In the News

DEPRIVED: Doctors work to help those with PTSD get a better night's rest [Albuquerque Journal, N.M.] | Sleep - latest

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bhcMar. 1--Susan Smith still feels sleepy most of the time. The South Valley resident naps once or twice a day. She nods off at around 7 p.m. and then wakes up several times in the night.

"I still am sleepy during the day," she says. "I get really drained. I'm like an old lady by the end of the day. But I am a lot better than I was."

Since July 2008 she has used a Bi-level Positive Airway Pressure device, or BiPap, that provides a steady air supply at night to control her sleep apnea. She also gets help with nightmares that have plagued her for years.

Smith, 57, suffers from posttraumatic stress disorder following an assault as a young adult. She is one of many people fighting the debilitating symptoms of both PTSD and sleep problems like nightmares and insomnia, according to Dr. Barry Krakow, medical director of Maimonides Sleep Arts & Sciences in Albuquerque and author of "Sound Sleep, Sound Mind: 7 Keys to Sleeping Through the Night."


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Your Health: Easing nightmares can ease depression - USATODAY.com

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USAtodayLOGOThe night Yael Levy turned a circle of menacing sharks into a ring of harmless dolphins, she knew she had achieved mastery over a life-long foe: her nightmares.

"I was able to change my nightmare while it was happening," says the 29-year-old New York City graduate student. "I had control over my dreams."

That relief was more than Levy expected when she showed up at the Sleep-Wake Disorders Center at Montefiore Medical Center two years ago. Levy says she just wanted help for her insomnia. She had no idea her nightmares were treatable, too.

That's typical, says Shelby Freedman Harris, the Montefiore psychologist who helped Levy. But she and other experts say they often can relieve nightmares, even when the disturbing dreams are coupled with insomnia, depression, post-traumatic stress disorder (PTSD) or other problems.

"Traditionally, the idea was that you treat the main problem first and the nightmares will go away. With depression, often the nightmares and sleep disturbances are the last symptoms to go," Harris says. But addressing nightmares directly may help ease depression and other ills.

"In the past, the nightmares weren't targeted specifically," says Bret Moore, a former Army psychologist who now practices in Wilston, N.D. But when Moore treated soldiers for acute post-traumatic stress in Iraq, he found many craved rapid relief from disturbing nightmares. Using the same techniques Harris uses, he often was able to help, he says. He published case reports in the American Journal of Psychiatry in 2007.

The treatment is called imagery rehearsal therapy (IRT). It's a form of cognitive behavioral therapy, which focuses on changing harmful thought patterns. It's not the only nightmare therapy, but it is gaining ground, says physician Barry Krakow, a sleep specialist who runs the Maimonides International Nightmare Treatment Center in Albuquerque.


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Nocturnal Perdition | Psychology Today

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ptYou hunt for a place to hide. Maybe you are drowning, struggling in dark water. Or perhaps your plane is hurtling toward the ground.

Nine out of ten of us awake suddenly from dreams such as these. Researchers estimate that at least 5 percent of the population, probably more, suffers regularly from nightmares. These bad dreams may strike a few times a week or a few times a month. Studies show recurrent nightmares are grossly underreported.

"Nightmares are so confusing to people," says Barry Krakow, M.D., medical director for the Center for Sleep Medicine and Nightmare Treatment in Albuquerque, N.M. "They think it is their psyche screaming out, but that's only part of the story."

Unlike most normal dreams, nightmares don't appear to help a person work through the events in their daily lives. Even after decades of research, scientists still puzzle over why some people have nightmares but others don't. Although the causes of recurrent nightmares are still mysterious, some personality patterns have emerged among those who experience them.


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Sleep Early For A Night Owl | LIVESTRONG.COM

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LiveStrongAdequate sleep is an important part of your health and well-being. Changing the way you approach sleep can help you fall asleep early and stay asleep long enough to wake refreshed and ready to face your day, writes Barry Krakow, author of "Sound Sleep, Sound Mind: 7 Keys to Sleeping Through the Night." With a few behavior changes, your body will be ready for sleep early, and you will be able to sleep through the night.

Step 1

Begin preparing your body for sleep early. According to Krakow, if you dim the lights and reduce the noise level in your home and bedroom, your body will begin mentally preparing to go to bed. Turn your computer and television off, and engage in quiet activities, such as meditation or reading to calm your mind and relax you. Gunther B. Paulien, author of "The Divine Prescription and Science of Health and Healing," recommends a warm shower right before bed as another way to encourage relaxation.


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Getting Rid Of Repeating Nightmares: A Simple, Potent, New Recipe

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Huffington PostOne of the most dramatic, butt-kicking examples of an effective new treatment tool for posttraumatic stress is a simple protocol called Nightmare Reprocessing, devised by two V.A. psychologists, Edgardo Padin-Rivera and Beverly Donovan at the Louis Stokes Cleveland V.A. Medical Center.

From all indications, when this method is followed, trauma survivors can rid themselves of a repeating nightmare in three weeks or less.

Experienced therapists will find this hard to swallow. I know I did. This is because traditional, deep dish, insight-based therapy doesn't get a whole lot of traction with repetitive nightmares.

And, to add insult to injury, Nightmare Reprocessing is a simple procedure that any idiot can follow. (Sorry, colleagues! I didn't like it either!) It doesn't require savvy training, deft insight or masterful technique. You just follow the steps... which I'll describe in a minute.

Drs. Padin-Rivera and Donovan developed their iteration by tweaking Barry Krakow's Imagery Rehearsal Therapy, which you may have read about last fall in the New Yorker. They added some clever elements from Francine Shapiro's EMDR (Eye Movement Desensitization & Reprocessing), streamlined the process, and came up with a fast, potent method.


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