The Contribution of the Psychology of Sleep and Dreaming to Understanding Sleep-Disordered Patients

Dream enactment behavior: review for the clinician

NONE

Dream enactment behavior commonly occurs on occasion in normal children and adults. Disruptive and frequent dream enactment behavior may come to the attention of the clinician either as the primary reason for consultation or as a prominent characteristic of a patient with other sleep disorders. Questioning patients with chronic neurologic and psychiatric disorders may also reveal previously unrecognized behavior. In the absence of sleep pathology, process of dream enactment likely begins with active, often emotionally charged dream content that may occasionally break through the normal REM sleep motor suppressive activity. Disrupted sleep resulting from many possible causes, such as circadian disruption, sleep apnea, or medications, may also disrupt at least temporarily the motor-suppressive activity in REM sleep, allowing dream enactment to occur. Finally, pathological neurological damage in the context of degenerative, autoimmune, and infectious neurological disorders may lead to chronic recurrent and severe dream enactment behavior. Evaluating the context, frequency, and severity of dream enactment behavior is guided first and foremost by a structured approach to the sleep history. Physical exam and selected testing support the clinical diagnosis. Understanding the context and the likely cause is essential to effective therapy.

"They told me all mothers have worries", stillborn mother's experiences of having a 'gut instinct' that something is wrong in pregnancy: Findings from an international case-control study

OBJECTIVE

To describe and explore 'gut instinct' that something was wrong in women who identified that they experienced gut instinct during pregnancy.

METHOD

A case-control study utilising an international web-based questionnaire. Stillborn cases (n = 146) and liveborn controls (n = 234) answered the gut instinct question within 30 days of the pregnancy ending. Of those, 84 cases and 27 controls also provided qualitative comment data. Descriptive statistics were used for the question, with a fixed option and summative content analysis was used to analyse the comment data.

FINDINGS

In all, 110 (75%) of the stillborn cases answered "yes" to the gut instinct question vs only 28 (12%) of the controls who had a livebirth meaning the risk of stillbirth was 22.5 fold higher in those who experience "gut instinct" than in those who do not experience this feeling. Four themes were identified from the comment data namely: When the gut instinct occurred; How the gut instinct made the woman feel; Dreams and other related phenomena; Reassured by someone or something.

CONCLUSIONS

Women who had a stillborn baby reported a "gut instinct" that something was wrong more frequently than mothers of a live born baby. Our findings may be influenced by recall negativity bias, and a prospective study is needed to confirm or refute our findings. The possibility that "maternal intuition" exists during pregnancy and responds to changes in fetal or placental health merits further exploration.

IMPLICATIONS FOR PRACTICE

Maternity care providers should be alert to the woman when she expresses intuitive feelings, as well as asking her to report her concerns and act appropriately to assess and manage fetal wellbeing.

Dream recall and its relationship to sleep, perceived stress, and creativity among adolescents

PURPOSE

To explore associations between dream recall, gender, sleep, perceived stress, and creativity in a large sample of adolescents. In adults, women report a higher frequency of dream recall than men. Moreover, increased awakenings seem to increase dream recall, whereas low sleep quality is associated with low dream recall. In addition, there is some evidence that dream recall is associated with personality traits such as creativity. For adolescents, comparable data from larger samples are missing to date.

METHOD

A total of 5,580 adolescents (mean age: 18.23 years; 3,711 females and 1,869 males) participated in the present study. Participants completed an Internet-administered questionnaire related to dreaming, sleep, perceived stress, and creativity.

RESULTS

As compared with males, female adolescents reported a higher dream recall rate and felt a stronger impact of dreams on the subsequent day. Female adolescents also described themselves as more creative, and reported suffering more from sleep complaints and perceived stress. Multiple regression analyses further revealed that increased dream recall was independently predicted by factors such as female gender, sleep quality, and creativity, whereas perceived stress, awakenings during the night, and sleep duration had no predictive value.

CONCLUSIONS

Similar to the findings of studies conducted on adults, dream recall was also associated with female gender in a large sample of adolescents. Additionally, it seemed that several different factors such as good mood, increased sleep quality, and creativity influenced dream recall. These results can provide a basis for better understanding the psychology of dreams in adolescence. In contrast to nightmares, recalling dreaming is associated with health and well-being.