Odour cueing during sleep augments trauma-focused psychotherapy
- 1University of Luebeck
Abstract
Trauma-focused psychotherapies reduce posttraumatic stress disorder (PTSD) symptoms by updating maladaptive traumatic memories into more adaptive representations. However, many patients do not achieve clinically meaningful improvement, highlighting the need for augmentation strategies. Targeted memory reactivation (TMR), in which memory cues are re-presented during sleep to strengthen memory consolidation, is a promising approach. We combined a mechanistic study in healthy participants with a randomized clinical trial to test whether odour cueing during sleep augments trauma-focused psychotherapy. In healthy participants, re-exposure to the therapy-associated odour during sleep increased slow-wave activity and slow oscillations, while greater increases in slow oscillation-spindle coupling were associated with reduced emotional arousal during recall of aversive autobiographical memories. In patients with PTSD, repeated odour cueing during sleep throughout 12 weeks of trauma-focused treatment improved clinician-rated and self-reported PTSD symptoms, particularly re-experiencing and negative alterations in cognition and mood, and accelerated treatment response and remission. These findings provide converging mechanistic and clinical evidence that TMR can enhance trauma-focused psychotherapy, potentially through sleep-dependent memory consolidation.
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BibTeX
@misc{schaich2026odour,
title = {{Odour cueing during sleep augments trauma-focused psychotherapy}},
author = {A. Schaich and S. Groch and M. Ehsanifard and J. Lehmann-Grube and C. Sayk and H.-V. Ngo-Dehning and M. Kammerer and E. Fassbinder and J. Amores and F. Paulus and S. Krach and J. P. Klein and I. Wilhelm-Groch},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.14.26362979},
url = {https://www.medrxiv.org/content/10.64898/2026.09.14.26362979v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Odour cueing during sleep augments trauma-focused psychotherapy
AU - A. Schaich
AU - S. Groch
AU - M. Ehsanifard
AU - J. Lehmann-Grube
AU - C. Sayk
AU - H.-V. Ngo-Dehning
AU - M. Kammerer
AU - E. Fassbinder
AU - J. Amores
AU - F. Paulus
AU - S. Krach
AU - J. P. Klein
AU - I. Wilhelm-Groch
PY - 2026
DA - 2026/09/14
PB - medRxiv
DO - 10.64898/2026.09.14.26362979
UR - https://www.medrxiv.org/content/10.64898/2026.09.14.26362979v1
AB - Trauma-focused psychotherapies reduce posttraumatic stress disorder (PTSD) symptoms by updating maladaptive traumatic memories into more adaptive representations. However, many patients do not achieve clinically meaningful improvement, highlighting the need for augmentation strategies. Targeted memory reactivation (TMR), in which memory cues are re-presented during sleep to strengthen memory consolidation, is a promising approach. We combined a mechanistic study in healthy participants with a randomized clinical trial to test whether odour cueing during sleep augments trauma-focused psychotherapy. In healthy participants, re-exposure to the therapy-associated odour during sleep increased slow-wave activity and slow oscillations, while greater increases in slow oscillation-spindle coupling were associated with reduced emotional arousal during recall of aversive autobiographical memories. In patients with PTSD, repeated odour cueing during sleep throughout 12 weeks of trauma-focused treatment improved clinician-rated and self-reported PTSD symptoms, particularly re-experiencing and negative alterations in cognition and mood, and accelerated treatment response and remission. These findings provide converging mechanistic and clinical evidence that TMR can enhance trauma-focused psychotherapy, potentially through sleep-dependent memory consolidation.
ER -