A recently published study from the University of Oklahoma and the University of Tulsa proposes a new model to explain why children’s nightmares persist over long periods of time and how treatments can be designed to break the nightmare cycle.
This research frontier of sleepNow, I will introduce the Darkness Model, which memorizes the factors that prevent children from escaping chronic nightmares. Central to this model is the idea of ”nightmare efficacy,” or the idea that children can learn skills to rid themselves of nightmares and regain good sleep.
The DARC-NESS model considers the mechanisms that maintain nightmares and the mechanisms that can break the nightmare cycle. A child’s reaction to nightmares is what causes chronic nightmares. This means that if you can learn how to react to your nightmares differently, you can break the cycle. It is empowering to understand that we can take steps to make our dreams come true. ”
Dr. Lisa Cromer, Professor of Psychology at the University of Tulsa and Volunteer Child Psychiatry Faculty at the OU School of Community Medicine in Tulsa
Rather than focusing solely on the content of nightmares, this model encourages clinicians to consider broader factors such as how the child interprets dreams, worries at bedtime, experience of anxiety at bedtime, and coping after waking.
This information helps us develop a personalized treatment plan rather than a one-size-fits-all approach. For some children, treatment focuses on reducing anxiety at bedtime. Some people may benefit from participating in exposure-based treatments, such as improving their sleep habits or working with a clinician to “rewrite” their nightmares by describing, writing, or drawing them.
“We believe we now have a way to conceptualize why nightmares persist and how we can better treat them in children,” said Tara Buck, M.D., a child and adolescent psychiatrist at OU Health and an associate professor at the OU School of Community Medicine in Tulsa. “What is unique about this model is that it is customizable to the patient’s needs and focuses on what the patient has control over. We look for potential intervention points and work with patients and their families to target them.”
Unlike insomnia, where children worry that they won’t be able to sleep, children who suffer from chronic nightmares worry that they won’t be able to sleep. intention sleep. Buck says helping children feel confident in their ability to cope with nightmares has big benefits beyond sleep.
“Self-efficacy is at the heart of this model,” she says. “When children feel empowered to do something about their nightmares, they begin to realize how things are interconnected, because they sleep better, have more energy, go to school more consistently, and their parents report improved behavior.”
This model is designed to be used by a variety of clinicians, including therapists and pediatricians. For years, health care providers have assumed that nightmares cannot be treated or that they will go away if the underlying trauma or mental health condition is addressed. However, this is not always the case.
“We’ve been working with kids who have been in mental health treatment for a long time and who still have nightmares,” Buck said. “We need a nightmare treatment model that helps children when their nightmares are recurrent and distressing.”
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Reference magazines:
Cromer, L.D.; others. (2026). DARC-NESS: A mastery-based cognitive-behavioral model for treating chronic nightmares in adolescents. Frontier of sleep. DOI: 10.3389/frsle.2026.1772987. https://www.frontiersin.org/journals/sleep/articles/10.3389/frsle.2026.1772987/full
