The dream experiences of insomnia sufferers in cognitive behavioral therapy: A qualitative study

Abstract

Individuals with insomnia have more negative dream contents than good sleepers, but no study has examined their perceptions of their dreams and their need to address this topic during therapy. Five adults were recruited from the Sleep Psychology Clinic at Université Laval after receiving a cognitive behavioral therapy for insomnia (CBT-I). They were administered a semi-structured interview constructed by the research team. The interviews were recorded and transcribed into verbatim for content analysis. The Insomnia Severity Index was administered before and after treatment, and sleep diaries were completed two weeks prior to the therapy and in the last two weeks of therapy. The participants experienced negative dreams but attributed little importance to them. They did not feel the need to discuss their dreams in therapy. However, they would be opened to address their dreams in therapy if it was relevant to their situation. Motives considered to be acceptable for talking about dreams in therapy were the experience of nightmares, a disruptive effect of dreams on sleep quality and daytime functioning, or the analysis of dreams to understand the causes of one’s difficulties. This study constitutes a first step in documenting the perceptions of individuals with insomnia regarding their dreams, and the perceived importance of these dreams in the context of CBT-I. While assessing the experience of nightmares is recommended, the results suggest that some individuals with insomnia do not need to discuss their dreams during CBT-I.