Nightmare efficacy as treatment lever

Researchers propose that chronic childhood nightmares persist because children wake and react in ways that prevent fear resolution; the DARC‑NESS model identifies 'nightmare efficacy'—the child's belief they can control or cope with bad dreams—as a central, modifiable factor alongside appraisal, conditioned arousal, and sleep hygiene. Targeted interventions that boost a child's sense of control over dreams (reframing, coping scripts, bedtime routines) can break the vicious cycle without high‑intensity therapy. — If low‑cost, mechanism‑targeted strategies can reduce chronic nightmares, this could shift pediatric practice, school screening priorities, and parenting guidance toward early, simple interventions with population health benefits.