Advancing Research for Cognitive Behavioral Therapy to Treat Nightmares: Lisa Cromer, PhD

WATCH TIME: 4 minutes

"We're seeing kids as young as eight with serious suicidal thinking tied to chronic nightmares. If we can remove the nightmares, we may be removing the driver of their hopelessness."

Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that helps individuals identify and modify negative thought patterns or behaviors. In the context of nightmares in children, a specific form of CBT is often adapted.

For children with nightmares, they may undergo imagery rehearsal therapy, where they are guided to reimagine the nightmare with a positive or neutral ending, then mentally rehearse this new version during the day. In addition, children may undergo cognitive restructuring to help challenges irrational fears and thoughts related to nightmares, as well as relaxation techniques like deep breathing or guided imagery before bed to reduce anxiety.

Lisa Cromer, PhD, a professor of psychology at the University of Tulsa, has been researching ways to adapt CBT in various settings, including nightmares for children, for over 15 years. At the 2025 SLEEP Annual Meeting, held June 8-11 in Seattle, Washington, she presented a talk on this topic, giving the clinical audience insights on the evolution of CBT, understanding the maintenance cycle of nightmares, and how to identify the underpinnings of what children may be facing.

During the meeting, Cromer sat down with NeurologyLive^® to discuss a few topics related to the use of CBT to treat nightmares, including the current research landscape. In the interview, Cromer shared insights into her team’s research on CBT for nightmares, and the shift to focusing on the relationship between chronic nightmares and suicidality in youth. Furthermore, she highlighted emerging data from ongoing studies that suggest reducing nightmare frequency through CBT may significantly reduce suicidal ideation, with a possible link to increased self-efficacy and hope.

Click here for more SLEEP 2025 coverage.