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Sleep enhances exposure therapy

Published online by Cambridge University Press:  10 July 2013

B. Kleim ,
F. H. Wilhelm ,
L. Temp ,
J. Margraf ,
B. K. Wiederhold  and
B. Rasch
B. Kleim*
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
F. H. Wilhelm
Affiliation:
Department of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
L. Temp
Affiliation:
University of Basel, Basel, Switzerland
J. Margraf
Affiliation:
Center for the Study and Treatment of Mental Health, Department of Clinical Psychology, Ruhr-University Bochum, Germany
B. K. Wiederhold
Affiliation:
Virtual Reality Medical Center, San Diego, CA, USA Virtual Reality Medical Center, Brussels, Belgium
B. Rasch
Affiliation:
Department of Biopsychology, University of Zurich, Zurich, Switzerland
*
* Address for correspondence: B. Kleim, Ph.D., Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, Box 26, CH-8050 Zurich, Switzerland. (Email: [email protected])
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Abstract

Background

Sleep benefits memory consolidation. Here, we tested the beneficial effect of sleep on memory consolidation following exposure psychotherapy of phobic anxiety.

Method

A total of 40 individuals afflicted with spider phobia according to DSM-IV underwent a one-session virtual reality exposure treatment and either slept for 90 min or stayed awake afterwards.

Results

Sleep following exposure therapy compared with wakefulness led to better reductions in self-reported fear (p = 0.045, d = 0.47) and catastrophic spider-related cognitions (p = 0.026, d = 0.53) during approaching a live spider, both tested after 1 week. Both reductions were associated with greater percentages of stage 2 sleep.

Conclusions

Our results indicate that sleep following successful psychotherapy, such as exposure therapy, improves therapeutic effectiveness, possibly by strengthening new non-fearful memory traces established during therapy. These findings offer an important non-invasive alternative to recent attempts to facilitate therapeutic memory extinction and consolidation processes with pharmacological or behavioral interventions.

Keywords

Electroencephalographyemotional learningexposure therapymemory consolidationphobiasleep
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 7 , May 2014 , pp. 1511 - 1519
Copyright
Copyright © Cambridge University Press 2013 

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