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Delage JP, Côté J, Journault WG, Lemyre A, Bastien CH. The relationships between insomnia, nightmares, and dreams: A systematic review. Sleep Med Rev 2024; 75:101931. [PMID: 38733767 DOI: 10.1016/j.smrv.2024.101931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 05/13/2024]
Abstract
Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and nightmares in individuals without a concomitant psychopathology. The relationships between insomnia and dreams are also addressed. PsycINFO and Medline were searched for papers published in English or French from 1970 to March 2023. Sixty-seven articles were included for review. Most results support positive relationships between insomnia variables and nightmare variables in individuals with insomnia, individuals with nightmares, the general population, students, children and older adults, and military personnel and veterans. These positive relationships were also apparent in the context of the COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective in alleviating both nightmares and insomnia symptoms. Regarding the relationships between insomnia and dreams, compared with controls, the dreams of individuals with insomnia are characterized by more negative contents and affects. The results show that insomnia and nightmares are connected and may be mutually aggravating. A model is proposed to explain how insomnia might increase the likelihood of experiencing nightmares, and how nightmares can in turn lead to sleep loss and nonrestorative sleep.
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Affiliation(s)
- Julia-Pizzamiglio Delage
- École de Psychologie, Université Laval, Québec, QC, Canada; CERVO Brain Research Center, Québec, QC, Canada
| | - Jeannie Côté
- École de Psychologie, Université Laval, Québec, QC, Canada
| | | | - Alexandre Lemyre
- École de Criminologie, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | - Célyne H Bastien
- École de Psychologie, Université Laval, Québec, QC, Canada; CERVO Brain Research Center, Québec, QC, Canada; Research Laboratory on Human Neurophysiology and Sleep, Université Laval, Québec, QC, Canada.
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2
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Reffi AN, Moore DA, Drake CL. Objective sleep disturbance in nightmares: is prolonged sleep onset latency a proxy for fear-of-sleep-related arousal? Sleep 2024; 47:zsae040. [PMID: 38353132 PMCID: PMC11009021 DOI: 10.1093/sleep/zsae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Affiliation(s)
- Anthony N Reffi
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - David A Moore
- Division of Acute Care Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI 48202, USA
- Division of Consultation Liaison Psychiatry, Department of Psychiatry and Behavioral Health, Henry Ford Hospital, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
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3
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Jakobson LS, McQuarrie AM, Van Landeghem C, Smith SD. Traits linked to sensory processing sensitivity mediate the relationship between externally oriented thinking and fantasizing. Front Psychol 2024; 15:1354120. [PMID: 38533217 PMCID: PMC10963545 DOI: 10.3389/fpsyg.2024.1354120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/29/2024] [Indexed: 03/28/2024] Open
Abstract
Introduction Alexithymia is characterized by difficulties identifying and describing feelings but expression of externally oriented thinking (EOT) and difficulty fantasizing is more variable. In two studies, we investigated whether links between EOT and fantasizing are mediated by sensory processing sensitivity (SPS). Methods University students completed measures of alexithymia, SPS, and fantasizing. Results In Study 1 (N = 700) we identified two clusters of SPS traits: a positive facet (sensitivity to subtle stimuli) and a negative facet (sensitivity to uncomfortable stimuli). In the 499 participants who completed the fantasy measure, low EOT scores predicted stronger SPS positive and negative traits, which predicted a stronger tendency to mentally project oneself into the lives of characters in books, movies, and plays. In Study 2 (N = 600), the link between EOT and this same fantasizing tendency was again mediated by features of SPS-in this case fantasy proneness and emotional reactivity. Discussion We suggest that, whereas individuals who score high on EOT have an impoverished fantasy life, those who score relatively low on EOT and turn their attention inward are able to maintain stronger representations of imagined events in working memory (enhancing the likelihood that they will be recalled) and react more strongly to these events (enhancing their salience). Stronger expression of these features of SPS, in turn, increases the likelihood that one will develop a cognitive style that involves the application of imagery-based strategies to support deep processing of the thoughts and feelings of characters depicted in narratives.
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Affiliation(s)
- Lorna S. Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Stephen D. Smith
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Winnipeg, Winnipeg, MB, Canada
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4
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El-Hourani M, Zadra A, Castellanos-Ryan N, Rioux C, Tremblay RE, Parent S, Séguin JR. Longitudinal Study of Early Adversity and Disturbing Dream Frequency: Moderating Role of Early Negative Emotionality. Res Child Adolesc Psychopathol 2024; 52:277-291. [PMID: 37589805 DOI: 10.1007/s10802-023-01109-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/18/2023]
Abstract
Although disturbing dreams are prevalent in youth and are associated with psychopathology, little is known about their developmental course and risk factors. We aimed to examine the association between early social environment and subsequent disturbing dream frequency across adolescence as moderated by early negative emotionality. Measures of children's early social environment and negative emotionality were collected from the mothers of 410 children (5-42 months old) and measures of disturbing dream frequency directly from the children (13-18 years old). Preliminary steps identified subgroups of families with distinct profiles of social environment using latent variable mixture modeling, and captured changes in disturbing dream frequency using latent growth modeling. Regression and moderation analyses were conducted to test the study objectives. Results showed that the diverse family patterns were best captured by two profiles reflecting adverse and positive social environments and that overall disturbing dream frequency decreased during adolescence. Moderation analyses showed that when early negative emotionality was higher, DD frequency was not only more elevated in an adverse environment, but lower in a positive environment. These results indicate that the development of disturbing dreams is most strongly associated with a combination of individual and environment factors. Our study adds to the literature by refining our conception of individual traits and disturbing dream development and has implications for the prevention of bad dreams, nightmares, and associated psychopathologies.
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Affiliation(s)
- Mira El-Hourani
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
| | - Antonio Zadra
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Natalie Castellanos-Ryan
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Charlie Rioux
- Department of Psychology, University of Oklahoma, Norman, Oklahoma, USA
| | - Richard E Tremblay
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Sophie Parent
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Jean R Séguin
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada.
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada.
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Pachi A, Tselebis A, Sikaras C, Sideri EP, Ivanidou M, Baras S, Milionis C, Ilias I. Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era. AIMS Public Health 2023; 11:36-57. [PMID: 38617404 PMCID: PMC11007420 DOI: 10.3934/publichealth.2024003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction The pandemic has led to notable psychological challenges among healthcare professionals, including nurses. Objective Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience. Methods Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected. Results The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship. Conclusions Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.
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Affiliation(s)
- Argyro Pachi
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Athanasios Tselebis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Christos Sikaras
- Nursing Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Eleni Paraskevi Sideri
- Emergency Department of General Hospital of Athens Korgialeneio-Benakeio Hellenic Red Cross, 11526, Athens, Greece
| | - Maria Ivanidou
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Spyros Baras
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | | | - Ioannis Ilias
- Department of Endocrinology, “Elena Venizelou” Hospital, 11521 Athens, Greece
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Faccini J, Joshi V, Del-Monte J. Nightmares, interoceptive sensibility and nociception: An exploratory study in a general population. Sleep Med 2023; 112:209-215. [PMID: 37918138 DOI: 10.1016/j.sleep.2023.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/01/2023] [Accepted: 09/30/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Nightmares are dysphoric dreams present in both clinical and non-clinical populations. Physiological activity underlies their emotional reactivity. Therefore, the objective of this study was to investigate the role of interoceptive processes (interoceptive sensibility and nociception) in nightmares in the general population. METHOD 542 French participants were recruited from the general population to complete an online survey. Interoceptive sensibility, nociception, nightmare frequency and nightmare distress were assessed through online scales and questionnaires. Network analysis, regression and mediation analyses were conducted to assess the relationship between these variables. RESULTS The results showed the existence of associations between certain dimensions of interoceptive sensibility, nociception, nightmare frequency and nightmare distress. The regression analysis highlighted the involvement of interoceptive dimensions in predicting the nightmare distress score. Mediation analysis highlighted that nociception was a mediating variable in the relationship between nightmare frequency and nightmare distress. CONCLUSION This study provides initial evidence in favour of the involvement of interoceptive processes in the understanding of nightmares. These results offer a new window of understanding the etiology of nightmares but also present the interest to target interoceptive processes in the management of nightmares.
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Affiliation(s)
- Julie Faccini
- University of Nîmes, LPS Laboratory, Aix-Marseille University, France.
| | - Vrutti Joshi
- University of Nîmes, LPS Laboratory, Aix-Marseille University, France
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7
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Tan S, Fan J. A systematic review of new empirical data on lucid dream induction techniques. J Sleep Res 2022; 32:e13786. [PMID: 36408823 DOI: 10.1111/jsr.13786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022]
Abstract
Lucid dreams are defined as dreams in which the dreamers are aware of the fact that they are dreaming as dreams continue. It has been ~12 years since the last review of the efficiency of lucid dream induction techniques was conducted. Hence, the present study aimed to review the lucid dream induction techniques published in the past decade. The second aim was to propose a modified classification for the existing lucid dream induction techniques, including cognitive techniques, external stimulation, substance intervention, and cortical stimulation. The third aim was to assess the methodological quality of the studies included in the review. It was hypothesised that, comparing with the studies included in the last review, the studies included in the present review had better overall methodological quality. A total of 19 peer-reviewed studies were included and analysed in the present review, from which 14 lucid dream induction techniques were identified. The results indicated that the mnemonic induction of lucid dream technique was the most effective for inducing lucid dreams. Moreover, two new techniques, the senses-initiated lucid dream technique and galantamine intervention, might also be competitive candidates for lucid dream induction but further replications are needed. As hypothesised, the overall methodological quality of the studies included in the present review was higher than that of the studies included the previous review. In all, 17 studies had moderate methodological quality, whereas only three studies had poor methodological quality.
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Affiliation(s)
- Shuyue Tan
- School of Psychology Shenzhen University Shenzhen China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health Shenzhen China
| | - Jialin Fan
- School of Psychology Shenzhen University Shenzhen China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health Shenzhen China
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8
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Insomnia symptoms do, but chronotype does not show relevant associations with mental well-being and negative dream experiences. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03901-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Chronotypes are diversely associated with sleep quality and mental health. Eveningness is generally associated with lower sleep quality and with increased risk for mental health complaints. Along with insomnia symptoms, frequent dysphoric dreams might be key elements of disturbed sleep, and may also indicate psychological imbalance. Our cross-sectional online study aimed to examine whether eveningness can be considered as an independent risk factor of poor mental well-being or whether this association is explained by symptoms of insomnia. Secondly, we examined the associations between eveningness and frequent dysphoric dreaming taking into account the influence of mental well-being and insomnia complaints. Method: We released an online survey with Morningness-Eveningness Questionnaire, Athens Insomnia Scale, General Mental Health, and frequency of dysphoric dreaming: nightmares and bad dreams separately. We analyzed the data of 2077 participants (MAGE = 28.5, SD = 9.6). Eveningness showed a weak but independent association with mental well-being. Additional analyses showed no signs of associations between eveningness and dysphoric dreaming, such as nightmares and bad dreams. The frequency of bad dreams was associated with insomnia complaints and mental well-being, but nightmare frequency was only linked to insomnia symptoms, but not to mental well-being. Insomnia complaints emerged as a more robust factor in poorer mental well-being than the eveningness preference. Eveningness was not associated with dysphoric dreaming. Restoring insomnia might be essential in individuals at risk for mental health complaints.
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Tzioridou S, Dresler M, Sandberg K, Mueller EM. The role of mindful acceptance and lucid dreaming in nightmare frequency and distress. Sci Rep 2022; 12:15737. [PMID: 36131106 PMCID: PMC9492730 DOI: 10.1038/s41598-022-19624-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/31/2022] [Indexed: 11/15/2022] Open
Abstract
A theoretical and empirical association between lucid dreaming and mindfulness, as well as lucid dreaming and nightmares has previously been observed; however, the relationship between nightmares and mindfulness has received surprisingly little attention. Here, we present the findings of two studies exploring the relation of nightmare frequency and distress with two components of mindfulness, termed presence and acceptance, as well as lucid dreaming. Study 1 (N = 338) consisted of a low percentage of frequent lucid dreamers whereas Study 2 (N = 187) consisted primarily of frequent lucid dreamers that used lucid dream induction training techniques and meditation. Across studies, nightmare-related variables showed a more robust association with mindful acceptance as opposed to mindful presence. Moreover, individuals with high levels of meditation expertise and practice of lucid dreaming induction techniques reported lower nightmare frequency. Finally, in Study 2, which consisted of frequent lucid dreamers, a positive correlation between lucid dreaming frequency and mindfulness was apparent. The present findings support the notion that wakeful mindfulness is associated with the quality of dreams and extend previous research by suggesting a disentangled role of the two facets of mindfulness in dream variation. This association remains open for experimental manipulation, the result of which could have clinical implications.
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Affiliation(s)
- Sofia Tzioridou
- Department of Psychology, Philipps University Marburg, Marburg, Germany. .,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Kristian Sandberg
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Erik M Mueller
- Department of Psychology, Philipps University Marburg, Marburg, Germany
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10
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Paranormal experiences, sensory-processing sensitivity, and the priming of pareidolia. PLoS One 2022; 17:e0274595. [PMID: 36103566 PMCID: PMC9473424 DOI: 10.1371/journal.pone.0274595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/01/2022] [Indexed: 12/03/2022] Open
Abstract
This investigation tested the effect of priming on pareidolia (the hearing of illusory words in ambiguous stimuli). Participants (41 women, 20 men, mean age 29.95 years) were assigned to primed (n = 30) or unprimed (n = 31) groups: the former were told the study was of ‘purported ghosts voices’, the latter ‘voices in noisy environments.’ Participants were assessed for perception of human voices within recordings of purported electronic voice phenomena (EVP), degraded human speech, normal human speech, and white noise. The primed group had significantly higher perception of voices within EVPs than in degraded speech, this difference was not found for unprimed participants. In contrast to the previous use of this design, the primed group did not have higher perception of voices in EVPs and degraded speech than did the unprimed group. The Aesthetic Sensitivity dimension of the Highly Sensitive Person Scale (HSPS) was associated with detection of degraded stimuli, but not with accuracy of stimulus identification. HSPS score was related to lifetime reporting of anomalous and paranormal experiences. This study partially replicates a paranormal priming effect and shows relationships between HSPS and detection of ambiguous stimuli and anomalous and paranormal experiences.
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11
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Bogdány T, Perakakis P, Bódizs R, Simor P. The heartbeat evoked potential is a questionable biomarker in nightmare disorder: A replication study. Neuroimage Clin 2022; 33:102933. [PMID: 34990964 PMCID: PMC8743245 DOI: 10.1016/j.nicl.2021.102933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/12/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
Abstract
Perogamvros et al. (2013) examined heart beat evoked potential (HEP) in nightmare sufferers. Increased HEP was proposed to be a robust biomarker in nightmare disorder. We aimed to replicate the original study in two separate and larger databases. We did not confirm the original finding showing differential HEP in REM sleep. Our data cast doubts on the utility of HEP as a biomarker in nightmare disorder.
Frequent nightmares are highly prevalent and constitute a risk factor for a wide range of psychopathological conditions. Despite its prevalence and clinical relevance however, the pathophysiological mechanisms of nightmares are poorly understood. A recent study (Perogamvros et, al 2019) examined the heart beat evoked potential (HEP) in a small group of nightmare sufferers (N = 11) and matched healthy controls (N = 11) and observed markedly different (Hedges’ g = 1.42 [0.62–2.22]) HEP response across the groups during Rapid Eye Movement (REM) sleep. Moreover, the HEP correlated with depression scores in the nightmare group only. The authors concluded that the HEP in REM sleep could be used as a trait-like biomarker reflecting pathological emotional-and sleep regulation in nightmare disorder. To replicate the above study, we performed the same analyses of HEPs in two separate, and larger databases comprising the polysomnographic recordings of nightmare sufferers and matched controls (NStudy 1 = 39 ; NStudy 2 = 41). In contrast to the original findings, we did not observe significant differences in HEP across the two groups in either of the two databases. Moreover, we found no associations between depression scores and HEP amplitudes in the relevant spatiotemporal cluster. Our data cast doubts on the utility of HEP as a biomarker in the diagnostic and treatment procedures of nightmare disorder and suggests that the interpretation of HEP as a marker of impaired arousal and emotional processing during REM sleep is premature and requires further validation.
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Affiliation(s)
- Tamás Bogdány
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
| | - Pandelis Perakakis
- Department of Social, Work, and Differential Psychology, Complutense University of Madrid, Spain
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary; National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Péter Simor
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary; UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Center for Research in Cognition and Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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12
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Holzinger B, Nierwetberg F, Chung F, Bolstad CJ, Bjorvatn B, Chan NY, Dauvilliers Y, Espie CA, Han F, Inoue Y, Leger D, Macêdo T, Matsui K, Merikanto I, Morin CM, Mota-Rolim SA, Partinen M, Plazzi G, Penzel T, Sieminski M, Wing YK, Scarpelli S, Nadorff MR, De Gennaro L. Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey. Nat Sci Sleep 2022; 14:1469-1483. [PMID: 36052103 PMCID: PMC9426865 DOI: 10.2147/nss.s368147] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored. PATIENTS AND METHODS For this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: ≥1-2 nights/week; low: <1-2 nights/week). A total of 9100 participants were excluded if answers on variables of interest were missing or receiving rewards for participation. Chi-square tests identified changes of nightmare frequency. Predictors of high nightmare frequency were assessed using logistic regression and presented as Odds Ratios. Post-hoc mediation models were used to investigate the role of post-traumatic stress symptoms (PTSS). RESULTS The mean age was 41.63 (SD=16.55) with 64.05% females. High nightmare frequency increased significantly from 13.24% to 22.35% during the pandemic. Factors associated with it included self-reported PTSS (OR=2.11), other mental disorders and various sleep disorders or problems. Financial burden due to the pandemic, confinement, having had COVID-19, and work situation during the pandemic were associated with nightmare frequency, those relations were partly mediated through PTSS. CONCLUSION Our results display the pandemic influence on nightmare frequency, which in turn connects to multiple mental health and sleep factors. These relations were partly mediated through PTSS. The COVID-19 pandemic appears to have caused traumatization of a substantial proportion of society. Health care workers should consider nightmares in their screening routines, as it might indicate PTSS and/or other mental and sleep disorders.
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Affiliation(s)
- Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria.,Medical University Vienna, Postgraduate Master ULG Sleep Coaching, Vienna, Austria
| | | | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - Yves Dauvilliers
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, INM, Univ Montpellier, INSERM, Montpellier, France
| | - Colin A Espie
- Sir Jules Thorn Sleep & Circadian Neuroscience Institute (SCNi), University of Oxford, Oxford, UK
| | - Fang Han
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, People's Republic of China
| | | | - Damien Leger
- Université de Paris, APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Tainá Macêdo
- Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kentaro Matsui
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Charles M Morin
- École de Psychologie, Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, QC, Canada
| | - Sérgio A Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital - Federal University of Rio Grande do Norte, Natal, Brazil
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, and Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Giuseppe Plazzi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Thomas Penzel
- Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michael R Nadorff
- Mississippi State University, Mississippi State, MS, USA.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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13
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Solomonova E, Picard-Deland C, Rapoport IL, Pennestri MH, Saad M, Kendzerska T, Veissiere SPL, Godbout R, Edwards JD, Quilty L, Robillard R. Stuck in a lockdown: Dreams, bad dreams, nightmares, and their relationship to stress, depression and anxiety during the COVID-19 pandemic. PLoS One 2021; 16:e0259040. [PMID: 34818346 PMCID: PMC8612516 DOI: 10.1371/journal.pone.0259040] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND An upsurge in dream and nightmare frequency has been noted since the beginning of the COVID-19 pandemic and research shows increases in levels of stress, depression and anxiety during this time. Growing evidence suggests that dream content has a bi-directional relationship with psychopathology, and that dreams react to new, personally significant and emotional experiences. The first lockdown experience was an acute event, characterized by a combination of several unprecedent factors (new pandemic, threat of disease, global uncertainty, the experience of social isolation and exposure to stressful information) that resulted in a large-scale disruption of life routines. This study aimed at investigating changes in dream, bad dream and nightmare recall; most prevalent dream themes; and the relationship between dreams, bad dreams, nightmares and symptoms of stress, depression and anxiety during the first COVID-19 lockdown (April-May 2020) through a national online survey. METHODS 968 participants completed an online survey. Dream themes were measured using the Typical Dreams Questionnaire; stress levels were measured by the Cohen's Perceived Stress Scale; symptoms of anxiety were assessed by Generalized Anxiety Disorder (GAD-7) scale; and symptoms of depression were assessed using the Quick Inventory of Depressive Symptomatology. RESULTS 34% (328) of participants reported increased dream recall during the lockdown. The most common dream themes were centered around the topics of 1) inefficacy (e.g., trying again and again, arriving late), 2) human threat (e.g., being chased, attacked); 3) death; and 4) pandemic imagery (e.g., being separated from loved ones, being sick). Dream, bad dream and nightmare frequency was highest in individuals with moderate to severe stress levels. Frequency of bad dreams, nightmares, and dreams about the pandemic, inefficacy, and death were associated with higher levels of stress, as well as with greater symptoms of depression and anxiety. CONCLUSIONS Results support theories of dream formation, environmental susceptibility and stress reactivity. Dream content during the lockdown broadly reflected existential concerns and was associated with increased symptoms of mental health indices.
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Affiliation(s)
- Elizaveta Solomonova
- Neurophilosophy Lab, McGill University, Montreal, Canada
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, Culture, Mind and Brain research group, McGill University, Montreal, Canada
| | - Claudia Picard-Deland
- Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, Montreal, Canada
- Department of Neuroscience, University of Montreal, Montreal, Canada
| | | | - Marie-Hélène Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
- Sleep Laboratory and Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
| | - Mysa Saad
- The Royal’s Institute of Mental Health Research, Ottawa, Canada
| | - Tetyana Kendzerska
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Samuel Paul Louis Veissiere
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, Culture, Mind and Brain research group, McGill University, Montreal, Canada
| | - Roger Godbout
- Sleep Laboratory and Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Psychiatry, University of Montreal, Montreal, Canada
| | - Jodi D. Edwards
- University of Ottawa Heart Institute, Ottawa, Canada
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Lena Quilty
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Rebecca Robillard
- The Royal’s Institute of Mental Health Research, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
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14
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Williams JM, Carr M, Blagrove M. Sensory Processing Sensitivity: Associations with the detection of real degraded stimuli, and reporting of illusory stimuli and paranormal experiences. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Marquis LP, Julien SH, Daneault V, Blanchette-Carrière C, Paquette T, Carr M, Soucy JP, Montplaisir J, Nielsen T. Local Neuronal Synchronization in Frequent Nightmare Recallers and Healthy Controls: A Resting-State Functional Magnetic Resonance Imaging Study. Front Neurosci 2021; 15:645255. [PMID: 33815047 PMCID: PMC8012764 DOI: 10.3389/fnins.2021.645255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
Nightmares are highly dysphoric dreams that are well-remembered upon awakening. Frequent nightmares have been associated with psychopathology and emotional dysregulation, yet their neural mechanisms remain largely unknown. Our neurocognitive model posits that nightmares reflect dysfunction in a limbic-prefrontal circuit comprising medial prefrontal and anterior cingulate cortices, hippocampus, and amygdala. However, there is a paucity of studies that used brain imaging to directly test the neural correlates of nightmares. One such study compared the regional homogeneity (ReHo) of resting-state functional magnetic resonance imaging blood-oxygen level-dependent signals between frequent nightmare recallers and controls. The main results were greater regional homogeneity in the left anterior cingulate cortex and right inferior parietal lobule for the nightmare recallers than for the controls. In the present study, we aimed to document the ReHo correlates of frequent nightmares using several nightmare severity measures. We acquired resting-state functional magnetic resonance imaging data from 18 frequent nightmare recallers aged 18-35 (3 males and 15 females) and 18 age- and sex-matched controls, as well as retrospective and prospective disturbed dreaming frequency estimates and scores on the Nightmare Distress Questionnaire. While there were inconsistent results for our different analyses (group comparisons, correlational analyses for frequency estimates/Nightmare Distress scores), our results suggest that nightmares are associated with altered ReHo in frontal (medial prefrontal and inferior frontal), parietal, temporal and occipital regions, as well as some subcortical regions (thalamus). We also found a positive correlation between retrospective disturbed dreaming frequency estimates and ReHo values in the hippocampus. These findings are mostly in line with a recent SPECT study from our laboratory. Our results point to the possibility that a variety of regions, including but not limited to the limbic-prefrontal circuit of our neurocognitive model, contribute to nightmare formation.
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Affiliation(s)
- Louis-Philippe Marquis
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Sarah-Hélène Julien
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Véronique Daneault
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Cloé Blanchette-Carrière
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Tyna Paquette
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Michelle Carr
- Department of Psychiatry, Sleep & Neurophysiology Research Laboratory, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
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16
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Schredl M, Schramm F, Valli K, Mueller EM, Sandman N. Nightmare Distress Questionnaire: associated factors. J Clin Sleep Med 2021; 17:61-67. [PMID: 32964832 PMCID: PMC7849636 DOI: 10.5664/jcsm.8824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The diagnosis of a nightmare disorder is based on clinically significant distress caused by the nightmares, eg, sleep or mood disturbances during the day. The question what factors might be associated with nightmare distress in addition to nightmares frequency is not well studied. METHODS Overall, 1,474 persons (893 women, 581 men) completed an online survey. Nightmare distress was measured with the Nightmare Distress Questionnaire. RESULTS The findings indicated that nightmare distress, measured by the Nightmare Distress Questionnaire, correlated with a variety of factors in addition to nightmare frequency: neuroticism, female sex, low education, extraversion, low agreeableness, and sensation seeking. Moreover, the percentage of replicative trauma-related nightmares was also associated with higher nightmare distress. CONCLUSIONS A large variety of factors are associated with nightmare distress, a finding that is of clinical importance. The construct harm avoidance, however, was not helpful in explaining interindividual differences in nightmare distress. Furthermore, the relationship between nightmare distress and other factors, eg, education or agreeableness, is not yet understood.
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Affiliation(s)
- Michael Schredl
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Finnja Schramm
- Psychology Department, University of Marburg, Marburg, Germany
| | - Katja Valli
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Department of Cognitive Neuroscience and Philosophy, University of Skövde, Skövde, Sweden
| | - Erik M Mueller
- Psychology Department, University of Marburg, Marburg, Germany
| | - Nils Sandman
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Department of Social Psychology, University of Helsinki, Helsinki, Finland
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17
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Carr M, Summers R, Bradshaw C, Newton C, Ellis L, Johnston E, Blagrove M. Frontal Brain Activity and Subjective Arousal During Emotional Picture Viewing in Nightmare Sufferers. Front Neurosci 2020; 14:585574. [PMID: 33117126 PMCID: PMC7561419 DOI: 10.3389/fnins.2020.585574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022] Open
Abstract
Nightmares are intensely negative dreams that awaken the dreamer. Frequent nightmares are thought to reflect an executive deficit in regulating arousal. Within a diathesis-stress framework, this arousal is specific to negative contexts, though a differential susceptibility framework predicts elevated arousal in response to both negative and positive contexts. The current study tested these predictions by assessing subjective arousal and changes in frontal oxyhemoglobin (oxyHB) concentrations during negative and positive picture-viewing in nightmare sufferers (NM) and control subjects (CTL). 27 NM and 27 CTL subjects aged 18–35 rated subjective arousal on a 1–9 scale following sequences of negative, neutral and positive images; changes in oxyHB were measured by Near-Infrared Spectroscopy (NIRS) using a 2 × 4 template on the frontal pole. Participants also completed the Highly Sensitive Person Scale, a trait marker for differential susceptibility; and completed a dream diary reporting negative and positive dream emotionality. The NM group had higher trait sensitivity, yet higher ratings of negative but not positive emotion in diary dreams. NM compared to CTL subjects reported higher subjective arousal in response to picture-viewing regardless of valence. Dysphoric dream distress, measured prospectively, was negatively associated with frontal activation when viewing negative pictures. Results suggest NM sufferers are highly sensitive to images regardless of valence according to subjective measures, and that there is a neural basis to level of trait and prospective nightmare distress. Future longitudinal or intervention studies should further explore positive emotion sensitivity and imagery in NM sufferers.
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Affiliation(s)
- Michelle Carr
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Richard Summers
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Ceri Bradshaw
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Courtney Newton
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Leslie Ellis
- The International Focusing Institute, Nyack, NY, United States
| | - Erin Johnston
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Mark Blagrove
- Department of Psychology, Swansea University, Swansea, United Kingdom
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18
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Carr M, Matthews E, Williams J, Blagrove M. Testing the theory of Differential Susceptibility to nightmares: The interaction of Sensory Processing Sensitivity with the relationship of low mental wellbeing to nightmare frequency and nightmare distress. J Sleep Res 2020; 30:e13200. [PMID: 32985043 DOI: 10.1111/jsr.13200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 11/29/2022]
Abstract
Propensity to have nightmares has been theorised in terms of diathesis-stress models, with this propensity being seen as negative or even pathological. In contrast, a recent model proposes that nightmare propensity is due to Differential Susceptibility to stimuli, where high susceptibility can be beneficial in positive environments but detrimental in negative environments. This susceptibility to stimuli is assessed as the biobehavioural trait Sensory Processing Sensitivity, which refers to a greater responsivity to internal and external stimuli, and an increased depth of cognitive and emotional processing. To test the Differential Susceptibility Framework for nightmares, 137 participants (females = 104, males = 33; mean age = 33.66 years), recruited from a student population and social media sites, were divided into high (n = 39), medium (n = 59) and low (n = 39) Sensory Processing Sensitivity categories based on their score on the Highly Sensitive Person Scale. Low mental wellbeing and the presence of minor psychiatric problems, measured by the General Health Questionnaire, was found to be significantly correlated with nightmare frequency for the high and medium SPS groups (rs = .29 and .28, respectively), but not for the low Sensory Processing Sensitivity group (r = .19). General Health Questionnaire score was also significantly correlated with trait nightmare distress, for the high Sensory Processing Sensitivity group only (r = .32). These findings in favour of the Differential Susceptibility Framework have aetiology and treatment implications for nightmares that differ from diathesis-stress models.
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Affiliation(s)
- Michelle Carr
- Sleep & Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Eve Matthews
- Sleep Laboratory, Department of Psychology, Faculty of Life and Health Sciences, Swansea University, Wales, UK
| | - Jessica Williams
- Sleep Laboratory, Department of Psychology, Faculty of Life and Health Sciences, Swansea University, Wales, UK
| | - Mark Blagrove
- Sleep Laboratory, Department of Psychology, Faculty of Life and Health Sciences, Swansea University, Wales, UK
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19
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Carr M, Haar A, Amores J, Lopes P, Bernal G, Vega T, Rosello O, Jain A, Maes P. Dream engineering: Simulating worlds through sensory stimulation. Conscious Cogn 2020; 83:102955. [PMID: 32652511 PMCID: PMC7415562 DOI: 10.1016/j.concog.2020.102955] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/19/2020] [Accepted: 05/18/2020] [Indexed: 01/14/2023]
Abstract
We explore the application of a wide range of sensory stimulation technologies to the area of sleep and dream engineering. We begin by emphasizing the causal role of the body in dream generation, and describe a circuitry between the sleeping body and the dreaming mind. We suggest that nearly any sensory stimuli has potential for modulating experience in sleep. Considering other areas that might afford tools for engineering sensory content in simulated worlds, we turn to Virtual Reality (VR). We outline a collection of relevant VR technologies, including devices engineered to stimulate haptic, temperature, vestibular, olfactory, and auditory sensations. We believe these technologies, which have been developed for high mobility and low cost, can be translated to the field of dream engineering. We close by discussing possible future directions in this field and the ethics of a world in which targeted dream direction and sleep manipulation are feasible.
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Affiliation(s)
- Michelle Carr
- Sleep & Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
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20
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Dream lucidity is associated with positive waking mood. Conscious Cogn 2020; 83:102971. [PMID: 32535498 DOI: 10.1016/j.concog.2020.102971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 12/22/2022]
Abstract
Lucid dreaming is a unique phenomenon with potential applications for therapeutic interventions. Few studies have investigated the effects of lucidity on an individual's waking mood, which could have valuable implications for improving psychological wellbeing. The current experiment aims to investigate whether the experience of lucidity enhances positive waking mood, and whether lucidity is associated with dream emotional content and subjective sleep quality. 20 participants were asked to complete lucid dream induction techniques along with an online dream diary for one week, which featured a 19-item lucidity questionnaire, and subjective ratings of sleep quality, dream emotional content, and waking mood. Results indicated that higher lucidity was associated with more positive dream content and elevated positive waking mood the next day, although there was no relationship with sleep quality. The results of the research and suggestions for future investigations, such as the need for longitudinal studies of lucidity and mood, are discussed.
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21
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Schredl M, Gilles M, Wolf I, Peus V, Scharnholz B, Sütterlin M, Bardtke S, Send TS, Samaras A, Deuschle M. Nightmares and Stress: A Longitudinal Study. J Clin Sleep Med 2019; 15:1209-1215. [PMID: 31538591 PMCID: PMC6760404 DOI: 10.5664/jcsm.7904] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES In nightmare etiology, trait and state factors play important roles. However, the interaction of state and trait factors has never been studied in a longitudinal design. METHODS The current sample included 406 pregnant women who were followed up approximately 6 months after giving birth (n = 375) and 4 years later (n = 302). A nightmare frequency scale and several stress-related questionnaires were presented at three measurement points. RESULTS Despite the major life events in this sample, nightmare frequency was very stable over this time period and decreased slightly. In line with previous findings, cross-sectional analyses showed that stressors were associated with current nightmare frequency but longitudinal analyses indicated that previously measured nightmare frequency showed even stronger effects on current nightmare frequency. CONCLUSIONS Because the nightmare frequencies were very stable, it would be desirable to carry out intervention studies treating nightmares as early as possible-even in childhood-and study whether nightmare occurrence is lower even years after the intervention. CITATION Schredl M, Gilles M, Wolf I, Peus V, Scharnholz B, Sütterlin M, Bardtke S, Send TS, Samaras A, Deuschle M. Nightmares and stress: a longitudinal study. J Clin Sleep Med. 2019;15(9):1209-1215.
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Affiliation(s)
- Michael Schredl
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Maria Gilles
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Isabell Wolf
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Verena Peus
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Barbara Scharnholz
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Marc Sütterlin
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Svenja Bardtke
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Tabea Sarah Send
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angelina Samaras
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael Deuschle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
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22
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Nielsen T, Carr M, Picard-Deland C, Marquis LP, Saint-Onge K, Blanchette-Carrière C, Paquette T. Early childhood adversity associations with nightmare severity and sleep spindles. Sleep Med 2019; 56:57-65. [DOI: 10.1016/j.sleep.2019.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 12/22/2022]
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23
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Greven CU, Lionetti F, Booth C, Aron EN, Fox E, Schendan HE, Pluess M, Bruining H, Acevedo B, Bijttebier P, Homberg J. Sensory Processing Sensitivity in the context of Environmental Sensitivity: A critical review and development of research agenda. Neurosci Biobehav Rev 2019; 98:287-305. [DOI: 10.1016/j.neubiorev.2019.01.009] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
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24
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Marquis LP, Julien SH, Baril AA, Blanchette-Carrière C, Paquette T, Carr M, Soucy JP, Montplaisir J, Nielsen T. Nightmare Severity Is Inversely Related to Frontal Brain Activity During Waking State Picture Viewing. J Clin Sleep Med 2019; 15:253-264. [PMID: 30736883 PMCID: PMC6374093 DOI: 10.5664/jcsm.7628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/16/2018] [Accepted: 10/24/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Growing evidence suggests that nightmares have considerable adverse effects on waking behavior, possibly by increasing post-sleep negative emotions. Dysphoric reactions to nightmares are one component of nightmare severity for which the neural correlates are unknown. Here, we investigate possible neural correlates of nightmare severity in a sample of individuals who frequently recall nightmares. METHODS Our principal measure of nightmare severity is nightmare distress as indexed by the Nightmare Distress Questionnaire (NDQ), and secondary measures are retrospective and prospective estimates of frequency of recalling dysphoric dreams (DD). We used high-resolution technetium 99m ethyl cysteinate dimer single photon emission computed tomography to assess regional cerebral blood flow (rCBF) while 18 individuals who were frequent nightmare recallers viewed negative and neutral pictures from the International Affective Picture System. We correlated rCBF with NDQ scores and DD recall frequency estimates. RESULTS Negative correlations were observed between NDQ scores and rCBF during negative picture viewing in bilateral insula and anterior cingulate, right medial frontal gyrus, bilateral superior temporal gyrus, right inferior frontal and precentral gyri, and bilateral putamen. Retrospective DD recall correlated with rCBF activity primarily in regions overlapping those related to NDQ scores. Prospective DD recall was only weakly related to rCBF. Results for the neutral condition overlapped partially with those for the negative condition; in particular, NDQ and retrospective DD recall were related to rCBF in medial prefrontal and anterior cingulate gyri. CONCLUSIONS Results point to a possible overlap in brain mechanisms involved in nightmare dysphoria (during sleep) and distress (during wakefulness) among individuals who frequently recall nightmares. They provide partial support for a neurocognitive model of nightmares. COMMENTARY A commentary on this article appears in this issue on page 179.
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Affiliation(s)
- Louis-Philippe Marquis
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Sarah-Hélène Julien
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Andrée-Ann Baril
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Cloé Blanchette-Carrière
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Tyna Paquette
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Michelle Carr
- Sleep Laboratory, Swansea University, Swansea, United Kingdom
| | | | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
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25
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Perogamvros L, Park HD, Bayer L, Perrault AA, Blanke O, Schwartz S. Increased heartbeat-evoked potential during REM sleep in nightmare disorder. NEUROIMAGE-CLINICAL 2019; 22:101701. [PMID: 30739843 PMCID: PMC6370851 DOI: 10.1016/j.nicl.2019.101701] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/13/2018] [Accepted: 01/28/2019] [Indexed: 01/11/2023]
Abstract
Nightmares are characterized by the experience of strong negative emotions occurring mainly during REM sleep. Some people suffer from nightmare disorder, which is defined by the repeated occurrence of nightmares and by significant distress in wakefulness. Yet, whether frequent nightmares relate to a general increase in emotional reactivity or arousal during sleep remains unclear. To address this question, we recorded heartbeat-evoked potentials (HEPs) during wakefulness, NREM and REM sleep in patients with nightmare disorder and healthy participants. The HEP represents a cortical (EEG) response to the heartbeat and indexes brain-body interactions, such as interoceptive processing and intrinsic levels of arousal. HEP amplitude is typically increased during states of high emotional arousal and motivation, and is decreased in depression. Here we compared the amplitude of HEPs between nightmare patients and healthy controls separately during AWAKE, NREM, REM periods, and found higher HEP amplitude in nightmare patients compared to healthy controls over a cluster of frontal regions only during REM sleep. This effect was not paralleled by any group difference in cardiac control measures (e.g. heart rate variability, interbeat interval). These findings corroborate the notion that nightmares are essentially a REM pathology and suggest that increased emotional arousal during REM sleep, as measured by HEP, is a physiological condition responsible for frequent nightmares. This result also supports that HEP may be used as a biomarker of increased emotional and sensory processing during REM sleep in these patients.
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Affiliation(s)
- Lampros Perogamvros
- Center for Sleep Medicine, Division of Pulmonology, Department of Medical Specialties, Geneva University Hospitals, Geneva, Switzerland; Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
| | - Hyeong-Dong Park
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland
| | - Laurence Bayer
- Center for Sleep Medicine, Division of Pulmonology, Department of Medical Specialties, Geneva University Hospitals, Geneva, Switzerland
| | - Aurore A Perrault
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Neurology, University of Geneva, Switzerland
| | - Sophie Schwartz
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
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26
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Gieselmann A, Ait Aoudia M, Carr M, Germain A, Gorzka R, Holzinger B, Kleim B, Krakow B, Kunze AE, Lancee J, Nadorff MR, Nielsen T, Riemann D, Sandahl H, Schlarb AA, Schmid C, Schredl M, Spoormaker VI, Steil R, van Schagen AM, Wittmann L, Zschoche M, Pietrowsky R. Aetiology and treatment of nightmare disorder: State of the art and future perspectives. J Sleep Res 2019; 28:e12820. [PMID: 30697860 PMCID: PMC6850667 DOI: 10.1111/jsr.12820] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/17/2018] [Accepted: 11/22/2018] [Indexed: 12/11/2022]
Abstract
This consensus paper provides an overview of the state of the art in research on the aetiology and treatment of nightmare disorder and outlines further perspectives on these issues. It presents a definition of nightmares and nightmare disorder followed by epidemiological findings, and then explains existing models of nightmare aetiology in traumatized and non‐traumatized individuals. Chronic nightmares develop through the interaction of elevated hyperarousal and impaired fear extinction. This interplay is assumed to be facilitated by trait affect distress elicited by traumatic experiences, early childhood adversity and trait susceptibility, as well as by elevated thought suppression and potentially sleep‐disordered breathing. Accordingly, different treatment options for nightmares focus on their meaning, on the chronic repetition of the nightmare or on maladaptive beliefs. Clinically, knowledge of healthcare providers about nightmare disorder and the delivery of evidence‐based interventions in the healthcare system is discussed. Based on these findings, we highlight some future perspectives and potential further developments of nightmare treatments and research into nightmare aetiology.
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Affiliation(s)
- Annika Gieselmann
- Department of Clinical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Malik Ait Aoudia
- Centre du Psychotrauma de l'Institut de Victimologie à Paris, Paris, France
| | - Michelle Carr
- Department of Psychology, Swansea University, Swansea, UK
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert Gorzka
- Central Institute for Mental Health, Bundeswehrkrankenhaus Hamburg, Hamburg, Germany
| | | | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zürich, Zürich, Switzerland
| | - Barry Krakow
- Maimonides Sleep Arts and Sciences, Ltd, Albuquerque, New Mexico, USA
| | - Anna E Kunze
- Department of Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Jaap Lancee
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany
| | - Hinuga Sandahl
- Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Ballerup, Denmark
| | - Angelika A Schlarb
- Department of Psychology and Sports, Bielefeld University, Bielefeld, Germany
| | - Carolin Schmid
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Michael Schredl
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | | | - Regina Steil
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Annette M van Schagen
- Foundation Centrum '45, Partner in Arq Psychotrauma Expert Group, Oegstgeest, the Netherlands
| | - Lutz Wittmann
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Maria Zschoche
- Department of Psychology and Sports, Bielefeld University, Bielefeld, Germany
| | - Reinhard Pietrowsky
- Department of Clinical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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27
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The marginalisation of dreams in clinical psychological practice. Sleep Med Rev 2018; 42:10-18. [DOI: 10.1016/j.smrv.2018.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/09/2018] [Accepted: 04/18/2018] [Indexed: 02/08/2023]
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28
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Sleep spindle and psychopathology characteristics of frequent nightmare recallers. Sleep Med 2018; 50:113-131. [DOI: 10.1016/j.sleep.2017.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/02/2017] [Indexed: 02/01/2023]
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29
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Sleep spindles are altered in early- but not late-onset nightmare recallers. Sleep Med 2018; 52:34-42. [PMID: 30218785 DOI: 10.1016/j.sleep.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 11/22/2022]
Abstract
Nightmares are a common sleep disorder, defined as highly disturbing mentation which usually awakens the individual from rapid eye movement (REM) sleep. While nightmares are mainly a REM sleep phenomenon, Picard-Deland et al., (2017) recently showed an association between nightmare recall and sleep spindles, which are a non-rapid eye movement (NREM) oscillatory feature. Their results pointed to fewer slow spindles and a higher oscillatory frequency for fast spindles among frequent nightmare recallers compared with controls. To test the suggestion that nightmares stem from changes to emotional neural circuits arising in early childhood (Nielsen, 2017), including early changes in sleep spindles (Scholle et al., 2007), we investigated if the spindle features of early-onset nightmare recallers (ie, recalling nightmares since childhood) (N = 22), differed from those of late-onset nightmare recallers (ie, since adolescence or adulthood) (N = 11), or from those of controls (N = 23). A retrospective analysis of the sleep spindles of 56 participants who had undergone a polysomnographically-recorded morning nap revealed that Early starters uniquely exhibited lower slow spindle densities in five of six derivations (all p < 0.045) and higher fast spindle frequencies in all six derivations (all p < 0.015). These results add precision to previously reported findings for Nightmare recallers: spindle differences are shown to hold only for Early starters. The lifelong occurrence of nightmares may be closely tied to disruptions in the normal development of spindle generation processes occurring early in development.
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30
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Carr M, Saint-Onge K, Blanchette-Carrière C, Paquette T, Nielsen T. Elevated perseveration errors on a verbal fluency task in frequent nightmare recallers: a replication. J Sleep Res 2017; 27:e12644. [DOI: 10.1111/jsr.12644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Michelle Carr
- Dream and Nightmare Laboratory; Center for Advanced Research in Sleep Medicine; CIUSSS-NîM - Hôpital du Sacré-Coeur de Montréal; Montréal Québec Canada
- Swansea University Sleep Laboratory; Department of Psychology; Swansea University; Swansea UK
| | - Kadia Saint-Onge
- Dream and Nightmare Laboratory; Center for Advanced Research in Sleep Medicine; CIUSSS-NîM - Hôpital du Sacré-Coeur de Montréal; Montréal Québec Canada
- Department of Psychology; Université de Montréal; Montréal Québec Canada
| | - Cloé Blanchette-Carrière
- Dream and Nightmare Laboratory; Center for Advanced Research in Sleep Medicine; CIUSSS-NîM - Hôpital du Sacré-Coeur de Montréal; Montréal Québec Canada
- Department of Psychology; Université de Montréal; Montréal Québec Canada
| | - Tyna Paquette
- Dream and Nightmare Laboratory; Center for Advanced Research in Sleep Medicine; CIUSSS-NîM - Hôpital du Sacré-Coeur de Montréal; Montréal Québec Canada
| | - Tore Nielsen
- Dream and Nightmare Laboratory; Center for Advanced Research in Sleep Medicine; CIUSSS-NîM - Hôpital du Sacré-Coeur de Montréal; Montréal Québec Canada
- Department of Psychiatry; Université de Montréal; Montréal Québec Canada
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