Imagery Control Therapy and Lucid Dreaming for REM-Related Symptoms in Narcolepsy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 98
- 试验地点
- 1
研究概览
简要总结
This randomized controlled trial evaluated the efficacy of a cognitive behavioral intervention based on lucid dreaming training and imagery control therapy for reducing REM-related symptoms in patients with narcolepsy type 1. Specifically, the study examined the impact of the intervention on hypnagogic hallucinations and sleep paralysis, which are common and distressing symptoms associated with REM sleep intrusions in narcolepsy.
Ninety-eight adults with confirmed narcolepsy type 1 were randomly assigned to either an experimental intervention group or a control group receiving standard pharmacological treatment, structured clinical follow-up, and sleep hygiene psychoeducation. The intervention consisted of six weekly 90-minute telehealth sessions integrating psychoeducation, dream awareness training, lucid dreaming induction techniques, imagery rehearsal therapy (IRT), metacognitive strategies, emotional regulation, and relapse prevention.
Primary outcomes included changes in the frequency and distress associated with hypnagogic hallucinations and sleep paralysis. Secondary outcomes included subjective sleep quality, metacognitive dream-related variables, and quality of life. Participants were assessed at baseline, post-treatment, and at 6- and 12-month follow-up evaluations.
The study aimed to determine whether behavioral interventions targeting dream awareness, emotional regulation, and metacognitive control could complement pharmacological treatment and improve REM-related symptoms and sleep-related quality of life in narcolepsy.
详细描述
Detailed Description
Narcolepsy type 1 is a chronic neurological sleep-wake disorder characterized by excessive daytime sleepiness, cataplexy, and REM sleep dissociation phenomena, including hypnagogic hallucinations and sleep paralysis. Although pharmacological therapies are effective for managing daytime sleepiness and cataplexy, treatment options for REM-related perceptual symptoms remain limited. Hypnagogic hallucinations and sleep paralysis are frequently associated with emotional distress, impaired quality of life, anxiety, and sleep disruption.
Lucid dreaming refers to the awareness of dreaming while the dream is occurring and may involve the ability to voluntarily influence dream content. Previous studies have suggested that lucid dreaming training and imagery-based cognitive techniques may reduce emotional distress associated with nightmares and other disturbing dream experiences. Given the high prevalence of lucid dreaming experiences among patients with narcolepsy, these strategies may represent a promising behavioral approach for REM-related symptoms.
This study was designed as a randomized controlled longitudinal trial to evaluate the efficacy of a cognitive behavioral intervention integrating lucid dreaming training and imagery control therapy in patients with narcolepsy type 1. The study was conducted between March 2023 and April 2025 using synchronous telehealth sessions delivered through a secure videoconferencing platform.
A total of 98 participants with clinically and polysomnographically confirmed narcolepsy type 1 were recruited from specialized sleep medicine centers in Colombia and Costa Rica. Eligible participants were adults presenting clinically significant hypnagogic hallucinations and/or sleep paralysis and receiving stable pharmacological treatment. Participants with severe psychiatric disorders, dissociative disorders, or active substance use disorders were excluded.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
(Participants and care providers were not blinded because of the behavioral nature of the intervention, but outcome evaluators and the statistical analyst remained blinded to group allocation.)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged ≥18 years diagnosed with Narcolepsy Type 1, confirmed by clinical evaluation and polysomnography.
- •Experiencing clinically significant hypnagogic hallucinations and/or sleep paralysis.
- •Stable pharmacological treatment for narcolepsy, such as modafinil and/or methylphenidate.
- •Able and willing to provide informed consent electronically.
- •Available to participate in six weekly virtual intervention sessions.
- •Willing to adhere to structured medical follow-up, including sleep hygiene education, nap guidance, sleep habit stabilization, and participation in sleep schedule programs.
排除标准
- •Presence of severe psychiatric disorders or dissociative disorders. Active use of psychoactive substances during the study period.
- •Participation in other interventions targeting lucid dreaming or imagery rehearsal during the trial.
- •Any medical or cognitive condition that, in the investigator's judgment, would interfere with participation or adherence to the intervention.