Sleep's Influence on the Treatment of Intrusive Emotional

Study Overview
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Brief Summary
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Intrusive memories represent a debilitating core feature of PTSD, one of the most prevalent psychiatric disorders following trauma. Exposure therapy is amongst the most successful treatments of PTSD that is recommended by most of the current national and international guidelines. The current study aims to test whether sleep as adjunct to written exposure sessions, a type of exposure- based treatment for PTSD, may boost the effectiveness of the therapy.

Detailed Description
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Intrusive memories represent a debilitating core feature of PTSD, one of the most prevalent psychiatric disorders following trauma. Exposure therapy is amongst the most successful treatments of PTSD that is recommended by most of the current national and international guidelines. However, not all patients benefit equally and only about 50% show sustained response. There is thus room for improvement in terms of (i) better understanding who benefits from this type of therapy and (ii) possible ways of augmenting existing trauma-focused therapies. The current study aims to contribute to these endevours. Specifically, the study aims to test whether sleep as adjunct to written exposure sessions, a type of exposure- based treatment for PTSD, may boost the effectiveness of the therapy.

Official Title
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Sleep's Influence on the Treatment of Intrusive Emotional Memories With Trauma-focused CBT

Conditions
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Intrusive Memories, PTSD

Intervention / Treatment
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* Behavioral: Sleep/Nap


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: DSM V criteria of PTSD (at least moderate symptoms in two categories) Currently receiving Written Exposure Therapy at one of the psychotherapy centers at the Psychiatric University Clinic (PUC). Not more than moderate alcohol consumption (not more than 5 alcoholic drinks/week). Ability to understand the study instructions Exclusion Criteria: Travel over > 3 time zones in < 3 months head injury shift work current substance abuse neurological disease drug addiction Current suicidality Specific exclusion criteria for the fMRI: Acute psychotic symptoms Pregnancy Claustrophobia Magnetic resonance imaging incompatibility: Cardiac pacemaker or other metallic implants (e.g. metallic cardiac valve, insulin pump) Metallic foreign particles (e.g. after bullet wound, shell splinter, clips, metal prostheses)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomised controlled trial
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Sleep after exposure<br>Participants take a nap during 90 min following three exposure (WET) sessions. | Behavioral: Sleep/Nap<br>* Participants sleep after a maximum of three sessions of exposure therapy.<br>|
| No Intervention: Wake after exposure<br>Participants watch a 90 min documentary following three exposure (WET) sessions. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinician- assessed Posttraumatic stress symptom severity at 1 week | Clinician- assessed PTSD symptom severity (CAPS- 5) | One week post- treatment | 
| Self-reported Posttraumatic stress symptom severity at 1 week | Self - reported PTSD symptom severity (PCL-5) | One week post- treatment | 
| Clinician- assessed Posttraumatic stress symptom severity at 1 month | Clinician- assessed PTSD symptom severity (CAPS- 5) | One month post- treatment | 
| Self-reported Posttraumatic stress symptom severity at 1 month | Self - reported PTSD symptom severity (PCL-5) | One month post- treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total sleep time | Total sleep time according to EEG | Immediately after written exposure therapy | 
| Time spent in N1 sleep | N1 time according to EEG | Immediately after written exposure therapy | 
| Time spent in N2 sleep | N2 time according to EEG | Immediately after written exposure therapy | 
| Time spent in N3 sleep | N3 time according to EEG | Immediately after written exposure therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sleep, memory, consolidation