Sleep, Dreaming, and Virtual Reality for Mental Health

February 14, 2026 updated by: Ken Paller, Northwestern University

Transformative Benefits of Contemplative Sleep Practices and a Novel Pathway to Deliver Benefits to the General Public

People spend approximately one-third of their lives asleep, yet sleep is often underused as an opportunity to support psychological well-being. Contemplative traditions, including Tibetan Dream Yoga, have developed practices that use waking imagination and lucid dreaming to explore perception, awareness, and habitual patterns of thinking. Recent advances in sleep monitoring, dream communication, and lucid dream induction now make it possible to study these practices using scientific methods.

This study is a randomized controlled trial designed to examine the feasibility and effects of a Dream-Yoga-inspired intervention compared with an active control condition. The intervention combines waking and dreaming practices that are adapted for individuals without prior experience and delivered using virtual reality-based training and home sleep technology. The program is designed to be scalable and culturally neutral, without requiring prior knowledge of contemplative or religious traditions.

The primary goals of the study are to characterize sleep and waking neurophysiology associated with Dream-Yoga-inspired practices and to evaluate whether participation is associated with changes in sleep-related brain activity and cognitive processes. Outcomes include measures of lucid dreaming, sleep physiology, and waking cognitive and perceptual processes. Anxiety will be assessed as an exploratory outcome to examine whether participation may be associated with changes in emotional experience. This study is not designed to provide treatment for anxiety or other clinical conditions.

Results from this study will help inform the development of scalable sleep-based mental training approaches and guide future research on the use of dreaming and sleep practices to support psychological health and well-being.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Dream Yoga is a contemplative practice with a documented history spanning more than a millennium, described in traditional manuals as a set of waking and sleep-based exercises intended to cultivate insight, perceptual flexibility, and altered self-referential processing. These practices include the intentional induction of lucid dreaming, in which individuals become aware that they are dreaming and may exert varying degrees of volitional influence over dream content. Advances in sleep physiology, polysomnography, wearable sleep monitoring, and methods for inducing and verifying lucid dreams now make it possible to examine such practices using objective neurophysiological measures.

This randomized controlled trial evaluates the effects of a Dream-Yoga-inspired intervention compared with an active control condition in healthy adults without prior contemplative training. The intervention adapts core elements of traditional Dream Yoga into a standardized, secular program designed for accessibility and scalability. The study focuses on characterizing sleep and waking neurophysiological features associated with participation in the intervention and assessing changes in lucid dreaming, cognitive, and perceptual measures. Anxiety is assessed as an exploratory outcome.

Study Design and Procedures

Participants are randomly assigned to either a Dream-Yoga-inspired intervention or a structurally matched active control condition. All participants complete baseline ("pre") and post-intervention ("post") assessments separated by an eight-week intervention period. Baseline procedures include informed consent, demographic questionnaires, neuropsychological testing, and self-report measures. Participants receive standardized training in the use of home sleep monitoring devices and study procedures.

Throughout the four-week intervention, participants attend weekly virtual group sessions of approximately 35 mins each, led by trained facilitators. Both study arms are matched for contact time, group interaction, facilitator attention, and homework expectations. Participants complete daily brief self-report measures related to sleep and dreaming during the intervention period.

A subset of participants undergoes additional laboratory-based electrophysiological assessments, including overnight polysomnography and waking electroencephalography, at baseline and following the intervention. These recordings are used to examine sleep architecture and EEG microstructure, including exploratory analyses of oscillatory activity and functional relationships between brain regions. Participants not included in laboratory recordings provide sleep-related data using wearable devices, which offer longitudinal but lower-resolution physiological measures.

Dream-Yoga-Inspired Intervention

The intervention introduces participants to structured waking and sleep-based mental practices derived from Dream Yoga, adapted for individuals without prior experience. Waking practices emphasize attention regulation, imagery, metacognitive awareness, and intention-setting prior to sleep. Sleep-based components include instruction on recognizing dream states, cultivating lucidity, and engaging in specific cognitive exercises during dreams.

Participants use wearable sleep devices that deliver auditory cues during REM sleep to support lucid dreaming and remind participants of intended dream-based practices. Participants are instructed in established signaling methods to indicate lucidity during sleep using predefined eye-movement patterns. The intervention integrates both waking and sleep-based exercises and includes individualized check-ins to support adherence to assigned practices.

The intervention also incorporates two group-based virtual reality (VR) sessions delivered early in the study period. These sessions are designed to engage perceptual flexibility and self-referential processing through immersive, interactive experiences. The VR component serves as an adjunct to waking Dream-Yoga-inspired practices and is intended to reinforce experiential learning relevant to the intervention's goals.

Active Control Condition

The control condition consists of a modified Health Enhancement Program (HEP) adapted to match the intervention in duration, format, and participant engagement. The program includes education and experiential activities related to health-promoting behaviors with a particular focus on sleep and dreaming such as physical activity, nutrition, sleep habits, stress management, and expressive activities. VR sessions in the control condition focus on general health and well-being topics rather than contemplative or dream-related content. Home practice is encouraged, and adherence is supported through individual check-ins, mirroring the intervention arm.

Randomization and Blinding

Randomization is performed by a statistician not involved in recruitment or assessment. Outcome assessors and investigators involved in data analysis are blinded to group assignment. Facilitators deliver only one intervention type to minimize cross-condition contamination.

Sample Size and Statistical Approach

Participants are enrolled and randomized equally between groups. Primary analyses examine changes in sleep and waking neurophysiological measures from baseline to post-intervention between groups using mixed-effects models. Secondary analyses examine changes in cognitive measures. Exploratory analyses assess changes in additional self-report measures, including sleep-related experiences, lucid dreaming characteristics, and anxiety.

Study Type

Interventional

Enrollment (Estimated)

70

Phase

  • Early Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Illinois
      • Evanston, Illinois, United States, 60208
    • Virginia
      • Charlottesville, Virginia, United States, 22903-2628

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Individuals interested in participating will be screened for eligibility through a Qualtrics survey, a Score between 5-21 points in GAD-7.

Healthy, English-speaking adults (at least 18 years old) with high dream recall (at least 1/week).

Exclusion Criteria:

  • We will exclude people who self-report any of the following:

    1. history of an established meditative practice
    2. psychological or psychiatric disorders (other than mild anxiety)
    3. sleep disorders, nightshift work in the past month, extreme chronotype or irregular sleeping pattern
    4. use of recreational drugs in the past month
    5. history of asthma, seizures or heart problems
    6. unwillingness to wear headband during sleep

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Dream Yoga Inspired Intervention
This customized contemplative training will guide participants in exploring techniques used in Tibetan Dream Yoga. Strategies in Tibetan Dream-Yoga manuals are thus transferred to a modern context and adapted as a group intervention. Goals will be set for dreaming that include gaining a degree of volitional influence over the dream. Wearable devices will be used to present cues during sleep both to provoke lucidity and to remind individuals of Dream-Yoga exercises to be engaged during sleep. Virtual-reality (VR) sessions provide a novel adjunct to Dream Yoga, in keeping with prior research integrating lucid dreaming and VR (Gott et al., 2021). The protocol progresses though several group activities; individuals feel themselves dispersing into a void within the VR world, and then blending with others, leading the reduced self-grasping. If this unique VR component can blur conventional self-other boundaries, it may reinforce the progressive instructions in Dream Yoga.
Behavioral: Dream Yoga Inspired Intervention
This customized contemplative training will guide participants in exploring techniques used in Tibetan Dream Yoga. Strategies in Tibetan manuals are thus transferred to a modern context and adapted as a group intervention. Goals will be set for dreaming that include gaining lucidity, a degree of volitional influence over the dream. Participants will be instructed on how to work with their dream-world self-concept, which can include changing the environment deliberately, making other individuals appear, and switching identities with other individuals in the dream. Wearable devices will be used to present cues during sleep both to provoke lucidity and to remind individuals of Dream-Yoga exercises to be engaged during sleep. The intervention includes both wake- and sleep-based instructions, with instructions on learning to apply the new orientation in their daily lives.
Other Names:
  • Contemplative Sleep Practice Intervention
  • Dream Yoga
Active Comparator: Sleep Health Enhancement program
A modified version of the Health Enhancement Program (HEP), which was developed as an active control condition for mindfulness-based interventions, with a particular focus on sleep hygiene. It controls for several non-specific factors such as expectations of positive change, group support, behavioural activation, facilitator attention, at-home practice, treatment duration, and format (MacCoon et al., 2012; Rosenkranz et al., 2013). Our modified HEP will be structurally equivalent to the Dream-Yoga condition, with high similarity on non-program-specific factors, including timing and number of sessions. The VR sessions will focus on health enhancement. Participants will be taught positive health-enhancing practices, such as healthy diet and gentle exercise, with activity-based sessions covering exercise, sleep, dreaming, stress, anxiety, nutrition, journaling, music enjoyment, and drawing. Home practice and implementation will be similar in both groups.
Behavioral: Sleep Health Enhancement Program (SHEP)
The control group will receive a modified version of the Health Enhancement Program (HEP), which was developed as an active control condition for mindfulness-based interventions, with a particular focus on sleep hygiene and dream journaling. It controls for several non-specific factors such as expectations of positive change, group support, behavioural activation, facilitator attention, at-home practice, treatment duration, and format (MacCoon et al., 2012; Rosenkranz et al., 2013). Our modified HEP will be structurally equivalent to the Dream-Yoga condition, with high similarity on non-program-specific factors, including timing and number of sessions. The two VR sessions will focus on relaxation. Participants will be taught positive health-enhancing practices, such as healthy diet and gentle exercise, with activity-based sessions covering exercise, sleep, dreaming, stress, anxiety, nutrition, journaling, music enjoyment, and drawing.
Other Names:
  • Health Enhancement Program

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in frontal midline theta
Time Frame: Baseline to 8 weeks
The intervention will preferentially increase frontal midline theta during a short period of breath meditation (one recording session before and one after the intervention); EEG power band-passed at 4-10 Hz will be quantified and related to findings on self-referential processing (Nondual Awareness Dimensional Assessment)
Baseline to 8 weeks
Changes in Sleep Architecture
Time Frame: Baseline and 8 weeks
Sleep architecture will be compared with regard to time spent in each sleep stage, microarousals, slow-wave power, sleep spindles, and coupling between slow waves and spindles. Spectral power differences in different sleep stages.
Baseline and 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in Lucid Dreaming Frequency
Time Frame: Baseline to 8 weeks
Lucidity will be assessed with a composite of questionnaires at week 1 and measuring changes at week 8 and using self-reports of lucid dreams recorded in daily dream journals and/or nightly reports during the 7-week intervention.Additionally participants will fill tge Self-report Questionnaires: 1. Lucid Dreaming Skills Questionnaire (LUSK) 2. Lucid Dream Control-Specific Experiences (LDC-SE)
Baseline to 8 weeks
Changes in Cognitive Flexibility - Cognitive Flexibility Scale
Time Frame: Baseline to 8 weeks
Several facets of cognitive flexibility will be measured with the Cognitive Flexibility Scale
Baseline to 8 weeks
Changes in Cognitive Flexibility - Probabilistic Reversal
Time Frame: Baseline to 8 weeks
Several facets of cognitive flexibility will be measured with several standard neuropsychological tests such as the Probabilistic Reversal Learning.
Baseline to 8 weeks
Changes in Cognitive Flexibility - Stroop Test
Time Frame: Baseline to 8 weeks
Several facets of cognitive flexibility will be measured with standard neuropsychological tests such as the Stroop color-word test, Emotional Stroop.
Baseline to 8 weeks

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in PROMIS Anxiety Questionnaire Score
Time Frame: baseline to 8 weeks
The Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Questionnaire is a self-report measure assessing anxiety symptoms. It generates a T-score standardized to the general U.S. population (mean = 50, SD = 10). Higher scores indicate more severe anxiety symptoms.
baseline to 8 weeks
Change in Self-referential Processing
Time Frame: Baseline to 8 week
Self-referential processing will be assessed using a composite of subjective and neurophysiological measures. Subjective measures include the Mindful Attention Awareness Scale (MAAS), the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), and the Nondual Awareness Dimensional Assessment (NADA) and Beck Cognitive Insight Scale. A composite score may be computed via z-score standardization. A composite score may be computed via z-score standardization or used in exploratory correlation analyses. Higher mindfulness and nondual awareness scores, together with increased frontal midline theta, will be interpreted as indicators of enhanced self-referential regulation.
Baseline to 8 week
Changes in Markers of Inflammation
Time Frame: Baseline to 8 weeks
Circulating markers of inflammation will be measured via a finger blood prick and changes will be quantified before and after the intervention.
Baseline to 8 weeks
Changes in cellular aeging and oxidative stress
Time Frame: Baseline and 8 weeks
Circulating markers of ageing and oxidative stress will be measured via a finger blood prick and changes will be quantified before and after the intervention.
Baseline and 8 weeks
Changes in Creativity - Alternate Uses Task
Time Frame: Baseline to 8 weeks
Several facets of Creativitywill be measured with the Remote Association Task.
Baseline to 8 weeks
Changes in Creativity - Remote Associates Task
Time Frame: Baseline to 8 weeks
Several facets of creativity will be measured with the Remote Association Task.
Baseline to 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Northwestern University

Collaborators

University of Virginia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 15, 2026

Primary Completion (Estimated)

October 31, 2026

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

February 6, 2026

First Submitted That Met QC Criteria

February 6, 2026

First Posted (Actual)

February 13, 2026

Study Record Updates

Last Update Posted (Actual)

February 18, 2026

Last Update Submitted That Met QC Criteria

February 14, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • STU00222189-MOD0004

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data (IPD) underlying the primary and secondary feasibility outcomes will be shared, including retention and adherence data, responses to feasibility and acceptability questionnaires (FIM, AIM, SSQ), and basic demographic variables (age, sex). No identifying information will be included. Exploratory questionnaire data and behavioral task data may also be shared in de-identified form, depending on journal or funder requirements.

IPD Sharing Time Frame

IPD will be made available beginning 6 months after publication of the primary results and will remain available for 5 years.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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