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A treatment to end nightmares that cause panic at bedtime | Health & Wellness

Everyone has had nightmares at some point in life. It is not a pleasant situation, but it is not a problem if it does not interfere with daily life. However, there are people to whom the latter does happen. Their ailment is called “nightmare disorder”, and consists of bad dreams occurring very frequently and preventing them from carrying out their day-to-day activities normally. In these cases, a therapy can be used in which patients can rehearse positive versions of their dreams. It is quite effective, it works with 70% of patients. Now, a study conducted in Switzerland and published this Thursday in the journal Current Biology has found that, if a sound associated with a positive daytime experience is also played, the frequency of these nightmares is more effectively reduced.

It is estimated that this disorder affects approximately 4% of the adult population, says the study. However, the psychologist at the Sleep Research Institute (IIS) Iván Eguzquiza affirms that the figure is likely to be higher. “There are many people who have normal sleep badly or have nightmares.” Eguzquiza also speaks of a feedback situation: “The more fear we have of nightmares, the easier it is for them to appear”. The expert explains that this fear makes us think about them during the day, so it is more likely that we fall asleep with it in mind.

“Patients come to us because they are terrified of sleeping,” says Francisco Segarra, a psychologist who is an expert in sleep medicine and a member of the Spanish Sleep Society (SES). The professional warns that dreams can become very aggressive and describes the case of one of his patients, who suffered nightmares in which “everything was images of murder, blood and mutilation.”

The scientists from the University of Geneva who have carried out this new study added this sound to the therapy in 16 of the 38 patients in the investigation, which they associated with positive emotions. Then, through wireless headbands with headphones, they played it back while they slept. This increased the effectiveness of the treatment, so that three weeks later, in people who had not combined both, the frequency of nightmares had been reduced from three or four a week to one, and in those who had used the sound , completely disappeared.

In the classic therapy against this disorder, the patient exposes his most recurrent nightmares and changes their ending, so that he can associate it with positive emotions. If, for example, someone dreams that he falls into a fire, the story is rewritten so that he falls slowly into the sea near a beach, explains Sophie Schwartz, author of the investigation. This procedure makes it possible for the brain to associate the story with a happy ending when it dreams again and not cause such an overwhelming situation, adds Segarra, who has not participated in the work.

Most nightmares, and all other dreams, occur during REM sleep. In this stage the brain is disconnected from the body, but the mental activity is similar to that of wakefulness. There is then a regrouping of the images that the brain has seen at some point. Whether the dreams are good or bad will depend on the experiences and emotions that have been had throughout the day, says María José Martínez, coordinator of the SES Chronobiology working group.

Before applying the therapy, it is necessary to rule out that the nightmares occur as a result of sleep problems, such as apnea, or REM sleep behavior disorder, in which the patient, in addition to having distressing and violent nightmares, can represent what they are dreaming It can even be related to the consumption of alcohol or some types of drugs, stresses Ana Fernández, Coordinator of the Sleep and Wake Disorders Study Group of the Spanish Society of Neurology. In these cases, if the problem is tackled, the bad dreams disappear, explains the expert.

The nightmare disorder causes more awakenings and fragmentation of sleep, so the person to whom it occurs does not have a quality rest. This translates into physical consequences such as tiredness and drowsiness. In the long term, it can even cause depression of the immune system, develops Francisco Segarra, a member of the SES. At an emotional level it can generate anxiety, irritability, impulsivity problems, and at a cognitive level it decreases concentration, attention and memory.

Iván Eguzquiza, from the IIS, emphasizes the interest aroused by a finding like this, which may represent an advance for the treatment of sleep hygiene problems —the set of habits and attitudes that allow us to fall asleep properly and sleep soundly— . It can even be used for the treatment of post-traumatic stress disorder, says the psychologist.

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