Enhancing imagery rehearsal therapy for nightmares with targeted memory reactivation.
Sophie Schwartz, Alice Clerget, Lampros Perogamvros
Current Biology November 21, 2022 DOI: 10.1016/j.cub.2022.09.032 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 36 |
| Population | Patients with nightmare disorder |
| Intervention | Imagery rehearsal therapy |
| Duration | 2-week intervention, 3-month follow-up |
| Topics | Dreaming |
| Keywords | Rem sleep Imagery rehearsal therapy Nightmares Targeted memory reactivation |
| Key findings | Targeted memory reactivation during REM sleep combined with imagery rehearsal therapy reduced nightmare frequency and increased positive dream emotions more than imagery rehearsal therapy alone. |
Abstract
Nightmare disorder (ND) is characterized by dreams with strong negative emotions occurring during rapid eye movement (REM) sleep. ND is mainly treated by imagery rehearsal therapy (IRT), where the patients are asked to change the negative story line of their nightmare to a more positive one. We here used targeted memory reactivation (TMR) during REM sleep to strengthen IRT-related memories and accelerate remission of ND. Thirty-six patients with ND were asked to perform an initial IRT session and, while they generated a positive outcome of their nightmare, half of the patients were exposed to a sound (TMR group), while no such pairing took place for the other half (control group). During the next 2 weeks, all patients performed IRT every evening at home and were exposed to the sound during REM sleep with a wireless headband, which automatically detected sleep stages. The frequency of nightmares per week at 2 weeks was used as the primary outcome measure. We found that the TMR group had less frequent nightmares and more positive dream emotions than the control group after 2 weeks of IRT and a sustained decrease of nightmares after 3 months. By demonstrating the effectiveness of TMR during sleep to potentiate therapy, these results have clinical implications for the management of ND, with relevance to other psychiatric disorders too. Additionally, these findings show that TMR applied during REM sleep can modulate emotions in dreams.
Comparable studies
Other randomized controlled trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Efficacy of a Cognitive‐Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD Combat veterans of Operation Enduring Freedom and/or Operation Iraqi Freedom (mean age... | 2013 | Randomized controlled trial | n = 40 |
| Lucid Dreaming Treatment for Nightmares: A Pilot Study Chronic nightmare sufferers | 2006 | Randomized controlled trial | n = 23 |
| Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study Participants spending three consecutive nights in a sleep laboratory | 2013 | Randomized controlled trial | n = 19 |
| Pre-sleep treatment with galantamine stimulates lucid dreaming: A double-blind, placebo-controlled, crossover study Adults with high dream recall and an interest in lucid dreaming | 2018 | Randomized crossover trial | n = 121 |
| Studies with lucid dreaming as add-on therapy to Gestalt therapy Adults with nightmares (ICD-10: F51.5) at least twice a week | 2015 | Randomized controlled trial | n = 32 |
Citations in the library
Cited by 21
- Reduced REM and N2 sleep, and lower dream intensity predict increased mind-wandering Sleep November 16, 2023
- Treating narcolepsy-related nightmares with cognitive behavioural therapy and targeted lucidity reactivation: A pilot study. Journal of Sleep Research June 1, 2025
- The cathartic dream: Using a large language model to study a new type of functional dream in healthy and clinical populations Journal of Sleep Research February 9, 2025
- Lucid dreaming of a prior virtual-reality experience with ego-transcendent qualities: a proof-of-concept study. Neuroscience of Consciousness 2025
- Evidence for an emotional adaptive function of dreams: a cross-cultural study. Scientific Reports October 2, 2023
and 16 more in the library
Cites 20
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Sleep June 1, 2010
- Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Dreaming December 1, 2004
- Nightmares affect the experience of sleep quality but not sleep architecture: an ambulatory polysomnographic study Borderline Personality Disorder and Emotion Dysregulation February 12, 2015
- Telephone-guided imagery rehearsal therapy for nightmares: Efficacy and mediator of change. Journal of Sleep Research June 1, 2021
and 15 more in the library