Can a C-major chord help cure patients of persistent nightmares? A new paper by researchers at the Université de Genève says yes.
The paper, published in the October issue of Current Biology delves into therapies and protocols to help patients who experience pathological nightmares. Also called Nightmare Disorder or ND, patients have terrifying nightmares more than once a week, and it can cause a cascade of other issues from lack of sleep to anxiety and mood alteration.
Imagery Rehearsal Therapy (IRT)
Essentially, the therapy looks to help patients rewrite the script on frightening nightmares by rehearsing positive images and scenarios that they can insert into the dream.
- Patients practice imagining positive alternatives to nightmare situations, and typically repeat the process daily over two weeks;
- For this study, that was packed into one IRT session.
The problem: some patients don’t respond to the treatment.
IRT + Targeted Memory Reactivation (TMR)
For the new study, researchers combined IRT with another protocol called TMR or Targeted Memory Reactivation. TMR has been around since 2010, when a separate study discovered that people have the ability to train themselves to associate sounds with specific experiences, and that the effect still applies while sleeping.
- The participants were conditioned to associate a specific sound with a positive scenario;
- The sound was played during an IRT session — i.e. while they were imagining a situation associated with positive feelings, to combine both visual and audio stimuli;
- As they entered REM sleep (the stage most often associated with dreaming), the sound was played;
- The protocol was repeated for 14 nights.
”We asked the patients to imagine positive alternative scenarios to their nightmares. However, one of the two groups of patients did this exercise while a sound — a major piano chord — was played every ten seconds. The aim was for this sound to be associated with the imagined positive scenario. In this way, when the sound was then played again but now during sleep, it was more likely to reactivate a positive memory in dreams,” says Sophie Schwartz, a full professor in the Department of Basic Neurosciences at the UNIGE Faculty of Medicine and the Swiss Center for Affective Sciences, as quoted in Science Daily.
Participants wore a headband EEG device called Dreem that registered the stages of sleep, and delivered the sound every 10 seconds during REM sleep. A control group was played the same sound, but without prior conditioning (i.e. with IRT only and no TMR).
What sound did they choose? A C69 chord played on the piano, or C major with a major sixth and a major ninth.
Thirty-six patients with ND participated in the study. As the researchers summarized, “Thanks to this new therapy, the patients’ nightmares decreased significantly and their positive dreams increased.”
Both groups saw a decrease in nightmares. But, the group who’d associated the C69 chord with the positive dream scenario showed a significantly greater effect. The nightmares were reduced, and they actually began to experience more positive dreams.
- Before the study, the first group experienced an average of 2.58 nightmares per week, and the second group 2.94;
- At the end of the study, the first group (IRT only) were having 1.02 nightmares per week, and the second (IRT + TMR) only 0.19.
The group who went through both protocols also reported having more positive dreams. That effect was slightly diminished, but still noticeable, up to three months after the end of the study.
”While the results of the therapy coupling will need to be replicated before this method can be widely applied, there is every indication that it is a particularly effective new treatment for the nightmare disorder. The next step for us will be to test this method on nightmares linked to post-traumatic stress,” concludes Lampros Perogamvros, a privat-docent in the Department of Basic Neurosciences at the UNIGE Faculty of Medicine and a senior clinical fellow at the HUG’s Center for Sleep Medicine.