The "Dream Changer": a randomized controlled trial evaluating the efficacy of a parent-based intervention for childhood nightmares

Abstract

Study objectives: Recurrent nightmares in childhood may have a range of detrimental effects for both the child and parents. This randomized controlled trial evaluated the efficacy of a novel parent-based intervention for childhood nightmares, using a new device called the "Dream Changer."

Methods: A total of 56 children aged 3-10 years (M = 7.1 ± 2.1 years; 51.8% boys), and one of their parents were randomized to either the intervention or waitlist control group. The intervention group received a "Dream Changer"-a light-emitting remote-control-like device that the child was encouraged to take to bed and use upon experiencing a nightmare. Parents completed online surveys at baseline, 1-week, and 2-weeks following the intervention. Parents in the intervention group additionally completed a 3-month follow-up survey. Outcome variables included children's nightmare frequency, sleep-wake patterns, and sleep anxiety, as well as parents' daytime sleepiness.

Results: Significant group-by-time interaction effects were found for nightmare frequency (p = 0.001) and sleep anxiety (p = 0.006). Parents of children who received the "Dream Changer" reported fewer nightmares (Mdifference = 1.7, p < 0.001, d = 1.06) and decreased anxiety (Mdifference = 0.9, p = 0.001, d =0.41) at post-intervention, whereas such benefits were not found in the waitlist control group. Three-month follow-up assessments demonstrated that gains were maintained over-time. Interaction effects were not significant for children's sleep metrics or for parents' daytime sleepiness.

Conclusions: The present study provides preliminary evidence for the efficacy of a brief, highly accessible intervention for reducing children's nightmares and nighttime anxiety. Future research may wish to test these effects using larger samples and longer follow-up assessments.

Clinical trial registration: The trial has been registered at the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/; Identifier:ACTRN12620000633987).

Keywords: children; insomnia; nightmares; nighttime fears; sleep; sleep anxiety.