Combined Treatment of Nightmares With Targeted Memory Reactivation and Imagery Rehearsal Therapy

NCT05237778 | Completed

• 1 other identifier: 2019-02270
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

With this protocol, investigators examine whether targeted memory reactivation (TMR), a technique used to strengthen memories, can accelerate remission of nightmare disorder. This protocol uses TMR during REM sleep to strengthen positive memories generated by Imagery Rehearsal Therapy (IRT), a recommended treatment of nightmares. Patients with nightmare disorder are asked to perform an initial IRT session and, while they generate a positive outcome of their recurrent nightmare, half of the patients are exposed to a sound (TMR group), while no such pairing with a sound takes place for the other half (control group). During the next two weeks, all patients perform IRT every evening at home and are exposed to the sound during REM sleep with a wireless headband, which automatically detects sleep stages. Clinical evaluation of the severity of nightmares before and after (2-weeks follow-up and 3-months follow-up) this intervention takes place using the validated Nightmare Frequency Questionnaire (NFQ, primary outcome measure), which retrospectively identifies the frequency of nightmares. We hypothesize that patients treated with IRT and who are exposed, during REM sleep and over 14 nights, to a sound that had previously been associated with the new positive dream scenario of IRT (TMR group), will have more reduced frequency of nightmares compared to participants with stimulation of the same, but non-associated, sound during REM sleep (control group).

Conditions

Nightmares, REM-Sleep Type

Outcome Measures

Primary Outcomes (2)

• Nightmare Frequency Questionnaire (NFQ)

  Validated self-report scale to assess the number of nightmares per week

  2 weeks

• Nightmare Frequency Questionnaire (NFQ)

  Validated self-report scale to assess the number of nightmares per week

  3 months

Secondary Outcomes (8)

• Nightmare Distress Questionnaire (NDQ)

  2 weeks

• Beck Depression Inventory (BDI-II)

  2 weeks

• Pittsburgh Sleep Quality Index (PSQI)

  2 weeks

• Proportion of the emotion 'joy' in dreams

  2 weeks

• Proportion of the emotion 'fear' in dreams

  2 weeks

Study Arms (2)

TMR group

EXPERIMENTAL

Patients will receive a sound while they generate a positive outcome of imagery rehearsal therapy (IRT). They will also receive the sound during REM sleep.

Behavioral: Imagery Rehearsal Therapy and Targeted memory reactivation during REM sleep

Control group

ACTIVE COMPARATOR

Patients will not receive a sound while they generate a positive outcome of imagery rehearsal therapy (IRT). They will receive the same sound as the experimental group during REM sleep under the same conditions.

Behavioral: Imagery Rehearsal Therapy

Interventions

Imagery Rehearsal Therapy and Targeted memory reactivation during REM sleep BEHAVIORAL

Emerging evidence shows that REM sleep plays a causal role in extinction learning, emotion regulation and consolidation of emotionally positive memories. By using targeted memory reactivation (TMR), a known method where we associate a sound with a waking experience (i.e., a positive outcome of imagery rehearsal therapy in this study) and strengthening it during REM sleep, we want to accelerate the remission of nightmares.

TMR group

Imagery Rehearsal Therapy BEHAVIORAL

These patients will receive the classic treatment of Imagery Rehearsal Therapy (IRT) for nightmares without any association with a sound.

Control group

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosis of nightmare disorder according to the International Classification of Sleep Disorders (ICSD-3) diagnostic and coding manual
• Patients with at least moderate severity (\>1 episode per week)

You may not qualify if:

• severe depression
• insomnia disorder
• psychosis or anxiety disorder
• other sleep disorder (e.g.,obstructive sleep apnea syndrome, restless legs syndrome)
• neurological disease
• use of medications that would be likely to produce nightmares (e.g. hypnotics, β-blockers, amphetamines, antimicrobial agents)
• use of anxiolytics, antipsychotic or antidepressant medication were excluded.

Sponsors & Collaborators

• University Hospital, Geneva: lead

Study Sites (1)

Center for Sleep Medicine, University Hospitals of Geneva

Geneva, 1225, Switzerland

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Clinical Fellow

Study Record Dates

• First Submitted: February 2, 2022
• First Posted: February 14, 2022
• Study Start: February 1, 2020
• Primary Completion: January 31, 2022
• Study Completion: January 31, 2022
• Last Updated: February 14, 2022

Record last verified: 2022-02

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)