Sleep is My Waking Passion

Yes, Nightmares Are Treatable featuring Dr. Courtney Worley, PhD.

Alison Kole Episode 114

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0:00 | 26:43

Nightmares aren’t just “bad dreams”—and you don’t have to live with them.

In this episode, Dr. Alison Kole sits down with behavioral sleep medicine expert Dr. Courtney Worley to break down what actually defines a nightmare disorder, why nightmares happen (far beyond trauma), and—most importantly—how to treat them.

They dive into the gold-standard, evidence-based therapy you’ve probably never been offered (imagery rehearsal therapy), how your brain can be retrained to stop recurring nightmares, and when it’s time to seek professional help. If you—or your patients—are struggling with persistent nightmares, this episode is a must-listen.

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Nightmares are common. Nightmare disorder is not—and it’s highly treatable.

In this episode of Sleep Is My Waking Passion, I sat down with Dr. Courtney Worley, a clinical psychologist and behavioral sleep medicine specialist, to unpack one of the most overlooked sleep conditions: nightmares.

Here are 3 key takeaways:

  • Nightmares are a transdiagnostic symptom: They’re not just about trauma. Nightmares can show up in insomnia, narcolepsy, depression, anxiety, medication effects, and more—making proper evaluation essential.
  • There is a first-line, evidence-based treatment: Imagery Rehearsal Therapy (IRT) helps patients “rewrite” their nightmares using neuroplasticity—and it works in as little as 4–6 sessions.
  • Not all “nightmares” are the same: Distinguishing between REM nightmares, non-REM parasomnias, and conditions like obstructive sleep apnea can completely change management.

Most patients never report nightmares—and many clinicians don’t ask.

That needs to change.

Listen to the full episode to learn how to recognize, treat, and rethink nightmares in your patients (and yourself).