麻酔中の夢がPTSD治療への可能性を示す(Anesthesia dreams show promise for treating PTSD)

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2026-09-08 スタンフォード大学

スタンフォード大学の研究チームは、全身麻酔から覚醒する際に意図的に夢を誘発することで、心的外傷後ストレス障害(PTSD)の新たな治療法につながる可能性を示した。研究チームは、患者への事前説明、覚醒時のプロポフォール使用、脳波(EEG)による監視、10分間の静かな覚醒、直後の夢の聞き取りからなる5段階のプロトコルを開発。選択手術を受けた452人では69%が夢を報告し、その86%が肯定的な内容だった。特に10分間中断されずに覚醒できた57人では夢の出現率が93%に上昇した。PTSD患者では、友人や家族が登場しトラウマ体験をより穏やかに再構成する夢の後、症状や悪夢が改善した事例も報告されている。研究者らは現在、PTSD患者を対象とした試験を進めており、将来的にはMDMAやシロシビンなどの幻覚作用を伴う治療に代わる、より短時間で制御しやすい精神疾患治療となる可能性を検証している。

<関連情報>

外科麻酔中の夢を促進するための多成分プロトコルの実現可能性 Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical Anesthesia

Pilleriin Sikka,May Ching Ngo,Sherry Hu,Tiara Boyd Wilkerson,Miranda Shull,Kathryn Imbordino,Toru Ishii,Makoto Kawai,Ben Deverett,Harrison Shong-Wen Chow,Boris D. Heifets
Anesthesiology  Published:February 3, 2026
DOI:10.1097/ALN.0000000000005968

Abstract

Background:
Dreaming during anesthesia is common and may have mental health benefits. However, systematic research on its incidence and outcomes in clinical settings remains limited. This study implemented a standardized propofol-based, electroencephalography (EEG)-guided emergence bundle to facilitate a preemergence state conducive to dreaming, integrating it into routine care to assess adherence, dream recall, patient experience, and safety.

Methods:
In this prospective quality improvement feasibility study, 474 patients undergoing elective surgeries were anesthetized according to a five-element protocol: (1) preinduction verbal priming about dreaming; (2) propofol as emergence anesthetic; (3) EEG (SedLine, Masimo Corporation, USA) monitoring to guide emergence; (4) 10 min or longer of minimized stimulation before emergence; and (5) immediate postemergence interviews regarding dream recall, valence, and subjective sleep quality. In a subset of breast cancer patients (N = 106), preregistered analyses examined postanesthesia recovery unit outcomes.

Results:
Of 452 patients interviewed, 69% reported dreaming. Among 57 patients with full adherence to all protocol elements, 93% reported dreaming. Most dreams were positive (86%), with no very negative dreams. Dreamers (mean ± SD, 9.16 ± 1.57) reported higher sleep quality than nondreamers (7.65 ± 2.86; P < 0.001). The protocol was safe, with no intraoperative awareness. Recovery times and analgesic and antiemetic use did not differ between groups. Feasibility was supported by high adherence to most elements (100% for verbal priming and propofol use, greater than or equal to 90% for EEG monitoring, and 95% for immediate interviews), although adherence to the no-stimulation emergence period was low (14%).

Conclusions:
This study demonstrates the feasibility of using a standardized anesthetic protocol in real-world clinical setting to facilitate anesthesia dreaming. With full adherence, dream recall rates approached experimental studies. The protocol was safe and linked to positive patient experiences, although dream recall was unrelated to postanesthesia care unit outcomes. These findings align with Enhanced Recovery After Surgery principles and provide a foundation for exploring potential therapeutic applications of anesthesia dreaming.

医療・健康
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