title: Sleep enhances exposure therapy.
abstract: BACKGROUND
  Sleep benefits memory consolidation. Here, we tested the beneficial effect of sleep on memory consolidation following exposure psychotherapy of phobic anxiety.
  
  
  METHODS
  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.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Kleim
authors.affiliation: Department of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria.
authors.forename: F H
authors.initials: FH
authors.lastname: Wilhelm
authors.affiliation: University of Basel, Basel, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Temp
authors.affiliation: Center for the Study and Treatment of Mental Health, Department of Clinical Psychology, Ruhr-University Bochum, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Margraf
authors.affiliation: Virtual Reality Medical Center, San Diego, CA, USA.
authors.forename: B K
authors.initials: BK
authors.lastname: Wiederhold
authors.affiliation: Department of Biopsychology, University of Zurich, Zurich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Rasch
mesh_terms: D000328:Adult; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D010698:Phobic Disorders / Q000628:therapy*; D012890:Sleep / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult