New Model Provides Insights Into Treating Chronic Nightmares in Children

The University of Oklahoma and the University of Tulsa have introduced a groundbreaking theoretical framework to better understand and address chronic nightmares in children. Published in *Frontiers in Sleep*, their study presents the DARC-NESS model, which shifts focus from the content of nightmares themselves to how children interpret and respond to them. This innovative approach aims to help clinicians design more effective therapies to break the cycle of recurring nightmares, which can disrupt sleep, increase anxiety, and negatively impact daily life.

The DARC-NESS model emphasizes that it is not the nightmare itself but the child’s response to it that perpetuates chronic sleep disturbances. “It’s a child’s response to a nightmare that causes the chronic nightmares to happen,” explained Lisa Cromer, Ph.D., a professor of psychology at the University of Tulsa and co-author of the study. “Which means if we can learn to respond to nightmares differently, then we can interrupt that cycle.”

Central to this model is the concept of “nightmare efficacy,” which involves teaching children skills to address their fears and restore healthy sleep patterns. By fostering a sense of agency in children, they can develop the tools needed to manage their nightmares effectively. The framework also highlights the importance of distinguishing between different types of sleep disturbances—such as insomnia versus chronic nightmares—to tailor treatments appropriately.

The DARC-NESS model is designed to be adaptable and flexible for clinicians, including therapists, pediatricians, and sleep specialists. Treatment strategies may include reducing bedtime anxiety, establishing better sleep routines, or using exposure-based techniques like describing, writing, or drawing the nightmare, followed by working with a clinician to “rewrite” or alter the story. This customizable approach ensures that interventions can be tailored to meet each child’s unique needs.

By addressing the underlying psychological and behavioral factors contributing to chronic nightmares, the DARC-NESS model offers a promising new direction for helping children achieve healthier sleep and reduce long-term emotional distress.