Chronic nightmares have a prevalence of 3 to 8% in the general population, but they seem not to play a relevant role in the health care system despite the existence of evidence-based treatments. The aim of this study was to identify nightmare-related knowledge, attitudes and coping approaches in the German mental health care system. A total of 219 health-care providers (primary care, psychiatrists, psychotherapists, in-patient versus out-patient) and another 335 nightmare sufferers were interviewed by telephone and/or filled out self-rating questionnaires. They were asked to estimate nightmare prevalence, to specify nightmare causes and how they cope with nightmares. Health care providers were asked to estimate the relevance of nightmares and the need for treatment. All groups overestimated the prevalence of nightmares. Stress, traumatic events and inner conflicts were rated the highest regarding the possible causes of nightmares, with small differences between the groups. Only a minority of nightmare sufferers tried coping strategies on their own and rated them as being moderately helpful. About one third asked health care providers for help, mainly from general practitioners and medical specialists, but rated this a little helpful. Health care providers rated the relevance of nightmares and the need for treatment as being of moderate importance. Given the high prevalence of clinically relevant nightmares and the fact that helpful and efficient treatment approaches exist, all parts of the health care system as well as the nightmare sufferers need to be better informed. That may help to decrease nightmare disorders.
Key words: Nightmares, health care system, treatment, coping.
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