Interest in telephone nightmare counselling in patients with sleep-related breathing disorders
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Originalien Somnologie https://doi.org/10.1007/s11818-020-00254-9 © The Author(s) 2020
Michael Schredl1,3 for AG Traum der Deutschen Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) · Katharina Lüth1 for AG Traum der Deutschen Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) · Judith Schmitt2 for AG Traum der Deutschen Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) 1
Sleep Laboratory, Central Institute of Mental health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany 2 Abteilung für Schlafmedizin, Theresienkrankenhaus und St. Hedwig-Klinik GmbH, Mannheim, Germany 3 Schlaflabor, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany
Interest in telephone nightmare counselling in patients with sleep-related breathing disorders Nightmare disorder (F51.5) is characterized by extended, extremely dysphoric, and well-remembered dreams that cause clinically significant distress and/or impairment in social, occupational, or other important areas of functioning [1]. The prevalence of nightmare disorder in the general population is estimated to be about 2 to 6% [11] and about 30% in a patient group with various mental disorders, e.g., mood and anxiety disorders [27]. Even though effective treatment strategies such as like imagery rehearsal therapy (IRT) are available [2, 5, 30], nightmares are typically undertreated [12, 17]. This is of clinical importance as frequent nightmare sufferers often report severe burden [6], and nightmares have been identified as an independent predictor of suicidal ideation and suicide [13]. Two possible explanations for why nightmares are rarely treated have been investigated. First, nightmare disorders are rarely diagnosed, even in sleep centers. Krakow reported that 16.3% of sleep-disordered patients (N = 718) also have problems with nightmares; however, for this specific research project, all clinicians were instructed to ask every patient explicitly about nightmares [7]. The information about problematic nightmares would have been lost in the routine procedures typical for this sleep medicine center. In a German multicen-
ter study with N = 4001 patients undergoing diagnostic procedures for various reasons in different sleep laboratories [20], 13.4% of patients reported nightmares at least once a week—a typical cut-off for diagnosing a nightmare disorder. However, only 1.6% of the sample actually received a nightmare disorder diagnosis. The second factor reflects that nightmare sufferers rarely seek professional help for their condition. An online survey indicated that only 29.6% of 335 nightmare sufferers had ever asked a health care provider for help [28]. Similar or even lower figures were reported for persons with frequent nightmares (nightmares once a week or more often), i.e., 15.19% [18], 22.79% [22], and 33.00% [21], or students with relevant nightmare disorder symptoms (11.11%; [12]). Nightmare frequency and nightmare distress were correlated with seeking professional help [12, 18, 21], but no effects of gender, age, and education on this variabl
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