A memory-enhancing technique improves the standard treatment for nightmare disorder.
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| A small study found that a new treatment for nightmare disorder resulted in fewer nightmares over a longer period of time than the standard treatment. DEMAERRE/GETTY/ISTOCK |
Uninterrupted sleep would be a dream come true for people who are plagued by recurring nightmares. Neuroscientists have now demonstrated a technique that, for some, may chase away bad dreams in a small experiment.
Researchers report online on October 27 in Current Biology that enhancing the standard treatment for nightmare disorder with a memory-boosting technique reduced average weekly nightmares among a few dozen people from three to near zero.
"The fact that they could actually make a significant difference in the frequency of those nightmares is enormous," says Gina Poe, a UCLA neuroscientist who was not involved in the study.
People suffering from nightmare disorder fear the night not because of monsters under the bed, but because of monsters in their dreams. Frequent, terrifying dreams disrupt sleep and can even impair well-being in the waking hours. IRT, or imagery rehearsal therapy, is the most commonly used treatment for nightmare disorder. Patients in this treatment reimagine nightmares in a positive light, mentally rehearsing the new story line while awake. It helps most people but fails nearly one-third of the time.
To increase the effectiveness of IRT, neuroscientist Sophie Schwartz of the University of Geneva and her colleagues used a learning technique known as targeted memory reactivation, or TMR. In this technique, a person concentrates on learning something while a sound is played, and the same cue is played again during sleep. The cue may be reactivated and strengthened by experiencing it during sleep, which is important for memory storage (SN: 10/3/19).
The researchers in the new study trained 36 people with nightmare disorder in IRT, randomly assigning half of them to rehearse their revised nightmares in silence. The other half practiced for five minutes while a short piano chord, the TMR cue, played every 10 seconds.
Participants practiced IRT daily for two weeks and kept a dream diary. A headband equipped with sensors recorded their brains' electrical activity and tracked their sleep stages while they slept. The piano chord served as a dream soundtrack, with the headband sounding every 10 seconds during rapid eye movement sleep, which is associated with dreaming. The sound was played for all participants by the headband, but only half had come to associate the sound with their new scenario during the IRT training.
TMR nearly eliminated nightmares for those trained on the chord, reducing the weekly average from three to 0.2, and even encouraged happier dreams. The group that only received IRT improved as well, but still had one weekly nightmare.
After three months, the TMR-IRT combination had more staying power, with the average increasing only slightly from about 0.2 to 0.3 nightmares per week, whereas the IRT-only group increased to 1.5.
Larger studies will be required to determine the generalizability of this treatment combination. The participants in this study were all young adults aged 20 to 35 with nightmare disorder and no other psychiatric conditions. The study also did not compare IRT and TMR to no treatment, despite the fact that previous research has shown how effective IRT can be.
If a TMR-IRT combination proves to be as effective in future research, it will be a long time before it is widely available. Commercially available sleep trackers in the form of watches and rings have yet to distinguish between sleep stages as precisely as brain-monitoring devices.
Even with these caveats, Poe believes the results are encouraging. She suggests that future research could look into whether the TMR-IRT combination can help people suffering from post-traumatic stress disorder (PTSD), in which nightmares reenact traumatic events (SN 9/12/14).
Schwartz wants to give it a shot. "I'm not sure we'll be successful with these specific patients," she says. "However, if we do, this would be a huge addition to the treatment options for PTSD."A memory-enhancing technique improves the standard treatment for nightmare disorder.
Uninterrupted sleep would be a dream come true for people who are plagued by recurring nightmares. Neuroscientists have now demonstrated a technique that, for some, may chase away bad dreams in a small experiment.
Researchers report online on October 27 in Current Biology that enhancing the standard treatment for nightmare disorder with a memory-boosting technique reduced average weekly nightmares among a few dozen people from three to near zero.
"The fact that they could actually make a significant difference in the frequency of those nightmares is enormous," says Gina Poe, a UCLA neuroscientist who was not involved in the study.
People suffering from nightmare disorder fear the night not because of monsters under the bed, but because of monsters in their dreams. Frequent, terrifying dreams disrupt sleep and can even impair well-being in waking hours. IRT, or imagery rehearsal therapy, is the most commonly used treatment for nightmare disorder. Patients in this treatment reimagine nightmares in a positive light, mentally rehearsing the new storyline while awake. It helps most people but fails nearly one-third of the time.
To increase the effectiveness of IRT, neuroscientist Sophie Schwartz of the University of Geneva and her colleagues used a learning technique known as targeted memory reactivation, or TMR. In this technique, a person concentrates on learning something while a sound is played, and the same cue is played again during sleep. The cue may be reactivated and strengthened by experiencing it during sleep, which is important for memory storage (SN: 10/3/19).
The researchers in the new study trained 36 people with nightmare disorder in IRT, randomly assigning half of them to rehearse their revised nightmares in silence. The other half practiced for five minutes while a short piano chord, the TMR cue, was played every 10 seconds.
Participants practiced IRT daily for two weeks and kept a dream diary. A headband equipped with sensors recorded their brains' electrical activity and tracked their sleep stages while they slept. The piano chord served as a dream soundtrack, with the headband sounding every 10 seconds during rapid eye movement sleep, which is associated with dreaming. The sound was played for all participants by the headband, but only half had come to associate the sound with their new scenario during the IRT training.
TMR nearly eliminated nightmares for those trained on the chord, reducing the weekly average from three to 0.2, and even encouraged happier dreams. The group that only received IRT improved as well but still had one weekly nightmare.
After three months, the TMR-IRT combination had more staying power, with the average increasing only slightly from about 0.2 to 0.3 nightmares per week, whereas the IRT-only group increased to 1.5.
Larger studies will be required to determine the generalizability of this treatment combination. The participants in this study were all young adults aged 20 to 35 with nightmare disorder and no other psychiatric conditions. The study also did not compare IRT and TMR to no treatment, despite the fact that previous research has shown how effective IRT can be.
If a TMR-IRT combination proves to be as effective in future research, it will be a long time before it is widely available. Commercially available sleep trackers in the form of watches and rings have yet to distinguish between sleep stages as precisely as brain-monitoring devices.
Even with these caveats, Poe believes the results are encouraging. She suggests that future research could look into whether the TMR-IRT combination can help people suffering from post-traumatic stress disorder (PTSD), in which nightmares reenact traumatic events (SN 9/12/14).
Schwartz wants to give it a shot. "I'm not sure we'll be successful with these specific patients," she says. "However, if we do, this would be a huge addition to the treatment options for PTSD."A memory-enhancing technique improves the standard treatment for nightmare disorder.
Uninterrupted sleep would be a dream come true for people who are plagued by recurring nightmares. Neuroscientists have now demonstrated a technique that, for some, may chase away bad dreams in a small experiment.
Researchers report online October 27 in Current Biology that enhancing the standard treatment for nightmare disorder with a memory-boosting technique reduced average weekly nightmares among a few dozen people from three to near zero.
"The fact that they could actually make a significant difference in the frequency of those nightmares is enormous," says Gina Poe, a UCLA neuroscientist who was not involved in the study.
People suffering from nightmare disorder fear the night not because of monsters under the bed, but because of monsters in their dreams. Frequent, terrifying dreams disrupt sleep and can even impair well-being in the waking hours. IRT, or imagery rehearsal therapy, is the most commonly used treatment for nightmare disorder. Patients in this treatment reimagine nightmares in a positive light, mentally rehearsing the new story line while awake. It helps most people but fails nearly one-third of the time.
To increase the effectiveness of IRT, neuroscientist Sophie Schwartz of the University of Geneva and her colleagues used a learning technique known as targeted memory reactivation, or TMR. In this technique, a person concentrates on learning something while a sound is played, and the same cue is played again during sleep. The cue may be reactivated and strengthened by experiencing it during sleep, which is important for memory storage (SN: 10/3/19).
The researchers in the new study trained 36 people with nightmare disorder in IRT, randomly assigning half of them to rehearse their revised nightmares in silence. The other half practiced for five minutes while a short piano chord, the TMR cue, was played every 10 seconds.
Participants practiced IRT daily for two weeks and kept a dream diary. A headband equipped with sensors recorded their brains' electrical activity and tracked their sleep stages while they slept. The piano chord served as a dream soundtrack, with the headband sounding every 10 seconds during rapid eye movement sleep, which is associated with dreaming. The sound was played for all participants by the headband, but only half had come to associate the sound with their new scenario during the IRT training.
TMR nearly eliminated nightmares for those trained on the chord, reducing the weekly average from three to 0.2, and even encouraged happier dreams. The group that only received IRT improved as well but still had one weekly nightmare.
After three months, the TMR-IRT combination had more staying power, with the average increasing only slightly from about 0.2 to 0.3 nightmares per week, whereas the IRT-only group increased to 1.5.
Larger studies will be required to determine the generalizability of this treatment combination. The participants in this study were all young adults aged 20 to 35 with nightmare disorder and no other psychiatric conditions. The study also did not compare IRT and TMR to no treatment, despite the fact that previous research has shown how effective IRT can be.
If a TMR-IRT combination proves to be as effective in future research, it will be a long time before it is widely available. Commercially available sleep trackers in the form of watches and rings have yet to distinguish between sleep stages as precisely as brain-monitoring devices.
Even with these caveats, Poe believes the results are encouraging. She suggests that future research could look into whether the TMR-IRT combination can help people suffering from post-traumatic stress disorder (PTSD), in which nightmares reenact traumatic events (SN 9/12/14).
Schwartz wants to give it a shot. "I'm not sure we'll be successful with these specific patients," she says. "However, if we do, this would be a huge addition to the treatment options for PTSD."
CITATIONS
A. Clerget, S. Schwartz, and L. Perogamvros. Using targeted memory reactivation to improve imagery rehearsal therapy for nightmares. Biology Today. On the internet on October 27, 2022. doi: 10.1016/j.cub.2022.09.032.