Everyone has fallen asleep and found themselves in a nightmare. In the middle of the night, you have been jolted awake by frightening images that make your heart pound and palms sweat. But for some people this unpleasant scenario happens far too often. A recent study conducted by neuroscientists from the University of Geneva finds promise for relief from frequent nightmares.
More than 10 million people suffer from nightmare disorder
According to the American Academy of Sleep Medicine, 4% of adults — more than 10 million people — suffer from nightmare disorder. The disorder is diagnosed when nightmares are so frequent and unrelenting that they significantly decrease one’s quality of sleep, impair functioning during waking moments, cause behavioral problems and worsen mental illnesses such as anxiety and depression.
Timothy I. Morgenthaler, a sleep medicine therapist with the Mayo Clinic, explained to The Washington Post that “occasional nightmares are unwelcome, but when they occur frequently — enough that the person becomes distressed with the prospect of experiencing another nightmare, anticipating stressful images during sleep, sometimes avoiding sleep to avoid yet another nightmare — it affects their sleep, daytime function and arguably their health.”
Study finds hope for relief from nightmares
A standard form of treatment for nightmare disorder is imagery rehearsal therapy, or IRT. With IRT, the patient will try to rewrite the narrative of their distressing dream by giving it a happy ending. Then for several minutes throughout the day, the patient will “rehearse” the happier scenario. IRT is a technique that has been proven to reduce the number of nightmares, as well as their severity, per Smithsonian Magazine.
As Lampros Perogamvros, a psychiatrist with the Sleep Laboratory of the Geneva University Hospitals, who worked on the study, explained to The Washington Post, “As an example, we can imagine a nightmare in which the patient is hunted by someone in the forest and cannot find her way out. Colors, odors, emotions might be described by the patient, as well as the context of the nightmare. For example, the dreamer was walking in the forest with her family when suddenly everybody disappears, and a tense atmosphere emerges.”
“We let them picture it for a few minutes before asking them verbally what this new scenario is,” Perogamvros said. “To continue with our example, a door pops up during the human hunt. The dreamer opens it and enters a safe, peaceful environment such as her bedroom. The door is then locked to ensures the hunter cannot reach her anymore.”
Published in the journal Current Biology, the study conducted by Perogamvros and other neuroscientists adds a wrinkle to IRT. In order to boost the effectiveness of the therapy, the team combined it with a method called targeted memory reactivation. With TMR, a person learns to associate a cue, such as a noise or a smell, with a learning procedure, which is reapplied during sleep to strengthen the memory, according to Smithsonian Magazine.
The trigger chosen for the study was a piano chord. The team gave 36 people with nightmare disorder training in IRT, per Smithsonian Magazine. Eighteen of the people heard a piano chord while they reinvented their nightmares. Eighteen others, the control group, heard no additional sounds while they did the same. All of the participants in the study were then given a headband called an actimeter to wear while they slept for two weeks. The actimeter would monitor the wearer’s stage of sleep, as well as deliver sounds through bone conduction. The piano chord trigger was delivered every 10 seconds once the participant entered the dream stage of sleep.
What were the results of the study?
The results of the study were encouraging. All of the participants reported a decrease in nightmares, according to CNN. The decrease among those who practiced TMR was especially prevalent, moving from an average of three nightmares in a week to 0.2. Furthermore, those who heard the sound reported happier, more joyful dreams. Those that only practiced imagery rehearsal therapy reported an average of one nightmare a week. The staying power of the therapy was significant, with the TMR-only group’s average rising to 0.3 after three months, and the IRT-only group’s average rising to 1.5.
While further research needs to be done to verify the research and expand the concept, Morgenthaler, who is not involved in the study, believes that it is “a promising new avenue.” He told The Washington Post, “The researchers have used a clever design to investigate the effects of adding sound during REM sleep to strengthen the desired emotional effects of the replacement dream. If replicated, this may be an important new approach to the treatment of nightmare disorder.”
Perogamvros hopes that the results of the study open up possibilities for the treatment of insomnia, along with anxiety and flashbacks associated with post-traumatic stress disorder.