Methods for the objective recording and evaluation of attention and reflection ability during sleep

Abstract

The invention relates to a method for objectively recording and evaluating attention and reflective ability during sleep, characterized in that attention and reflective ability during sleep are determined using the rapid eye and / or rapid eyelid movements characteristic of the dream phases. To determine the rapid eye and rapid eyelid movements, at least one motion-sensitive FE sensor is arranged in front of at least one eye. The output signals of the proposed FE sensors are analyzed by an analysis unit (AE), and based on this analysis, the degree / intensity of attention and the degree / intensity of reflective ability during sleep are determined. The results of the analysis unit (AE) can be saved and made available to the user and therapist after awakening.Using a preferably external interaction unit (IE), preferably a unit for playing sounds or noises, the sleeping person can also be influenced in real time to promote the development of attention and reflection skills. Preferably, this is done by gently awakening the sleeping person when attention and reflection skills are detected as being too low. This allows the user to recognize their current mental state and, as a result, respond promptly through appropriate training.

Description

[0001] The invention relates to a method for objectively recording and evaluating attention and reflection ability during sleep.

[0002] The primary objective of the invention is to enable effective treatment of sleep disorders, particularly nightmares caused by anxiety, depression, post-traumatic stress disorders, and difficulty falling asleep. Another primary objective of the invention is to enable effective treatment for stress management, particularly in competitive athletes or managers. The investigation of sleep disorders and their causes is routinely performed using polysomnography in a sleep laboratory. Polysomnography measures the EEG (electroencephalogram), the EOG (electrooculogram), and the EMG (electromyogram) and uses them to analyze sleep disorders.

[0003] The treatment of these sleep disorders is very lengthy. Treatment typically involves psychotherapy (talk therapy) and, if necessary, medication. It is estimated that approximately one in twenty Germans suffers from recurring nightmares. A significant number of these people subsequently become unable to work for many months due to the severe psychological stress.

[0004] An alternative, fundamentally very effective approach to treating the aforementioned states of consciousness perceived as stressful incorporates lucid dreaming into Imagery Rehearsal Therapy (IRT). Lucid dreams are characterized by the dreamer becoming aware of their state, and previously memorized intentions to act can be purposefully carried out in the dream. IRT is based on the insight that dream events, and thus also the stressful emotions, can be influenced by actions performed while awake. In particular, that already existing dream content can be linked to new ideas, actions, and feelings in the memory. The goal of IRT is therefore to rewrite the dream content and thus also the stressful emotions. To do this, the patient intensively and regularly imagines a dream story that modifies the dream events in a way that is pleasant for them.Ideally, after some time, the patient will no longer dream the nightmare while asleep, but rather the imagined dream story. The success of IRT therefore depends on whether the patient succeeds in rewriting the nightmare. Since nightmares are usually associated with the feeling of being helplessly at the mercy of the dream events, this rewriting often fails. The patient may have the intention, but cannot quite believe that it will succeed due to the helplessness experienced in the dream. The effectiveness of IRT can, however, be significantly increased if the patient consciously recalls the imagined dream events in the nightmare. Once the patient acquires the ability to lucid dream, the imagined dream story can then be recognized as an alternative course of action and actively implemented. In this way, the experience of being at the mercy of the nightmare can be overcome, the dream events can be modified, and the nightmare can be ended [1].

[0005] The actual effectiveness of IRT incorporating lucid dreaming, however, depends significantly on how quickly the patient learns lucid dreaming. Regarding the prospects of success in the process of learning lucid dreaming, our current research suggests a difficult-to-understand discrepancy between the reported prospects of success in the sleep laboratory and the prospects of success in the regular home environment. Whether this is due to the special setting in the sleep laboratory or to the fact that only those with the appropriate motivation or predisposition to lucid dreaming attend the sleep laboratory is difficult to say. However, the fact is that all known methods in the regular home environment seem to produce no results, even after several weeks. As a result, the vast majority of people prematurely abandon their attempt to learn lucid dreaming out of frustration.

[0006] In our opinion, the reason for this lies in the following fact: With all known methods for learning lucid dreaming, one must believe that one's own efforts will lead to the goal—a lucid dream. There are no objective criteria by which one can determine whether one's own efforts are bringing one closer to the goal of lucid dreaming or are counterproductive. This fact is neither addressed nor researched in the relevant literature.

[0007] The most well-known technique for learning lucid dreaming involves asking yourself the question "Am I awake or am I dreaming?" as often as possible while awake, analyzing your perceived surroundings for inconsistencies (a reality check). If you do this conscientiously, you will also ask yourself this question in your dreams—so the hope is—and will then be able to recognize that you are dreaming, thus achieving lucid dreaming. However, this can quickly become a mere routine in which you are distracted. Then you lack the attention and reflection required to recognize the dream, and the lucid dream never occurs.

[0008] Based on this, the invention seeks to develop a method that enables the recording and assessment of attention and reflective ability during sleep based on objective criteria. This would allow patients to systematically train lucid dreaming for the first time, promptly recognize progress made during training or mental blocks, and thus learn lucid dreaming in a short period of time with motivation. By incorporating this active learning process into IRT, patients with nightmares would then have access to an effective treatment that actively engages the patient.

[0009] It is known that attention and reflective ability during sleep can be determined by asking subjects after waking up and using these subjective reports to try to determine the subject's attention or reflective ability during sleep.

[0010] Ideally, the subject sleeps in a sleep laboratory, and sleep phases are determined using polysomnography. The subject is then awakened during different sleep phases, and the subjective verbal or written reports are used to determine their attention or ability to reflect during the corresponding sleep phase.

[0011] In our opinion, the reliance on this rudimentary method of questioning is essentially due to the fact that the rapid eye and eyelid movements (caused by muscle twitches) characteristic of dream phases cannot be captured using polysomnography. Furthermore, the REM phases defined within the framework of polysomnography cannot be considered an adequate measure of dream phases (since dreams also occur outside of REM phases, for example, during the NREM phases of falling asleep) and thus also not of attention and reflective ability, since the rapid eyelid and / or eye movements during sleep, which are associated with attention and reflective ability, must be measured during dream phases and not exclusively during REM phases.

[0012] Furthermore, it is known that people who practice intensive mental training (Transcendental Meditation, TM) for many years or decades to maintain attention and reflection skills exhibit significant, characteristic changes in the EEG during sleep compared to untrained individuals [2]. It is also known that the rapid eye and eyelid movements characteristic of dream phases correlate temporally with PGO waves (ponto-geniculo-occipital waves) and are associated with the ability to recall dreams [3].

[0013] The invention is therefore based on the finding that not only the occurrence of dreams, but also attention and reflection ability during sleep are temporally correlated with the occurrence of PGO waves (ponto-geniculo-occipital) and therefore the intensity and frequency of eye and / or eyelid twitches are indicators of the degree of attention and reflection ability during sleep and from these indicators training methods can be derived that lead to a higher general degree of awareness during sleep, as is achieved within the framework of TM.

[0014] To achieve this object, the combinations of features specified in claims 1 to 6 are proposed. Advantageous embodiments and further developments of the invention emerge from the dependent claims 2 to 6.

[0015] According to the invention, it is proposed to determine the attention and / or the ability to reflect during sleep by determining the rapid eye and / or rapid eyelid movements characteristic of the dream phases and by determining the attention and / or the ability to reflect based on their frequency and / or intensity and / or amplitude and / or temporal distribution.

[0016] An advantageous embodiment of the invention provides that, to determine rapid eye and / or eyelid movements, at least one motion-sensitive sensor (B-sensor) is applied, preferably glued, to at least one eyelid, and using these B-sensors to determine the frequency and / or intensity and / or amplitude and / or temporal distribution of the rapid eye and / or eyelid movements. A B-sensor is understood here to be a sensor that enables the detection of rapid eye and / or eyelid movements based on a mechanical deformation of the sensor due to a rapid eye and / or eyelid movement. A piezoelectric bending sensor can preferably be used for this purpose, as these are very small and can be easily glued to the eyelid.

[0017] A further advantageous embodiment of the invention provides that, to determine rapid eye and / or eyelid movements, at least one field-effect sensor (FE sensor) is arranged in front of at least one eye, preferably at a distance of approximately 10 mm from the eye, and the frequency and / or intensity and / or amplitude and / or temporal distribution of the rapid eye and / or eyelid movements is determined using the FE sensors. Field-effect sensors here refer to all sensors that enable the electrical fields emanating from the eyes to be detected and, based on the changes in these electrical fields, enable the rapid eye and / or eyelid movements to be detected and / or the signal profiles to be analyzed.Preferably, the sensors (20) described in patent application [4] and the method described therein for detecting rapid eye and rapid eyelid movements can be used for this purpose.

[0018] An advantageous embodiment of the invention provides that the output signals of the B and / or FE sensors used are analyzed by means of an analysis unit (AE) and, based on this analysis, the degree / intensity of attention and / or the degree / intensity of reflectivity during sleep is determined.

[0019] A further embodiment of the invention provides that the results of the analysis unit (AE) are stored and displayed to the user and / or therapist after waking up, preferably as a chronological progression over the night. Based on the determined temporal distribution of attention and reflective ability, the user can then adequately evaluate the inner mental states experienced by the user for the first time and thus systematically train lucid dreaming, promptly recognize the progress achieved during training or mental blocks, and thus learn lucid dreaming in a motivated manner in a short time. By incorporating this active learning process into IRT, patients with nightmares thus have access for the first time to an effective treatment that actively involves the patient.If, for example, after waking up from a sleep-onset phase, the user has no memory of having fallen asleep, the assessment should result in very low attention and very low reflection capacity. If, on the other hand, after waking up from a sleep-onset phase, the user has the memory, for example, of having been fascinated by a play of colors or of briefly appearing images or scenes and of having been clearly aware of the situation and what they had experienced, the assessment should result in very high attention and very high reflection capacity. If the user is not able to remember anything immediately after waking up, but the memory comes after a few seconds, for example the memory of a play of colors without any kind of reaction from the user, the assessment should result in low / medium attention and low reflection capacity. To give just a few simple examples.

[0020] A further advantageous embodiment of the invention provides that the attention and / or reflection ability determined at a specific point in time is made available to the user in real time and can be influenced by means of a preferably external interaction unit (IE), preferably a unit for playing tones and / or noises and / or a unit for generating optical signals, on the sleeping person in such a way that the development of attention and / or reflection ability can be promoted, preferably by gently awakening the sleeping person when the attention and / or reflection ability has been identified as being too low and the user can thereby identify his or her current mental state and, as a result, respond to it appropriately and promptly. Literature: 1 (SLEEP 2 / 2018; pages 76 -80). 2 (Sleep, 20(2); 102-110; 1997). 3 J. Sleep Res. (2004) 13, 137-144 4 DE102016012192.0. QUOTES CONTAINED IN THE DESCRIPTION

[0000] This list of documents submitted by the applicant was generated automatically and is included solely for the convenience of the reader. This list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions. Cited patent literature

[0000] DE 102016012192.0

[0020] Cited non-patent literature

[0000] SLEEP 2 / 2018; pages 76-80

[0020] Sleep, 20(2); 102-110; 1997

[0020] J. Sleep Res. (2004) 13, 137-144

[0020]

Claims

[1] Methods for the objective recording and evaluation of attention and reflection ability during sleep, characterized by that attention and / or reflective ability during sleep is determined by means of the rapid eye and / or eyelid movements characteristic of the dream phases and that attention and / or reflective ability is determined on the basis of their frequency and / or intensity and / or amplitude and / or temporal distribution. [2] Method according to claim 1, characterized bythat to determine the rapid eye and / or rapid eyelid movements, at least one movement-sensitive B-sensor, preferably a piezoelectric sensor, is applied, preferably glued, to at least one eyelid, and by means of these B-sensors the frequency and / or intensity and / or amplitude and / or temporal distribution of the rapid eye and / or rapid eyelid movements is determined to determine the attention and / or reflectivity. [3] Method according to claim 1, characterized bythat to determine the rapid eye and / or rapid eyelid movements, at least one FE sensor is arranged in front of at least one eye, preferably at a distance of approximately 10 mm in front of the eye, and by means of the FE sensors the frequency and / or intensity and / or amplitude and / or temporal distribution of the rapid eye and / or rapid eyelid movements is determined to determine the attention and / or reflectivity. [4] Method according to one of claims 2 to 3, characterized by that the output signals of the B-sensors and / or FE sensors used are analyzed by means of an analysis unit (AE) and, based on this analysis, the intensity of attention and / or the intensity of reflectivity during sleep is determined. [5] Method according to one of claims 1 to 4, characterized bythat the results of the analysis unit (AE) are saved and / or displayed to the user and / or therapist after waking up, preferably as a time course over the night. [6] Method according to one of claims 1 to 5, characterized bythat the attention and / or reflection ability determined at a specific point in time is made available to the user in real time and can be influenced by means of a preferably external interaction unit (IE), preferably a unit for playing tones and / or noises and / or a unit for generating optical signals, on the sleeping person in such a way that the development of attention and / or reflection ability can be promoted, preferably by gently waking the sleeping person when the attention and / or reflection ability has been identified as being too low and the user can thereby recognise his or her current mental state and as a result respond to it appropriately and in a timely manner.