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Background <p>Approximately 5% of people suffer from nightmares at least every 2&#xa0;weeks. One cognitive behavioral intervention for recurrent nightmares is imagery rehearsal therapy (IRT), in which individuals recall, modify, and rehearse a&#xa0;less distressing version of their dream.</p> Objective <p>This randomized controlled trial evaluated the efficacy of a&#xa0;web application called “DreamMend” as a&#xa0;self-help method for reducing nightmares and their associated burden. It delivers digital IRT via an artificial intelligence (AI)-powered chatbot.</p> Materials and methods <p>A&#xa0;total of 42&#xa0;participants were randomized to the intervention (<i>n</i> = 18) or control group (<i>n</i> = 24). The intervention group received access to DreamMend for 8&#xa0;weeks. Analyses were conducted in 34&#xa0;participants with available outcome data (intervention: <i>n</i> = 16; control: <i>n</i> = 18).</p> Results <p>Nightmare frequency in the intervention group decreased over the course of 8&#xa0;weeks, while it remained constant in the control group. Linear mixed models (LMMs) revealed a&#xa0;statistically significant time × group interaction, showing that the intervention group profits from the intervention. Nightmare distress decreased in both groups over the 8&#xa0;weeks. The LMMs revealed a&#xa0;significant time × group interaction, indicating that the intervention group experienced a&#xa0;significantly more marked decrease in distress.</p> Conclusion <p>The DreamMend web-based application significantly reduced nightmare frequency, distress, and overall nightmare burden compared with a&#xa0;waitlist control, even with variable adherence and minimal intervention exposure. These findings demonstrate that AI-supported digital IRT is a&#xa0;feasible and effective self-help intervention. Larger, more diverse trials are needed to confirm efficacy and examine long-term outcomes.</p>

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Efficacy of a web application as a self-help intervention for nightmares: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月30日

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  • Julia Voss,
  • Madlen Peters,
  • Gordon Pipa,
  • Katharina Lüth

摘要

Background

Approximately 5% of people suffer from nightmares at least every 2 weeks. One cognitive behavioral intervention for recurrent nightmares is imagery rehearsal therapy (IRT), in which individuals recall, modify, and rehearse a less distressing version of their dream.

Objective

This randomized controlled trial evaluated the efficacy of a web application called “DreamMend” as a self-help method for reducing nightmares and their associated burden. It delivers digital IRT via an artificial intelligence (AI)-powered chatbot.

Materials and methods

A total of 42 participants were randomized to the intervention (n = 18) or control group (n = 24). The intervention group received access to DreamMend for 8 weeks. Analyses were conducted in 34 participants with available outcome data (intervention: n = 16; control: n = 18).

Results

Nightmare frequency in the intervention group decreased over the course of 8 weeks, while it remained constant in the control group. Linear mixed models (LMMs) revealed a statistically significant time × group interaction, showing that the intervention group profits from the intervention. Nightmare distress decreased in both groups over the 8 weeks. The LMMs revealed a significant time × group interaction, indicating that the intervention group experienced a significantly more marked decrease in distress.

Conclusion

The DreamMend web-based application significantly reduced nightmare frequency, distress, and overall nightmare burden compared with a waitlist control, even with variable adherence and minimal intervention exposure. These findings demonstrate that AI-supported digital IRT is a feasible and effective self-help intervention. Larger, more diverse trials are needed to confirm efficacy and examine long-term outcomes.