A mad ride down a terrifyingly deep ravine, being attacked by menacing types with a knife – nightmares are horribly lifelike. And people with nightmare disorder have at least one a week. They are also exhausted and anxious during the day.
Swiss researchers found a new way to get rid of these nerve-racking bad dreams. Their patients were given a wireless headband that played a sound at night as soon as they started dreaming. That sound was pre-coupled with a positive version of the nightmare, which the dreamer had devised himself. The nightmares remained away for at least three months, the researchers wrote in the scientific journal last week Current Biology.
Nightmare disorder can haunt a person for decades. People with post-traumatic stress disorder (PTSD) often suffer from it, but the disorder also occurs without someone having experienced a traumatic event. About 1 in 25 people suffer from it. The most well-founded treatment is imagery rehearsal therapy (IRT). In doing so, the dreamer makes up a version of the nightmare that ends well, and repeats this rewritten scenario for five to ten minutes every day. This therapy works well, but in about a third of the patients it does not, and sometimes the nightmares return after a few weeks.
A sound or a smell
Psychiatrist Lampros Perogamvros of the University of Geneva decided to combine IRT with a well-known technique: targeted memory reactivation. During the day an experience is linked to a sound or a smell. If someone is exposed to that sound or smell at night during deep sleep, the learning sticks better. Perogamvros applied this technique during REM sleep (rapid eye movement), the stage of sleep in which people dream.
The study involved 36 people who had nightmares with no traumatic cause, two to four times a week. They were examined by a sleep expert and kept a dream diary and a sleep diary for two weeks. On a second visit to the hospital, each participant made up a positive version of their most common nightmare, and they imagined it for five minutes. Half of the participants heard a sound through headphones every ten seconds during this repetition of the positive script: the piano chord C69, for one second.
In the two weeks that followed, all participants were given a headband to take home to wear while sleeping. Among other things, it registered their brain waves and, as soon as REM sleep set in, played that chord every ten seconds – softly, but in such a way that the sleeper could just hear it, at a volume of around 40 decibels. They also kept the diaries, and they practiced the positive script for five minutes every day.
The positive story
After two weeks, the nightmares were less frequent in the people whose positive story was linked to the piano chord. On average, they still suffered from their nightmare once a month, the people who had only done IRT once a week. The group treated with the agreement also had other positive dreams much more often – the control group did not.
After three months, that difference was still there. The frequency of the nightmares had increased slightly again, but was still lower in both groups than before the treatment.
“A very interesting study and elegantly designed, thinks Jaap Lancee, psychologist at the University of Amsterdam, who specializes in nightmares. “You see a serious additional effect of the memory reactivation, on top of the effect of the IRT.”
The Swiss emphasize that the patients do not suddenly dream the new, fun version of the nightmare. “You see that at IRT,” says Lancee, “the positive story does not replace it, but the nightmare script is no longer triggered. The emotional charge has become less strong, and as a result you no longer miss that story.”
Before the new insights reach treatment practice, the study must be repeated, also in people with psychiatric disorders in which nightmares often occur, such as PTSD. Lancee: “If it proves to work in this clinical group, I’d say use it right away.”
Also read: Waking up clammy with sweat