HYPOTHESIS AND THEORY article
Front. Sleep
Sec. Pediatric and Adolescent Sleep
This article is part of the Research TopicImproving Sleep Health From Infancy Through Early Adulthood: Educational Interventions and Behavior Change StrategiesView all 6 articles
DARC-NESS: A Mastery-Based Cognitive-Behavioral Model for Treating Chronic Nightmares in Youth
Provisionally accepted
- 1The University of Tulsa, Tulsa, United States
- 2University of Rochester Medical Center, Rochester, United States
- 3The University of Oklahoma School of Community Medicine, Tulsa, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Theories of chronic nightmare maintenance highlight dysfunctional beliefs about sleep and nightmares, distress and arousal, anticipatory anxiety, maladaptive sleep habits, and sleep deprivation as perpetuating factors that maintain nightmare disorder over time. Theories of nightmare treatment suggest that self-efficacy is a common factor in nightmare mitigation. The current article introduces DARC-NESS, a multi-component theory of nightmare maintenance that emphasizes nightmare self-efficacy as a central mechanism influencing the maintenance cycle at multiple points. DARC-NESS is a mnemonic for the model's components: Dream (nightmare) content, Appraisals, Resources for regulation, Conditioned arousal, Nightmare Efficacy, Sleep hygiene and patterns, and Sleep quality and quantity, that interact to perpetuate nightmares. This model provides the theoretical basis for cognitive behavioral therapy (CBT) for child nightmares. The manuscript proposes treatment counterparts to each model component and presents a case illustration demonstrating how these interventions can disrupt the vicious cycle of chronic nightmares. Finally, flexible clinical applications are offered to guide clinicians in selecting and sequencing modular intervention elements to match individual case presentations.
Keywords: cognitive behavioral therapy for youth5, nightmare disorder4, nightmare maintenance1, pediatric sleep3, self-efficacy2
Received: 22 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Cromer, Cromwell, Prince and Buck. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lisa Cromer
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.