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Completed

NCT Number: NCT05933109

Mental Imagery and Targeted Memory Reactivation in PTSD

With this protocol, investigators examine whether targeted memory reactivation (TMR), a technique used to strengthen memories, can accelerate remission of traumatic nightmares and post-traumatic stress disorder (PTSD) symptomatology. This protocol uses TMR during REM sleep to strengthen positive memories generated by Imagery Rehearsal Therapy (IRT), a recommended treatment of nightmares. Patients with PTSD are asked to perform 3 weekly IRT sessions and, while they generate a positive outcome of their recurrent nightmare, half of the patients are exposed to a sound S1 (TMR group), while the other half is not exposed to this sound (control group). All patients will perform IRT every evening at home and will be exposed to the sound S1 during REM sleep with a wireless headband, which automatically detects sleep stages. Clinical evaluation of the severity of PTSD and nightmares before and after (1-month follow-up and 3-months follow-up) this intervention takes place using the validated Clinically Administered PTSD Scale for DSM-5 (CAPS-5, primary outcome measure). The investigators hypothesize that patients treated with IRT and who are exposed, during REM sleep to a sound that had previously been associated with the new positive dream scenario of IRT (TMR group), will have more reduced frequency of PTSD severity and nightmares compared to participants with stimulation of the same, but non-associated, sound during REM sleep (control group).

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Key information

Conditions

Nightmares, REM-Sleep Type Mental Disorders PTSD Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Trauma and Stressor Related Disorders

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Center for Sleep Medicine

Geneva, Switzerland

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • with untreated persistent PTSD according to DSM-5 (> 1 month), suffering from chronic nightmares
  • with no active specific treatment for PTSD

Exclusion criteria

  • patients with active specific treatment for PTSD
  • patients with neurological disorders

Treatment and study plan

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 a sound S1 is associated with a waking experience (i.e., a positive outcome of imagery rehearsal therapy in this study) and strengthening it during REM sleep, the investigators want to accelerate the remission of traumatic nightmares and PTSD symptomatology.

Imagery Rehearsal Therapy

Behavioral

These patients will receive the classic treatment of Imagery Rehearsal Therapy (IRT) for nightmares without association with the sound S1.

Primary outcomes

  1. Clinician-Administered PTSD Scale for DSM-5

    Time frame: 1 month

    Validated questionnaire that assesses PTSD symptoms, the score ranges from 0-80, zero indicating no symptom severity and 80 indicating the higher symptom severity.

  2. Clinician-Administered PTSD Scale for DSM-5

    Time frame: 3 months

    Validated questionnaire that assesses PTSD symptoms, the score ranges from 0-80, zero indicating no symptom severity and 80 indicating the higher symptom severity.

Secondary outcomes

  1. Nightmare Frequency

    Time frame: 1 month

    Number of nightmares per week

  2. Nightmare Frequency

    Time frame: 3 months

    Number of nightmares per week

  3. Nightmare Distress Questionnaire

    Time frame: 1 month

    Validated self-report scale to assess the emotional disturbance attributed to the nightmares, the score ranges from 0-52, zero indicating no symptom severity and 52 indicating the higher symptom severity.

  4. Nightmare Distress Questionnaire

    Time frame: 3 months

    Validated self-report scale to assess the emotional disturbance attributed to the nightmares, the score ranges from 0-52, zero indicating no symptom severity and 52 indicating the higher symptom severity.

  5. Positive emotions in dreams

    Time frame: 1 month

    Use of a dream diary

  6. Positive emotions in dreams

    Time frame: 3 months

    Use of a dream diary

  7. PTSD Checklist for DSM5

    Time frame: 1 month

    Validated self-report measure of PTSD, the score ranges from 0-80, zero indicating no symptom severity and 80 indicating the higher symptom severity.

  8. PTSD Checklist for DSM5

    Time frame: 3 months

    Validated self-report measure of PTSD, the score ranges from 0-80, zero indicating no symptom severity and 80 indicating the higher symptom severity.

  9. Beck Depression Inventory

    Time frame: 1 month

    Validated self-report scale to assess depressive symptoms, the score ranges from 0-63, zero indicating no symptom severity and 63 indicating the higher symptom severity.

  10. Beck Depression Inventory

    Time frame: 3 months

    Validated self-report scale to assess depressive symptoms, the score ranges from 0-63, zero indicating no symptom severity and 63 indicating the higher symptom severity.

  11. Pittsburgh Sleep Quality Index

    Time frame: 1 month

    Validated self-report scale to assess the quality of sleep, the score ranges from 0-21, zero indicating no symptom severity and 21 indicating the higher symptom severity.

  12. Pittsburgh Sleep Quality Index

    Time frame: 3 months

    Validated self-report scale to assess the quality of sleep, the score ranges from 0-21, zero indicating no symptom severity and 21 indicating the higher symptom severity.

Other outcomes

  1. Sleep efficiency

    Time frame: 1 month

    The ratio between total sleep time and total bed time

  2. REM arousal index

    Time frame: 1 month

    The ratio between number of arousals in stage REM x 60 and REM duration

  3. Arousal index

    Time frame: 1 month

    The ratio between number of arousals in sleep x 60 and sleep duration

Sponsors and collaborators

Lead sponsor

University Hospital, Geneva

Other

Registry information

Official study title

Augmentation of Imagery Rehearsal Therapy With Targeted Memory Reactivation for Post-Traumatic Stress Disorder (PTSD)

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
Jul 6, 2023
Registry last updated
Mar 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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