avoid exposure to the original nightmare content as much as possible. According to the findings, the new version included more elements of control and positivity. It seems then that elements of control are significant and critical in the therapeutic effectiveness of this method. According to the study, a two-hour private training session on lucid dreaming therapy led to a modest but significant change in the frequency of nightmares. (Victor I. Spoormaker, 2006).
A study conducted by Victor Spoormaker, found that lucid dream therapy in post-traumatic patients was effective in reducing the frequency and intensity of nightmares, but did not contribute to improving sleep disorders, anxiety and depression, which are symptoms that usually accompany post-traumatic stress (Barclay, 2014). Spoormaker’s study described above also demonstrated that lucid dream therapy did not change sleep quality or other post-traumatic symptoms (Victor I. Spoormaker, 2006).
Clinical Trials on Treating Nightmares
In 2010, the American Academy of Sleep Medicine – AASM, was appointed by the Standards of Practice Committee to develop Best Practice guidelines for treating nightmares in adults. The committee recommended considering lucid dreaming therapy LDT as a level 3 treatment for nightmare disorder. A level 3 recommendation indicates that there is sufficient scientific evidence on the benefits of the treatment, and positions the LTD method on an equal footing with other treatments such as hypnosis and self-exposure therapy. The committee’s recommendations are based on four Level 1 studies, conducted by Zadra & Pihl in 1997, which included five subjects practicing muscle relaxation and visualization. Additionally, based on a level 3 study conducted by Spoormaker & Van Den in 2006 on 16 subjects in which participants showed improvement after only two hours of instruction about LDT (Aurora, 2010).
In 2018, the AASM categorized lucid dreaming therapy as a possible method for treating nightmares.