Work

DARC-NESS: a mastery-based cognitive-behavioral model for treating chronic nightmares in youth

Year: 2026

Type: article

Abstract: Theories of chronic nightmare maintenance highlight dysfunctional beliefs about sleep and nightmares, distress and arousal, anticipatory anxiety, maladaptive sleep habits, and sleep deprivation as perpetuating factors that maintain nightmare disorder over time. Theories of nightmare treatment suggest that self-efficacy is a common factor in nightmare mitigation. The current article introduces DARC-NESS, a multi-component theory of nightmare maintenance that emphasizes nightmare self-efficacy as a central mechanism influencing the maintenance cycle at multiple points. DARC-NESS is a mnemonic for the model's components: Dream (nightmare) content, Appraisals, Resources for regulation, Conditioned arousal, Nightmare Efficacy, Sleep hygiene and patterns, and Sleep quality and quantity, that interact to perpetuate nightmares. This model provides the theoretical basis for cognitive behavioral therapy (CBT) for child nightmares. The manuscript proposes treatment counterparts to each model component and presents a case illustration demonstrating how these interventions can disrupt the vicious cycle of chronic nightmares. Finally, flexible clinical applications are offered to guide clinicians in selecting and sequencing modular intervention elements to match individual case presentations.

Source: Frontiers in Sleep

DOI: 10.3389/frsle.2026.1772987

Authors: Lisa DeMarni Cromer, Emily Kaier Cromwell, Lauren E. Prince, Tara R. Buck

Institutions: University of Tulsa, University of Rochester Medicine, University of Oklahoma

Language: English

Topic: Sleep and related disorders

Subfield: Experimental and Cognitive Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,353