SynthesisJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2015
Comparative meta-analysis of prazosin and imagery rehearsal therapy for nightmare frequency, sleep quality, and posttraumatic stress.
Synthesis in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04529070 (Nightmare Rescripting and Rehearsal), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Nightmare Rescripting and Rehearsal: Testing a 10-Minute Intervention to Treat Recurring Distressing Dreams in Primary Care.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- The effects of prazosin on sleep disturbances in post-traumatic stress disorder: a systematic review and meta-analysis.Sleep medicine · 2020Pooled it
- Randomized Controlled Trial of Imagery Rehearsal for Posttraumatic Nightmares in Combat Veterans.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Trial
- Is There a Place for Medicinal Cannabis in Treating Patients with Sleep Disorders? What We Know so Far.Nature and science of sleep · 2022Review
- Treatment Guidelines for PTSD: A Systematic Review.Journal of clinical medicine · 2021Review
- Telephone-guided imagery rehearsal therapy for nightmares: Efficacy and mediator of change.Journal of sleep research · 2021Article
- Using Prazosin to Treat Posttraumatic Stress Disorder and Associations: A Systematic Review.Psychiatry investigation · 2021Article
- Sleep parameters improvement in PTSD soldiers after symptoms remission.Scientific reports · 2021Article
- The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter's Therapy for Insomnia and Nightmares) Study.International journal of environmental research and public health · 2020Article
- Dream enactment behavior: review for the clinician.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- Comparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews.Systematic reviews · 2019Review
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives.Journal of sleep research · 2019Review
- An Assessment of Medical Practitioners' Knowledge of, Experience with, and Treatment Attitudes Towards Sleep Disorders and Nightmares.Journal of clinical psychology in medical settings · 2019Article
- Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013.Current psychiatry reports · 2018Review
- Successful treatment of nightmares may reduce psychotic symptoms in schizophrenia.World journal of psychiatry · 2018Article
- Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD.Current psychiatry reports · 2018Review
- Traumatic Brain Injury, Sleep Disorders, and Psychiatric Disorders: An Underrecognized Relationship.Medical sciences (Basel, Switzerland) · 2018Review
- Dreams and Nightmares in Personality Disorders.Current psychiatry reports · 2016Review
- Cognitive Behavioral Therapy for Insomnia and Imagery Rehearsal in Combat Veterans with Comorbid Posttraumatic Stress: A Case Series.Military behavioral health · 2016Article
- Treating nightmares--sleep medicine and posttraumatic stress disorder.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2015Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectiveIn this meta-analysis, we compare the short-term efficacy of prazosin vs. IRT on nightmares, sleep quality, and posttraumatic stress symptoms (PTSS).
methodsReference databases were searched for randomized controlled trials using IRT or prazosin for nightmares, sleep disturbance, and/or PTSS. Effect sizes were calculated by subtracting the mean posttest score in the control group from the mean posttest score in the treatment group, and dividing the result by the pooled standard deviation of both groups. Mixed effects models were performed to evaluate effects of treatment characteristics, as well as sample characteristics (veteran vs. civilian) on treatment efficacy.
resultsFour studies used prazosin, 10 used IRT alone or in combination with another psychological treatment, and 1 included a group receiving prazosin and another group receiving IRT. Overall effect sizes of both treatments were of moderate magnitude for nightmare frequency, sleep quality, and PTSS (p < 0.01). Effect size was not significantly different with type of treatment (psychological vs. pharmacological) on nightmare frequency (p = 0.79), sleep quality (p = 0.65), or PTSS, (p = 0.52). IRT combined with CBT for insomnia showed more improvement in sleep quality compared to prazosin (p = 0.03), IRT alone (p = 0.03), or IRT combined with another psychological intervention, (p < 0.01).
conclusionAlthough IRT interventions and prazosin yield comparable acute effects for the treatment of nightmares, adding CBT for insomnia to IRT seems to enhance treatment outcomes pertaining to sleep quality and PTSS. More randomized clinical trials with long-term follow-up are warranted. COMMENTARY: A commentary on this article appears in this issue on page 9.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.