Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder

Not Applicable

Completed

• Conditions: Sleep; Social Anxiety Disorder
• Interventions: Behavioral: Exposure Therapy; Behavioral: Exposure Therapy and Targeted memory reactivation during REM sleep

• Registration Number: NCT05261659
• Lead Sponsor: University Hospital, Geneva

Brief Summary

With this study, the investigators aim to use sleep and dreaming in order to enhance exposure therapy for social anxiety disorder (SAD), by pairing the positive feedback phase of exposure (public talk) to an auditory stimulus during wake (associated sound) and subsequently applying this stimulus during sleep (targeted memory reactivation, TMR). Exposure therapy sessions will take place in a virtual reality (VR) environment, while physiological measures during the preparation phase of public talk such as heart rate variability (HRV), skin conductance response (SCR) and subjective level of anxiety (SUDS) will be used in order to assess treatment efficiency across the sessions. Patients with SAD according to DSM-5 criteria will be included.

The main hypothesis of this study is that participants who are presented with the associated sound during sleep (TMR group) will have reduced intensity of social anxiety compared to participants with no such association (control group), after both a full night's sleep with auditory stimulation during REM sleep in the laboratory, and after 1 week of stimulation during REM sleep at home. In addition, it is expected that fear-related dreams may correlate with anxiety levels during wakefulness after 1 week of stimulation at home.

Detailed Description

Not available

Study Timeline

• Study Start: 2020-02-18
• Primary Completion: 2022-02-06
• Study Completion: 2022-02-06
• Study First Submitted: 2022-02-19
• Study First Submitted QC: 2022-02-19
• Status Verified: 2022-03
• Last Update Submitted: 2022-03-01
• Study First Posted: 2022-03-02
• Last Update Posted: 2022-03-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 51

Inclusion Criteria

• Patients with social anxiety disorder (according to DSM-5 criteria and Liebowitz Social Anxiety Scale > 65)
• aged between 16 and 40 yo
• no current treatment for SAD (cognitive-behavioral therapy, medications)

Exclusion Criteria

• mood disorder, psychosis,other anxiety disorder or other mental disorders according to DSM-5 criteria
• sleep disorder (e.g.,insomnia disorder, obstructive sleep apnea syndrome, restless legs syndrome) according to DSM-5 criteria
• use of psychiatric medication
• current treatment for SAD (cognitive-behavioral therapy, medications)
• neurological disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control group	Exposure Therapy	Patients will not receive a sound while they receive a positive feedback for their performance of exposure therapy (ET). They will receive the same sound as the experimental group during REM sleep under the same conditions.
TMR group	Exposure Therapy and Targeted memory reactivation during REM sleep	Patients will receive a sound while they receive a positive feedback for their performance of exposure therapy (ET). They will also receive the sound during REM sleep.

Primary Outcome Measures

Name	Time	Method
Subjective Units of Distress Scale	1 week	Validated rating of subjective distress on a scale of 0 to 10 (higher values reflect a worse outcome)
Root mean square of the successive [R-R intervals] differences	1 week	The RMSSD is used to estimate the vagally mediated changes in heart rate variability.

Secondary Outcome Measures

Name	Time	Method
Change of fear in dreams (average of fear during the second week with stimulations minus the first week without stimulations)	1 week	Use of a dream diary where the emotion of fear is graded in a dichotomous way (presence/absence).
Non-specific skin conductance responses	1 week	The skin conductance response measures sympathetic nervous system activation.

Trial Locations

Locations (1)

Center for Sleep Medicine, University Hospitals of Geneva; 🇨🇭 Geneva, Switzerland