Sleep, Dreaming, and Virtual Reality for Mental Health

Northwestern University

Status and phase: Enrolling; Early Phase 1

Conditions: Anxiety

Treatments: Behavioral: Sleep Health Enhancement Program (SHEP); Behavioral: Dream Yoga Inspired Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT07408206

STU00222189-MOD0004

Details and patient eligibility

About

People spend approximately one-third of their lives asleep, yet sleep is often underused as an opportunity to support psychological well-being. Contemplative traditions, including Tibetan Dream Yoga, have developed practices that use waking imagination and lucid dreaming to explore perception, awareness, and habitual patterns of thinking. Recent advances in sleep monitoring, dream communication, and lucid dream induction now make it possible to study these practices using scientific methods.

This study is a randomized controlled trial designed to examine the feasibility and effects of a Dream-Yoga-inspired intervention compared with an active control condition. The intervention combines waking and dreaming practices that are adapted for individuals without prior experience and delivered using virtual reality-based training and home sleep technology. The program is designed to be scalable and culturally neutral, without requiring prior knowledge of contemplative or religious traditions.

The primary goals of the study are to characterize sleep and waking neurophysiology associated with Dream-Yoga-inspired practices and to evaluate whether participation is associated with changes in sleep-related brain activity and cognitive processes. Outcomes include measures of lucid dreaming, sleep physiology, and waking cognitive and perceptual processes. Anxiety will be assessed as an exploratory outcome to examine whether participation may be associated with changes in emotional experience. This study is not designed to provide treatment for anxiety or other clinical conditions.

Results from this study will help inform the development of scalable sleep-based mental training approaches and guide future research on the use of dreaming and sleep practices to support psychological health and well-being.

Full description

Dream Yoga is a contemplative practice with a documented history spanning more than a millennium, described in traditional manuals as a set of waking and sleep-based exercises intended to cultivate insight, perceptual flexibility, and altered self-referential processing. These practices include the intentional induction of lucid dreaming, in which individuals become aware that they are dreaming and may exert varying degrees of volitional influence over dream content. Advances in sleep physiology, polysomnography, wearable sleep monitoring, and methods for inducing and verifying lucid dreams now make it possible to examine such practices using objective neurophysiological measures.

This randomized controlled trial evaluates the effects of a Dream-Yoga-inspired intervention compared with an active control condition in healthy adults without prior contemplative training. The intervention adapts core elements of traditional Dream Yoga into a standardized, secular program designed for accessibility and scalability. The study focuses on characterizing sleep and waking neurophysiological features associated with participation in the intervention and assessing changes in lucid dreaming, cognitive, and perceptual measures. Anxiety is assessed as an exploratory outcome.

Study Design and Procedures

Participants are randomly assigned to either a Dream-Yoga-inspired intervention or a structurally matched active control condition. All participants complete baseline ("pre") and post-intervention ("post") assessments separated by an eight-week intervention period. Baseline procedures include informed consent, demographic questionnaires, neuropsychological testing, and self-report measures. Participants receive standardized training in the use of home sleep monitoring devices and study procedures.

Throughout the four-week intervention, participants attend weekly virtual group sessions of approximately 35 mins each, led by trained facilitators. Both study arms are matched for contact time, group interaction, facilitator attention, and homework expectations. Participants complete daily brief self-report measures related to sleep and dreaming during the intervention period.

A subset of participants undergoes additional laboratory-based electrophysiological assessments, including overnight polysomnography and waking electroencephalography, at baseline and following the intervention. These recordings are used to examine sleep architecture and EEG microstructure, including exploratory analyses of oscillatory activity and functional relationships between brain regions. Participants not included in laboratory recordings provide sleep-related data using wearable devices, which offer longitudinal but lower-resolution physiological measures.

Dream-Yoga-Inspired Intervention

The intervention introduces participants to structured waking and sleep-based mental practices derived from Dream Yoga, adapted for individuals without prior experience. Waking practices emphasize attention regulation, imagery, metacognitive awareness, and intention-setting prior to sleep. Sleep-based components include instruction on recognizing dream states, cultivating lucidity, and engaging in specific cognitive exercises during dreams.

Participants use wearable sleep devices that deliver auditory cues during REM sleep to support lucid dreaming and remind participants of intended dream-based practices. Participants are instructed in established signaling methods to indicate lucidity during sleep using predefined eye-movement patterns. The intervention integrates both waking and sleep-based exercises and includes individualized check-ins to support adherence to assigned practices.

The intervention also incorporates two group-based virtual reality (VR) sessions delivered early in the study period. These sessions are designed to engage perceptual flexibility and self-referential processing through immersive, interactive experiences. The VR component serves as an adjunct to waking Dream-Yoga-inspired practices and is intended to reinforce experiential learning relevant to the intervention's goals.

Active Control Condition

The control condition consists of a modified Health Enhancement Program (HEP) adapted to match the intervention in duration, format, and participant engagement. The program includes education and experiential activities related to health-promoting behaviors with a particular focus on sleep and dreaming such as physical activity, nutrition, sleep habits, stress management, and expressive activities. VR sessions in the control condition focus on general health and well-being topics rather than contemplative or dream-related content. Home practice is encouraged, and adherence is supported through individual check-ins, mirroring the intervention arm.

Randomization and Blinding

Randomization is performed by a statistician not involved in recruitment or assessment. Outcome assessors and investigators involved in data analysis are blinded to group assignment. Facilitators deliver only one intervention type to minimize cross-condition contamination.

Sample Size and Statistical Approach

Participants are enrolled and randomized equally between groups. Primary analyses examine changes in sleep and waking neurophysiological measures from baseline to post-intervention between groups using mixed-effects models. Secondary analyses examine changes in cognitive measures. Exploratory analyses assess changes in additional self-report measures, including sleep-related experiences, lucid dreaming characteristics, and anxiety.

Enrollment: 70 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Individuals interested in participating will be screened for eligibility through a Qualtrics survey, a Score between 5-21 points in GAD-7.

Healthy, English-speaking adults (at least 18 years old) with high dream recall (at least 1/week).

Exclusion criteria

• We will exclude people who self-report any of the following:

  1. 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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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70 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 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 will be similar in both groups.

Treatment:

Behavioral: Sleep Health Enhancement Program (SHEP)