Sleep therapy for PTSD teaches coping with nightmares through which approach?

• A. Imagery rehearsal therapy and relaxation techniques
• B. Cognitive restructuring only
• C. Pharmacotherapy only
• D. Sleep deprivation

Answer: (A)

Coping with PTSD-related nightmares is best addressed through imagery rehearsal therapy combined with relaxation techniques. Imagery rehearsal therapy teaches the person to rescript a distressing nightmare by imagining a new, non-threatening ending while awake, then practicing that updated dream scenario to reduce fear and distress when the nightmare recurs. Pairing this with relaxation methods—such as deep breathing or progressive muscle relaxation—helps lower daytime and nocturnal arousal that can trigger or worsen nightmares, making it easier to fall asleep and stay asleep. Over time, this combination reduces both the frequency and intensity of nightmares and improves overall sleep quality.

Cognitive restructuring targets daytime thoughts and beliefs about the trauma, which can help overall PTSD symptoms but doesn’t provide the direct coping skills for nightmares during sleep. Pharmacotherapy might assist with sleep or related symptoms, but it doesn’t teach the patient techniques to manage or alter nightmares themselves. Sleep deprivation is not a therapeutic strategy and tends to worsen sleep and PTSD symptoms.