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Cortical hyperarousal in individuals with frequent nightmares.

Clara Sayk, Sophia Saftien, Nicole Koch, Hong‐Viet V. Ngo, Klaus Junghanns, Ines Wilhelm

Journal of Sleep Research April 1, 2024 DOI: 10.1111/jsr.14003 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort with intervention Peer reviewed
Sample size 57
Population Participants with frequent nightmares and healthy controls
Intervention Imagery rehearsal therapy
Duration 8 weeks with 4 nights in the sleep laboratory; six sessions of therapy between second and third night
Topics Dreaming
Keywords Arousal Electroencephalography Imagery rehearsal therapy Nightmares
Key findings Cortical hyperarousal, indicated by increased beta and low gamma power, is a trait in people with frequent nightmares and is reduced by imagery rehearsal therapy.

Abstract

Nightmares are common among the general population and psychiatric patients and have been associated with signs of nocturnal arousal such as increased heart rate or increased high-frequency electroencephalographic (EEG) activity. However, it is still unclear, whether these characteristics are more of a trait occurring in people with frequent nightmares or rather indicators of the nightmare state. We compared participants with frequent nightmares (NM group; n = 30) and healthy controls (controls; n = 27) who spent 4 nights in the sleep laboratory over the course of 8 weeks. The NM group received six sessions of imagery rehearsal therapy (IRT), the 'gold standard' of cognitive-behavioural therapy for nightmares, between the second and the third night. Sleep architecture and spectral power were compared between groups, and between nights of nightmare occurrence and nights without nightmare occurrence in the NM group. Additionally, changes before and after therapy were recorded. The NM group showed increased beta (16.25-31 Hz) and low gamma (31.25-35 Hz) power during the entire night compared to the controls, but not when comparing nights of nightmare occurrence to those without. Moreover, low gamma activity in rapid eye movement sleep was reduced after therapy in the NM group. Our findings indicate, cortical hyperarousal is more of a trait in people with frequent nightmares within a network of other symptoms, but also malleable by therapy. This is not only a new finding for IRT but could also lead to improved treatment options in the future that directly target high-frequency EEG activity.

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Long-term effects of extreme situational stress on sleep and dreaming Survivors of traumatic events who complained of sleep disturbances, compared with... 1987 Case-control study n = 11
The relationship of nightmare frequency and nightmare distress to well‐being Adults who reported dreams 2004 Observational cohort n = 147
Dreaming in NREM Sleep: A High-Density EEG Study of Slow Waves and Spindles Healthy human subjects 2018 Observational cohort n = 14

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