Feasibility of a Mental-Health Intervention Based on Contemplative Sleep Practices

Northwestern University

Status and phase: Active, not recruiting; Early Phase 1

Conditions: Anxiety

Treatments: Behavioral: Sleep Health Enhancement program; Behavioral: Dream Yoga Inspired Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT07217340

STU00222189

Details and patient eligibility

About

This is a feasibility study to test whether it is possible to deliver a program inspired by Tibetan Dream Yoga in a modern, accessible way. Dream Yoga is a set of contemplative practices that combine mental exercises during the day with techniques for becoming aware of dreaming within a dream (lucid dreaming) and engage in certain dream activities. The purpose of these practices is to help people explore and loosen rigid patterns of thought and behavior.

In this study, the investigators are developing and testing a program that includes guided imagination, meditation, and lucid-dreaming practices, supported by virtual-reality experiences and home-based sleep-monitoring technology. Participants are randomly assigned to either the Dream-Yoga-inspired program or a comparison program focused on general health and sleep education.

Because this is a feasibility trial, our main goals are to see whether people are willing and able to take part, whether they find the program acceptable, and whether the investigators can deliver it as planned. The investigators will also explore early signals of change in sleep, dreaming, and thinking.

The long-term goal of this research is to determine if such interventions could be beneficial for supporting psychological well-being, improving sleep, and enhancing creativity and flexibility of thought.

Full description

Recent methodological advances enable novel scientific explorations of dreaming activities. Whereas the science of dreaming suffered historically from inadequate strategies, a new era has dawned driven by innovations in physiological sleep monitoring, two-way communication during the dream state, and lucid-dream induction.

New opportunities for dream research emerged with the demonstration that dreamers can accurately perceive spoken questions and deliver coded answers to those questions while remaining in REM sleep verified with standard polysomnography. Subsequent studies confirmed the viability of these methods and used them to explore outstanding questions about dreams. The method the experimenters use to produce lucid dreaming in the sleep laboratory, Targeted Lucidity Reactivation (TLR), was substantiated with the published demonstration that 50% of participants tested achieved a lucid dream, and now extended to the home environment based on at-home strategies previously used for slow-wave-sleep Targeted Memory Reactivation. Building on this foundation, we can use lucid-dream induction and interactive dreaming in both lab and home environments to investigate contemplative sleep practices.

Over centuries, Tibetan-Buddhist contemplatives developed and documented techniques for spiritual insight. One portrayal of insight in this context is to deconstructed conventional reality, noted that ordinary waking experience is like a dream in that people tend to grasp onto perceptual objects, thoughts, or ideas without understanding their interdependent, impermanent, and mentally constructed nature. The Buddhist literature on Dream Yoga includes manuals describing recommended practices, descriptions of benefits that can be achieved, such as enhanced cognition and emotional flexibility. The progressive exercises of Dream Yoga, including waking imagination and activities during lucid dreams, enable the dreamer to gain control over dream content, creating a platform to alter deeply ingrained habits and work to deconstruct ordinary conceptualizations.

Based on traditional wake- and sleep-based practices, we have developed an accessible strategy for personal insight, capitalizing on modern virtual-reality and sleep technology to supplement dreaming experiences. People spend a third of their lives asleep, usually oblivious to the opportunities that sleep offers. Excessive pressure in people's lives makes some consider sleep a waste of time. Yet, sleep has untapped value for mental and physical health, as increasingly acknowledged due to steady advances in the science of sleep. Today's orthodox view nevertheless holds that, although people can constructively control the context of sleep with proper habits of Sleep Hygiene, there is little control after placing a head on the pillow-sleep either goes well or it doesn't. We propose that advanced contemplative practices during sleep may hold powerful opportunities.

There is a glaring worldwide need to optimize sleep. Poor sleep is associated with many psychiatric and neurological disorders. The high prevalence of insomnia and suboptimal sleeping also contributes to other problems (e.g., low work-productivity, depression, and suicidal tendencies). A new orientation known as sleep engineering makes use of methods such as strategic sensory stimulation and sleep-and wake-based mental exercises, which can be guided by contemplative insights to enhance psychological health and well-being.

Sleep is crucial for memory, emotional regulation, and numerous aspects of health. Methods for producing transformative dream experiences and reliably provoking lucid dreaming may hold promise for reducing depression and anxiety. A randomized controlled trial was designed to test whether the intervention produces changes in sleep and waking neurophysiology, cognitive flexibility, creative insight, and self-referential focus. The intervention includes practices during dreaming and waking, whereby people learn to cultivate specific skills, aided by virtual-reality experiences and wireless sleep-technology in their own homes. As an initial step, this randomized controlled trial is designed to examine feasibility, acceptability, tolerability, and potential outcomes.

Enrollment: 25 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Healthy, English-speaking adults (at least 18 years old) with
• High dream recall (at least 1/month).

Exclusion criteria

1. a history of an established meditative practice
2. psychological or psychiatric disorders (other than mild anxiety)
3. sleep disorders, nightshift work in the past month, extreme chronotype or irregular sleeping pattern
4. use of recreational drugs in the past month
5. history of asthma, seizures or heart problems
6. unwillingness to wear headband during sleep.
7. Not having an address in the domestic United States, so residents of other countries would be excluded.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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25 participants in 2 patient groups

Dream Yoga Inspired Intervention

Experimental group

Description:

This customized contemplative training will guide participants in exploring techniques used in Tibetan Dream Yoga. Strategies in Tibetan Dream-Yoga manuals are thus transferred to a modern context and adapted as a group intervention. Goals will be set for dreaming that include gaining a degree of volitional influence over the dream. Wearable devices will be used to present cues during sleep both to provoke lucidity and to remind individuals of Dream-Yoga exercises to be engaged during sleep. Virtual-reality (VR) sessions provide a novel adjunct to Dream Yoga, in keeping with prior research integrating lucid dreaming and VR (Gott et al., 2021). The protocol progresses though several group activities; individuals feel themselves dispersing into a void within the VR world, and then blending with others, leading the reduced self-grasping. If this unique VR component can blur conventional self-other boundaries, it may reinforce the progressive instructions in Dream Yoga.

Treatment:

Behavioral: Dream Yoga Inspired Intervention

Sleep Health Enhancement program

Active Comparator group

Description:

A modified version of the Health Enhancement Program (HEP), which was developed as an active control condition for mindfulness-based interventions, with a particular focus on sleep hygiene. It controls for several non-specific factors such as expectations of positive change, group support, behavioural activation, facilitator attention, at-home practice, treatment duration, and format (MacCoon et al., 2012; Rosenkranz et al., 2013). Our modified HEP will be structurally equivalent to the Dream-Yoga condition, with high similarity on non-program-specific factors, including timing and number of sessions. The two VR sessions will focus on health enhancement. Participants will be taught positive health-enhancing practices, such as healthy diet and gentle exercise, with activity-based sessions covering exercise, sleep, dreaming, stress, anxiety, nutrition, journaling, music enjoyment, and drawing. Home practice and implementation of health-enhancing habits will be encouraged.

Treatment:

Behavioral: Sleep Health Enhancement program