"Attenuate Nightmares with Music: A Promising Therapy for Nightmare Disorders"

2023-05-06 15:53:29

Nightmares, experienced since childhood, appeal to our fears and to the vivid images of our memory. Although not pathological in itself, some people experience them repeatedly, until they become disabling. Recently, a group of Swiss researchers discovered a method to attenuate this phenomenon: diffuse, during sleep, a familiar music and associated with happy memories. This technique would even increase positive dreams by manipulating emotions. A promising prospect for patients whose rest is greatly disturbed by almost daily nightmares.

Nightmares are common from early childhood and persist throughout life, sometimes associated with intense negative emotions occurring during REM sleep, distinct from simple “bad dreams”. Indeed, the latter seem to have a useful function by promoting the regulation of emotions. Some nightmares originate from a particularly traumatic event and are linked to post-traumatic stress disorder. Others are not associated with any specific negative event.

According to the “International Classification of Sleep Disorders”, established by the American Academy of Sleep Medicine, nightmares become pathological when they are recurrent, that is to say more than once a week, and when they have a serious impact during the day: causing fatigue, anxiety or intrusive nightmarish flashbacks. We then speak of “nightmare disorder”, which seems to be more and more frequent following the COVID-19 pandemic, but also eco-anxiety.

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Recently, researchers from the University of Geneva discovered that music played during the nightmarish phases of sleep could considerably attenuate them, or even transform them into positive dreams. The technique is associated with an already known process of repetition of positive images. These combinations of solutions offer real hope of regaining restful sleep for people suffering from nightmarish disorders. The study is published in the journal Current Biology.

Imagine and visualize positive images, a technique to improve

To help patients get rid of their nightmares, a technique exists, but its results vary, depending strongly on the person and their receptivity. This is Image Repetition Therapy (IRT), which asks patients to imagine alternative, positive outcomes to their nightmare scenarios each day for five to ten minutes.

Lampros Perogamvros, from the Department of Basic Neurosciences of the UNIGE Faculty of Medicine and co-author of the study, explains in a communiqué : « After two weeks of practice, the frequency of nightmares has been shown to decrease “. However, not all patients react the same way, and this technique may simply be ineffective for some. Not to mention that 4% of adults are subject to these chronic nightmares.

This is why the Perogamvros team tried to find an alternative by combining this image therapy with the method of targeted memory reactivation (TMR). In 2010, scientists demonstrated that it was possible to amplify the consolidation of memory, which takes place during sleep, by using sounds or smells previously associated with learning.

Indeed, when new information is learned, the brain encodes it in the form of a network of neurons activating in a specific way: a neuronal activation signature associated with this learning is then created. During the night, the sleeping brain seems to spontaneously replay this neuronal signature so that the information is imprinted in the memory.

In the case of the present study, the goal was to replay the neural signature of positive memories related to IRT exercises.

A soundtrack for the night

To test whether exposure to sound during sleep could increase the success of image therapy and therefore alleviate nightmares, Perogamvros and his colleagues examined 36 patients, all of whom were undergoing image rehearsal therapy.

Half of the group received no further treatment, while the other half had to create an association between a positive version of their nightmare and a sound — a major piano chord played every ten seconds — during an exercise. imagination, practiced daily.

Sophie Schwartz, professor in the Department of Basic Neurosciences at the UNIGE Faculty of Medicine and the Swiss Center for Affective Sciences, explains: ” The goal was for this sound to be associated with the imagined positive scenario. So when the sound was played again afterwards, but during sleep, it was more likely to reactivate a positive memory in dreams. ».

Each participant then received a sleep band containing electrodes that measured brain activity. It also made it possible to detect the different phases of sleep and to diffuse the piano chord. Concretely, the latter was played every ten seconds each time the patient reached REM sleep – the phase of sleep where nightmares most often occur. The exercise was carried out for two weeks, every evening.

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Both groups experienced a reduction in their nightmares, but significantly more for half who took the combination therapy, with benefits felt up to 3 months after the experience. These patients also saw the frequency of their positive and happy dreams increase.

The results confirm that such a combination therapy should be tested on a larger scale and with different types of populations, in order to determine the extent and the possibility of generalizing it. But Lampros Perogamvros concludes: Everything indicates that it is a particularly effective new treatment for nightmare disorder. The next step for us will be to test this method on nightmares related to post-traumatic stress. ».

These results also open new perspectives for the treatment of other disorders, such as insomnia and other symptoms of post-traumatic stress, such as flashbacks and anxiety.