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Given the high prevalence of lucid dreaming in narcolepsy, we added a promising adjuvant component, targeted lucidity reactivation (TLR), a procedure designed to enhance lucid dreaming and dream control. Using a multiple baseline single\u2010case experimental design, adults with narcolepsy and frequent nightmares (\u22653\/week, <jats:italic>N<\/jats:italic>\u2009=\u20096) were randomised to a 2 or 4 week baseline and received seven treatment sessions (CBT\u2010N or CBT\u2010N\u2009+\u2009TLR). Across the groups, there was a large effect size (between\u2010case standardised mean difference [BC\u2010SMD]\u2009=\u2009\u22120.97, 95% CI \u22121.79 to \u22120.14, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) for reduced nightmare frequency from baseline (M\u2009=\u20098.38\/week, SD\u2009=\u20097.08) to posttreatment (M\u2009=\u20092.25\/week, SD\u2009=\u20091.78). Nightmare severity improved significantly with large effect sizes on sleep diaries (BC\u2010SMD\u2009=\u2009\u22121.14, 95% CI \u22122.03 to \u22120.25, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and the Disturbing Dream and Nightmare Severity Index (<jats:italic>z<\/jats:italic>\u2009=\u2009\u22122.20, <jats:italic>p<\/jats:italic>\u2009=\u20090.03, <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.64). Treatment was associated with a reduction for some participants in sleep paralysis, sleep\u2010related hallucinations, and dream enactment. NREM parasomnia symptoms (<jats:italic>z<\/jats:italic>\u2009=\u2009\u22122.20, <jats:italic>p<\/jats:italic>\u2009=\u20090.03, <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.64) and self\u2010efficacy for managing symptoms (<jats:italic>z<\/jats:italic>\u2009=\u2009\u22122.02, <jats:italic>p<\/jats:italic>\u2009=\u20090.04, <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.58) improved significantly with large effect sizes. Participants who underwent TLR (<jats:italic>n<\/jats:italic>\u2009=\u20093) all recalled dreams pertaining to their rescripted nightmare. In interviews, participants noted reduced shame and anxiety about sleep\/nightmares. This study provides a proof of concept for the application of TLR as a therapeutic strategy with clinical populations, as well as preliminary evidence for the efficacy of CBT\u2010N in treating narcolepsy\u2010related nightmares.<\/jats:p>","DOI":"10.1111\/jsr.14384","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T01:28:26Z","timestamp":1729646906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Treating narcolepsy\u2010related nightmares with cognitive behavioural therapy and targeted lucidity reactivation: A pilot study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0778-6881","authenticated-orcid":false,"given":"Jennifer M.","family":"Mundt","sequence":"first","affiliation":[{"name":"Department of Neurology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Center for Circadian and Sleep Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi E.","family":"Pruiksma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R.","family":"Konkoly","sequence":"additional","affiliation":[{"name":"Department of Psychology Northwestern University  Evanston Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clair","family":"Casiello\u2010Robbins","sequence":"additional","affiliation":[{"name":"Triangle Area Psychology Clinic  Durham North Carolina USA"},{"name":"Unified Protocol Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Nadorff","sequence":"additional","affiliation":[{"name":"Department of Psychology Mississippi State University  Starkville Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel\u2010Clair","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Psychology Mississippi State University  Starkville Mississippi USA"},{"name":"Patient advocate"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunaina","family":"Karanth","sequence":"additional","affiliation":[{"name":"Department of Neurology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Patient advocate"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Byskosh","sequence":"additional","affiliation":[{"name":"McGaw Medical Center Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Psychology Northwestern University  Evanston Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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