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Sound Exposure During Sleep (SES) in PTSD Patients: An Open-Label Feasibility Study

Ino, K.; Zempo, K.; Hori, A.; Maruyama, T.; Tominaga, M.; Sugaya, Y.; Oba, M.; Yamauchi, Y.; Sato, L.; Sekiba, H.; Kawakami, C.; Bachman, G.; Waki, I.; Kitagawa, H.; Yanagisawa, M.; Kim, Y.; Sakaguchi, M.

2026-05-04 psychiatry and clinical psychology
10.64898/2026.05.02.26352243 medRxiv
Show abstract

Trauma-focused psychotherapies for post-traumatic stress disorder (PTSD) require waking re-engagement with traumatic memories, driving high dropout. We tested whether trauma-linked auditory cues delivered during slow-wave sleep are feasible. Of 13 patients who provided written informed consent, 6 (100% female) completed overnight Sound Exposure during Sleep (SES); none of the adverse events observed during overnight stimulation were judged by the study team to be attributable to the auditory intervention, and slow-wave sleep was preserved. Two sequential protocol versions were used: Version A (n = 2; capped at SUDs 30-40) and a no-ceiling amendment (Version B, n = 4). Post-hoc exploratory analyses (not powered for efficacy) showed Version B reduced subjective distress (mean difference -65.5%, 95% CI -104.2 to -26.7; nominal p = 0.012) and PCL-5 intrusion (-7.0; nominal p = 0.015). Findings are exploratory and require sham-controlled confirmation. Trial registration: jRCT1030230706.

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