Abstract Rationale Narcolepsy often includes highly disabling symptoms such as hypnagogic hallucinations and sleep paralysis, which significantly impair quality of life. Lucid dream therapy and imagery rehearsal techniques have shown efficacy in treating nightmares, but their application in narcolepsy remains underexplored. Objectives To evaluate the efficacy of lucid dream therapy and imagery control techniques in reducing the severity and frequency of hypnagogic hallucinations and sleep paralysis in patients with narcolepsy. Methods A randomized controlled study was conducted with 98 patients diagnosed with narcolepsy (81 females, mean age 42.2 ± 14.7 years) from Colombia and Costa Rica. Participants were divided into intervention (n = 49) and control (n = 49) groups. Both groups were under stable pharmacological treatment with modafinil or methylphenidate. The intervention group underwent six virtual sessions of lucid dream and imagery control training. Assessment tools included the Narcolepsy Severity Scale, Pittsburgh Sleep Quality Index, Lucidity and Dream Control Scale, and SF-36 Quality of Life Scale. Data were analyzed using paired-sample t-tests (IBM SPSS v25). Results Significant post-intervention improvements were observed in hallucination recall (p = 0.010), emotional control (p = 0.014), and hallucination frequency and distress (p 0.001). Sleep paralysis frequency and discomfort also decreased (p 0.001). Sleep quality improved (p = 0.025), as did quality-of-life dimensions of vitality, emotional role, and mental health (p 0.001 for all). These effects persisted at 6- and 12-month follow-up without significant relapse. No comparable changes were observed in the control group. Conclusions Lucid dream therapy combined with imagery control significantly reduced hypnagogic hallucinations and sleep paralysis symptoms in narcolepsy, improving both sleep quality and quality of life. This cognitive-behavioral approach represents an innovative, non-pharmacological adjunct to traditional narcolepsy management, expanding therapeutic options in sleep medicine. This abstract is funded by: None
Orozco et al. (Fri,) studied this question.
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