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Scarpelli S, Alfonsi V, De Gennaro L, Gorgoni M. Dreaming for two: A systematic review of mental sleep activity during pregnancy. Neurosci Biobehav Rev 2024; 163:105763. [PMID: 38852848 DOI: 10.1016/j.neubiorev.2024.105763] [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: 03/11/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
Changes in sleep and dreams are often observed during pregnancy. Dreaming may represent privileged access to the inner world of individuals, providing relevant information about their well-being. For this reason, a growing but heterogeneous literature has investigated dream experiences of pregnant women. The present paper aimed to systematically review the available evidence on the relationship between pregnancy and oneric activity, focusing on dream and nightmare frequency, dream contents, and emotional features. Moreover, dream changes between pre-partum and post-partum periods and the impact of previous pregnancy-related adverse events on dreaming have been summarized. Overall, 17 studies have been examined. The reviewed evidence suggests that women tend to have an abundant production of dreams and nightmares during pregnancy, and some results support the view that a high rate of dream recall is associated with poor sleep quality. Most studies have shown a high presence of pregnancy-related dream content, likely reflecting waking experiences and concerns. Additionally, dreaming may promote psychological preparation and activation of functional coping strategies to face life changes after childbirth.
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Affiliation(s)
- Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy.
| | | | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
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Simor P, Peigneux P, Bódizs R. Sleep and dreaming in the light of reactive and predictive homeostasis. Neurosci Biobehav Rev 2023; 147:105104. [PMID: 36804397 DOI: 10.1016/j.neubiorev.2023.105104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Dreams are often viewed as fascinating but irrelevant mental epihenomena of the sleeping mind with questionable functional relevance. Despite long hours of oneiric activity, and high individual differences in dream recall, dreams are lost into oblivion. Here, we conceptualize dreaming and dream amnesia as inherent aspects of the reactive and predictive homeostatic functions of sleep. Mental activity during sleep conforms to the interplay of restorative processes and future anticipation, and particularly during the second half of the night, it unfolds as a special form of non-constrained, self-referent, and future-oriented cognitive process. Awakening facilitates constrained, goal-directed prospection that competes for shared neural resources with dream production and dream recall, and contributes to dream amnesia. We present the neurophysiological aspects of reactive and predictive homeostasis during sleep, highlighting the putative role of cortisol in predictive homeostasis and forgetting dreams. The theoretical and methodological aspects of our proposal are discussed in relation to the study of dreaming, dream recall, and sleep-related cognitive processes.
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Affiliation(s)
- 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
| | - Philippe Peigneux
- 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
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
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Bušková J, Miletínová E, Králová R, Dvořáková T, Tefr Faridová A, Heřman H, Hrdličková K, Šebela A. Parasomnias in Pregnancy. Brain Sci 2023; 13:brainsci13020357. [PMID: 36831900 PMCID: PMC9954207 DOI: 10.3390/brainsci13020357] [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: 11/29/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES Pregnancy is often associated with reduced sleep quality and an increase in sleep disorders, such as restless leg syndrome, obstructive sleep apnea, and insomnia. There are few studies investigating the prevalence of parasomnias in pregnancy, although they may be expected to be a significant problem, as disturbed sleep in this time period in addition to these sleep disorders may trigger parasomnia episodes. METHODS We conducted a survey using an online questionnaire focusing on a comparison of the prevalence of parasomnias in three time periods: 3 months before pregnancy, during pregnancy, and 3 months after delivery. We also inquired about psychiatric and neurological comorbidities, current anxiety and depression symptoms, and pregnancy complications. RESULTS A total of 325 women (mean age 30.3 ± 5.3 years) participated in the online survey. The overall number of reported parasomnias increased during pregnancy compared to the 3 months before pregnancy (p < 0.001) and decreased after childbirth (p < 0.001). Specifically, we found a significant increase in sleepwalking (p = 0.02) and night terrors (p < 0.001), as well as in vivid dreams (p < 0.001) and nightmares (p < 0.001) during pregnancy. A similar significant increase during pregnancy was reported for head explosion (p < 0.011). In contrast, the number of episodes of sleep paralysis increased after delivery (p = 0.008). At the individual level, an increase in the severity/frequency of individual parasomnia episodes was also observed during pregnancy. Participants whose vivid dreams/nightmares persisted after delivery had higher BDI-II and STAI-T scores. Our data also suggest a significant impact of migraines and other chronic pain, as well as complications during pregnancy, on the presence of parasomnia episodes in our cohort. CONCLUSIONS We have shown that the prevalence of parasomnias increases during pregnancy and needs to be targeted, especially by non-pharmacological approaches. At the same time, it is necessary to inquire about psychiatric and neurological comorbidities and keep in mind that more sleep disorders may be experienced by mothers who have medical complications during pregnancy.
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Affiliation(s)
- Jitka Bušková
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic
- Correspondence: ; Tel.: +420-732325637
| | - Eva Miletínová
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic
| | - Radana Králová
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
| | - Tereza Dvořáková
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
| | - Adéla Tefr Faridová
- The Institute for the Care of Mother and Child, 147 10 Prague, Czech Republic
- Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
| | - Hynek Heřman
- The Institute for the Care of Mother and Child, 147 10 Prague, Czech Republic
| | - Kristýna Hrdličková
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
- Faculty of Arts, Charles University, 116 38 Prague, Czech Republic
| | - Antonín Šebela
- National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic
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Forest G, Sabourin C, Pétrin R, Robidoux R, De Koninck J. Dream content and depressive symptoms during pregnancy and postpartum. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Wong PF, D'Cruz R, Hare A. Sleep disorders in pregnancy. Breathe (Sheff) 2022; 18:220004. [DOI: 10.1183/20734735.0004-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/13/2022] [Indexed: 11/05/2022] Open
Abstract
Sleep disturbances are common in pregnancy and affect sleep quality. The maternal body is going through constant physical and physiological changes to adapt to the growing fetus. Sleep disorders may manifest at any point during pregnancy; some may result in adverse maternal or fetal outcomes. A strong clinical suspicion is crucial to identify sleep disorders in pregnancy and their management should be evaluated with a multidisciplinary team approach. In this review, we provide an overview of changes in sleep during pregnancy and summarise the key features of common sleep disorders in pregnancy, including practical tips on their management.Educational aimsTo provide an overview of common sleep disorders in pregnancy and their management options.To highlight the impact of the physiological changes in pregnancy on sleep.To outline the type of sleep studies available to investigate sleep disorders in pregnancy.
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Abstract
Memories of the past help us adaptively respond to similar situations in the future. Originally described by Schacter & Addis in 2007, the "constructive episodic simulation" hypothesis proposes that waking thought combines fragments of various past episodes into imagined simulations of events that may occur in the future. This same framework may be useful for understanding the function of dreaming. N = 48 college students were asked to identify waking life sources for a total of N = 469 dreams. Participants frequently traced dreams to at least one past or future episodic source (53.5% and 25.7% of dreams, respectively). Individual dreams were very often traced to multiple waking sources (43.9% of all dreams with content), with fragments of past memory incorporated into scenarios that anticipated future events. Waking-life dream sources are described in terms of their phenomenology and distribution across time and sleep stage, providing new evidence that dreams not only reflect the past, but also utilize memory in simulating potential futures.
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Affiliation(s)
- Erin J. Wamsley
- Department of Psychology and Program in Neuroscience, Furman University, Greenville, South Carolina, United States of America
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Dagnew B, Diress M, Getnet M, Seid MA, Fekadu SA, Gela YY, Yeshaw Y, Belsti Y, Akalu Y. Predictors of dream enactment behavior among medical students: The case of the University of Gondar, Ethiopia. PLoS One 2022; 17:e0263884. [PMID: 35213585 PMCID: PMC8880670 DOI: 10.1371/journal.pone.0263884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 01/28/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Dream enactment behavior is one of the features of rapid eye movement sleep behavior disorder. It might be a manifestation of neurodegenerative diseases and can lead to fall associated injuries. There is no evidence of dream enactment behavior and its associated factors in Ethiopia. Hence, this study targeted to pinpoint the predictors of dream enactment behavior among Medical students at the University of Gondar. METHODS The cross-sectional survey was carried out at the University of Gondar among Medical students selected by simple random sampling technique from Dec 2020 to Feb 2021. We used a structured pretested questionnaire to collect the data and dream enactment behavior was evaluated using rapid eye movement sleep behavior disorder single question. Descriptive statistics were computed, and determinant factors were identified using binary logistic regression model. In the final model, explanatory variables with a p<0.05 were considered as predictors (statistically significant) of the dream enactment behavior. The strength of association was determined using adjusted odds ratio (AOR) with its 95% CI. RESULTS Four-hundred and twelve students took part in the study with 97.4% response rate. The mean age of participants was 20.82(±1.88) years and 291(70.63%) were males. The prevalence of dream enactment was 34.47% (95% CI: 30.02-39.20). Daytime sleepiness score (AOR = 1.104; 95% CI: 1.053-1.160), age (AOR = 1.15; 95% CI: 1.019-1.290), monthly pocket money (AOR = 0.9991; 95% CI: 0.9985-0.9997), alcohol drink (AOR = 2.71; 95% CI: 1.076-6.846), and perceived stress (AOR = 3.854; 95% CI: 1.802-8.242) were statistically significant factors of dream enactment behavior. CONCLUSIONS In this study, the magnitude of dream enactment behavior was high which was significantly associated with daytime sleepiness score, age, monthly pocket money, alcohol drink, and perceived stress all of which are modifiable except age. The University of Gondar has to plan a strategy to avert the condition via the prevention of the determinant factors. Students need to reduce stress and avoid alcohol drink. We strongly urge forthcoming scholars to ascertain association of dream enactment and academic performance of university students.
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Affiliation(s)
- Baye Dagnew
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Sciences, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sofonias Addis Fekadu
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yitayeh Belsti
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Malinowski JE, Scheel D, McCloskey M. Do animals dream? Conscious Cogn 2021; 95:103214. [PMID: 34653784 DOI: 10.1016/j.concog.2021.103214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/22/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
The understanding of biological functions of sleep has improved recently, including an understanding of the deep evolutionary roots of sleep among animals. However, dreaming as an element of sleep may be particularly difficult to address in non-human animals because in humans dreaming involves a non-wakeful form of awareness typically identified through verbal report. Here, we argue that parallels that exist between the phenomenology, physiology, and sleep behaviors during human dreaming provide an avenue to investigate dreaming in non-human animals. We review three alternative measurements of human dreaming - neural correlates of dreaming, 'replay' of newly-acquired memories, and dream-enacting behaviors - and consider how these may be applied to non-human animal models. We suggest that while animals close in brain structure to humans (such as mammals and birds) may be optimal models for the first two of these measurements, cephalopods, especially octopuses, may be particularly good candidates for the third.
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Affiliation(s)
- J E Malinowski
- School of Psychology, University of East London, Stratford, UK.
| | - D Scheel
- Institute of Culture & Environment, Alaska Pacific University, Anchorage, AK, USA.
| | - M McCloskey
- Institute of Culture & Environment, Alaska Pacific University, Anchorage, AK, USA.
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Baltzan M, Yao C, Rizzo D, Postuma R. Dream enactment behavior: review for the clinician. J Clin Sleep Med 2020; 16:1949-1969. [PMID: 32741444 PMCID: PMC8034224 DOI: 10.5664/jcsm.8734] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Marc Baltzan
- Faculty of Medicine, Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montréal, Canada
- Centre Intégré Universitaire des Soins et Services Sociaux du Nord de L’île de Montréal, Montréal, Canada
- Mount Sinai Hospital, Centre Intégré Universitaire des Soins et Services Sociaux du Centre-ouest de L’île de Montréal, Montréal, Canada
- Institut de Médecine du Sommeil, Montréal, Canada
| | - Chun Yao
- Integrated Program in Neuroscience, McGill University, Montréal, Canada
- Research Institute of McGill University Health Centre, Montréal, Canada
| | - Dorrie Rizzo
- Faculty of Medicine, Department of Family Medicine, McGill University, Montréal, Canada
- Lady Davis Institute for Medical Research, Centre Intégré Universitaire des Soins et Services Sociaux de l’ouest de l’île, Montréal, Canada
| | - Ron Postuma
- Research Institute of McGill University Health Centre, Montréal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
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Roguski A, Rayment D, Whone AL, Jones MW, Rolinski M. A Neurologist's Guide to REM Sleep Behavior Disorder. Front Neurol 2020; 11:610. [PMID: 32733361 PMCID: PMC7360679 DOI: 10.3389/fneur.2020.00610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/25/2020] [Indexed: 01/10/2023] Open
Abstract
REM Sleep Behavior Disorder (RBD) is a chronic sleep condition characterized by dream enactment and loss of REM atonia. Individuals often present to clinic with complaints of injury to themselves or their bed-partner due to violent movements during sleep. RBD patients have a high risk of developing one of the neurodegenerative α-synucleinopathy diseases: over 70% will develop parkinsonism or dementia within 12 years of their diagnosis. RBD patients also exhibit accelerated disease progression and a more severe phenotype than α-synucleinopathy sufferers without RBD. The disease's low prevalence and the relatively limited awareness of the condition amongst medical professionals makes the diagnosis and treatment of RBD challenging. Uncertainty in patient management is further exacerbated by a lack of clinical guidelines for RBD patient care. There are no binary prognostic markers for RBD disease course and there are no clinical guidelines for neurodegeneration scaling or tracking in these patients. Both clinicians and patients are therefore forced to deal with uncertain outcomes. In this review, we summarize RBD pathology and differential diagnoses, diagnostic, and treatment guidelines as well as prognostic recommendations with a look to current research in the scientific field. We aim to raise awareness and develop a framework for best practice for RBD patient management.
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Affiliation(s)
- Amber Roguski
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Dane Rayment
- Rosa Burden Centre, Southmead Hospital, Bristol, United Kingdom
| | - Alan L Whone
- Department of Neurology, Southmead Hospital, Bristol, United Kingdom.,Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Matt W Jones
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Michal Rolinski
- Department of Neurology, Southmead Hospital, Bristol, United Kingdom.,Translational Health Sciences, University of Bristol, Bristol, United Kingdom
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Brock MS, Powell TA, Creamer JL, Moore BA, Mysliwiec V. Trauma Associated Sleep Disorder: Clinical Developments 5 Years After Discovery. Curr Psychiatry Rep 2019; 21:80. [PMID: 31410580 DOI: 10.1007/s11920-019-1066-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW We review recent and growing evidence that provides support for a novel parasomnia, trauma associated sleep disorder (TASD). Based on these findings, we further develop the clinical and polysomnographic (PSG) characteristics of TASD. We also address factors that precipitate TASD, develop a differential diagnosis, discuss therapy, and propose future directions for research. RECENT FINDINGS Nightmares, classically a REM phenomenon, are prevalent and underreported, even in individuals with trauma exposure. When specifically queried, trauma-related nightmares (TRN) are frequently associated with disruptive nocturnal behaviors (DNB), consistent with TASD. Capture of DNB in the lab is rare but ambulatory monitoring reveals dynamic autonomic concomitants associated with disturbed dreaming. TRN may be reported in NREM as well as REM sleep, though associated respiratory events may confound this finding. Further, dream content is more distressing in REM. Therapy for this complex disorder likely requires addressing not only the specific TASD components of TRN and DNB but comorbid sleep disorders. TASD is a unique parasomnia developing after trauma. Trauma-exposed individuals should be specifically asked about their sleep and if they have nightmares with or without DNB. Patients who report TRN warrant in-lab PSG as part of their evaluation.
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Affiliation(s)
- Matthew S Brock
- Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA.
| | - Tyler A Powell
- Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA
| | - Jennifer L Creamer
- Sleep Medicine Center, Martin Army Community Hospital, Fort Benning, GA, USA
| | - Brian A Moore
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,University of Texas at San Antonio, San Antonio, TX, USA
| | - Vincent Mysliwiec
- Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA
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Soldatkin VA, Krysenko PB, Kryuchkova MN. Is syndrome of embodied presence a rare psychopathological phenomenon? Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:82-91. [DOI: 10.17116/jnevro201911903182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Matar E, Lewis SJ. REM sleep behaviour disorder: not just a bad dream. Med J Aust 2017; 207:262-268. [PMID: 28899330 DOI: 10.5694/mja17.00321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/17/2017] [Indexed: 02/04/2023]
Abstract
Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterised by the loss of the normal atonia during the REM stage of sleep, resulting in overt motor behaviours that usually represent the enactment of dreams. Patients will seek medical attention due to sleep-related injuries or unpleasant dream content. Idiopathic RBD which occurs independently of any other disease occurs in up to 2% of the older population. Meanwhile, secondary RBD is very common in association with certain neurodegenerative conditions. RBD can also occur in the context of antidepressant use, obstructive sleep apnoea and narcolepsy. RBD can be diagnosed with a simple screening question followed by confirmation with polysomnography to exclude potential mimics. Treatment for RBD is effective and involves treatment of underlying causes, modification of the sleep environment, and pharmacotherapy with either clonazepam or melatonin. An important finding in the past decade is the recognition that almost all patients with idiopathic RBD will ultimately go on to develop Parkinson disease or dementia with Lewy bodies. This suggests that idiopathic RBD represents a prodromal phase of these conditions. Physicians should be aware of the risk of phenoconversion. They should educate idiopathic RBD patients to recognise the symptoms of these conditions and refer as appropriate for further testing and enrolment into research trials focused on neuroprotective measures.
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Affiliation(s)
- Elie Matar
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Simon Jg Lewis
- Brain and Mind Centre, University of Sydney, Sydney, NSW
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14
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Mental time travel to the future might be reduced in sleep. Conscious Cogn 2016; 48:180-189. [PMID: 27951414 DOI: 10.1016/j.concog.2016.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 10/31/2016] [Accepted: 11/13/2016] [Indexed: 01/06/2023]
Abstract
We present a quantitative study of mental time travel to the future in sleep. Three independent, blind judges analysed a total of 563 physiology-monitored mentation reports from sleep onset, REM sleep, non-REM sleep, and waking. The linguistic tool for the mentation report analysis is based on established grammatical and cognitive-semantic theories and has been validated in previous studies. Our data indicate that REM and non-REM sleep must be characterized by a reduction in mental time travel to the future, which would support earlier physiological evidence at the level of brain function.
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Schredl M, Gilles M, Wolf I, Peus V, Scharnholz B, Sütterlin M, Deuschle M. Nightmare frequency in last trimester of pregnancy. BMC Pregnancy Childbirth 2016; 16:346. [PMID: 27829406 PMCID: PMC5103377 DOI: 10.1186/s12884-016-1147-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/02/2016] [Indexed: 12/22/2022] Open
Abstract
Background Pregnancy-related dreams are often found in pregnant women but also the number of negatively toned dreams seems to be increased in this challenging phase of a woman’s life. Methods Nightmare frequency and subjectively experienced stress was elicited via questionnaires. The mothers-to-be were approached during their application visit about 4–8 weeks prior to delivery in three obstetric hospitals. The present analysis included 406 women aged 16–40 years in the last trimester of their pregnancy. Women with severe somatic illnesses and/or psychiatric disorders were excluded. The representative sample included 496 women (age range: 14–93 years.). Results The findings clearly indicate that pregnant women report nightmares more often compared to a representative sample and that nightmare frequency is closely related to subjectively experienced stress during daytime. Moreover, baby-related dreams were correlated with nightmare frequency but not with day-time stress. Conclusions Future studies should investigate the prevalence of nightmare disorders in pregnancy and study whether brief interventions like Imagery Rehearsal Therapy are beneficial for pregnant women suffering from nightmares.
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Affiliation(s)
- Michael Schredl
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University J5, 68159, Mannheim, Germany
| | - Maria Gilles
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University J5, 68159, Mannheim, Germany
| | - Isabell Wolf
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University J5, 68159, Mannheim, Germany
| | - Verena Peus
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University J5, 68159, Mannheim, Germany
| | - Barbara Scharnholz
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University J5, 68159, Mannheim, Germany
| | - Marc Sütterlin
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Michael Deuschle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University J5, 68159, Mannheim, Germany.
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Oriol C, Tordjman S, Dayan J, Poulain P, Rosenblum O, Falissard B, Dindoyal A, Naudet F. Exploring "psychic transparency" during pregnancy: a mixed-methods approach. BMC WOMENS HEALTH 2016; 16:55. [PMID: 27519958 PMCID: PMC4983093 DOI: 10.1186/s12905-016-0332-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 08/03/2016] [Indexed: 11/17/2022]
Abstract
Background Psychic transparency is described as a psychic crisis occurring during pregnancy. The objective was to test if it was clinically detectable. Methods Seven primiparous and seven nulliparous subjects were recorded during 5 min of spontaneous speech about their dreams. 25 raters from five groups (psychoanalysts, psychiatrists, general practitioners, pregnant women and medical students) listened to the audiotapes. They were asked to rate the probability of the women being pregnant or not. Their ability to discriminate the primiparous women was tested. The probability of being identified correctly or not was calculated for each woman. A qualitative analysis of the speech samples was performed. Results No group of rater was able to correctly classify pregnant and non-pregnant women. However, the raters’ choices were not completely random. The wish to be pregnant or to have a baby could be linked to a primiparous classification whereas job priorities could be linked to a nulliparous classification. Conclusions It was not possible to detect Psychic transparency in this study. The wish for a child might be easier to identify. In addition, the raters’ choices seemed to be connected to social representations of motherhood.
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Affiliation(s)
- Cécile Oriol
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Université de Rennes 1, Centre Hospitalier Guillaume Régnier, Rennes, France
| | - Sylvie Tordjman
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Université de Rennes 1, Centre Hospitalier Guillaume Régnier, Rennes, France.,Laboratoire de la Psychologie de la Perception, CNRS UMR 8158, Université Paris-Descartes, Paris, France
| | - Jacques Dayan
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Université de Rennes 1, Centre Hospitalier Guillaume Régnier, Rennes, France.,Inserm-EPHE-Université de Caen/Basse-Normandie, Unité U923, GIP Cyceron, CHU Côte de Nacre, Caen, France
| | - Patrice Poulain
- Pôle obstétrique, gynécologie, biologie de la reproduction, chirurgie plastique et reconstructrice, hôpital SUD, CHU de Rennes, Rennes, France
| | - Ouriel Rosenblum
- Service de Psychiatrie de l'enfant, Pitié-Salpêtrière, Paris, France
| | | | - Asha Dindoyal
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Université de Rennes 1, Centre Hospitalier Guillaume Régnier, Rennes, France
| | - Florian Naudet
- INSERM U669, Paris, France. .,Centre d'Investigation Clinique, INSERM 0203, Unité de Pharmacologie Clinique Unit, Universitary Hospital and University of Rennes 1, Rennes, France. .,Centre d'Investigation Clinique INSERM 1414, Unité de Pharmacologie Clinique, Hôpital de Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes cedex 9, France.
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Sandman N, Valli K, Kronholm E, Revonsuo A, Laatikainen T, Paunio T. Nightmares: risk factors among the Finnish general adult population. Sleep 2015; 38:507-14. [PMID: 25325474 DOI: 10.5665/sleep.4560] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 09/14/2014] [Indexed: 12/22/2022] Open
Abstract
STUDY OBJECTIVES To identify risk factors for experiencing nightmares among the Finnish general adult population. The study aimed to both test whether previously reported correlates of frequent nightmares could be reproduced in a large population sample and to explore previously unreported associations. DESIGN Two independent cross-sectional population surveys of the National FINRISK Study. SETTING Age- and sex-stratified random samples of the Finnish population in 2007 and 2012. PARTICIPANTS A total of 13,922 participants (6,515 men and 7,407 women) aged 25-74 y. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Nightmare frequency as well as several items related to socioeconomic status, sleep, mental well-being, life satisfaction, alcohol use, medication, and physical well-being were recorded with a questionnaire. In multinomial logistic regression analysis, a depression-related negative attitude toward the self (odds ratio [OR] 1.32 per 1-point increase), insomnia (OR 6.90), and exhaustion and fatigue (OR 6.86) were the strongest risk factors for experiencing frequent nightmares (P < 0.001 for all). Sex, age, a self-reported impaired ability to work, low life satisfaction, the use of antidepressants or hypnotics, and frequent heavy use of alcohol were also strongly associated with frequent nightmares (P < 0.001 for all). CONCLUSIONS Symptoms of depression and insomnia were the strongest predictors of frequent nightmares in this dataset. Additionally, a wide variety of factors related to psychological and physical well-being were associated with nightmare frequency with modest effect sizes. Hence, nightmare frequency appears to have a strong connection with sleep and mood problems, but is also associated with a variety of measures of psychological and physical well-being.
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Affiliation(s)
- Nils Sandman
- National Institute for Health and Welfare, Public Health Genomics Unit and Institute for Molecular Medicine FIMM, Helsinki, Finland.,University of Turku, Centre for Cognitive Neuroscience, Turku Brain and Mind Center, Department of Psychology, Turku, Finland
| | - Katja Valli
- University of Turku, Centre for Cognitive Neuroscience, Turku Brain and Mind Center Department of Psychology, Turku, Finland.,School of Bioscience, University of Skövde, Skövde, Sweden
| | - Erkki Kronholm
- National Institute for Health and Welfare, Department of Health, Unit of Chronic Disease Prevention, Turku, Finland
| | - Antti Revonsuo
- University of Turku, Centre for Cognitive Neuroscience, Turku Brain and Mind Center Department of Psychology, Turku, Finland.,School of Bioscience, University of Skövde, Skövde, Sweden
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Department of Health, Unit of Chronic Disease Prevention, Turku, Finland.,University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland.,Hospital District of North Karelia, Joensuu, Finland
| | - Tiina Paunio
- National Institute for Health and Welfare, Public Health Genomics Unit and Institute for Molecular Medicine FIMM, Helsinki, Finland.,Helsinki University and University Hospital, Department of Psychiatry, Helsinki, Finland
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Will students pass a competitive exam that they failed in their dreams? Conscious Cogn 2014; 29:36-47. [DOI: 10.1016/j.concog.2014.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 06/10/2014] [Accepted: 06/29/2014] [Indexed: 11/21/2022]
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Lara-Carrasco J, Simard V, Saint-Onge K, Lamoureux-Tremblay V, Nielsen T. Disturbed dreaming during the third trimester of pregnancy. Sleep Med 2014; 15:694-700. [PMID: 24780135 DOI: 10.1016/j.sleep.2014.01.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/24/2014] [Accepted: 01/29/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The majority of women develop sleep impairments during pregnancy, but alterations in dream experiences remain poorly understood. This study aimed to assess prospectively and comparatively the recall of dreaming and of disturbed dreaming in late pregnancy. METHODS Fifty-seven nulliparous, third-trimester pregnant women (mean age±SD, 28.7±4.06 years) and 59 non-pregnant controls (mean age±SD, 26.8±4.21 years) completed demographics and psychological questionnaires. A 14-day prospective home log assessed sleep and dream characteristics and the Sleep Disorders Questionnaire measured retrospective dream and disturbed dream recall. RESULTS Even though pregnant and non-pregnant women showed similar prospective dream recall (P=0.47), pregnant women reported prospectively more bad dreams (P=0.004). More pregnant women (21%) than non-pregnant women (7%) reported a nightmare incidence exceeding moderately severe pathology (>1/week) (P=0.03). Pregnant women also reported overall lower sleep quality (P=0.007) and more night awakenings (P=0.003). Higher prospective recall of bad dreams (r = -0.40, P=0.002) and nightmares (r = -0.32, P=0.001) both correlated with lower sleep quality in pregnant women. CONCLUSIONS Late pregnancy is a period of markedly increased dysphoric dream imagery that may be a major contributor to impaired sleep at this time. Further polysomnographic assessments of pregnant women are needed to clarify relationships between sleep and disturbed dream production in this population.
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Affiliation(s)
- Jessica Lara-Carrasco
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Québec, Canada
| | - Valérie Simard
- Department of Psychology, Université de Sherbrooke, Québec, Canada
| | - Kadia Saint-Onge
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Québec, Canada
| | - Vickie Lamoureux-Tremblay
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Québec, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Psychiatry, Université de Montréal, Québec, Canada.
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Arnulf I, Zhang B, Uguccioni G, Flamand M, Noël de Fontréaux A, Leu-Semenescu S, Brion A. A scale for assessing the severity of arousal disorders. Sleep 2014; 37:127-36. [PMID: 24470702 DOI: 10.5665/sleep.3322] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Arousal disorders may have serious health consequences. OBJECTIVE To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS). SETTING University hospital. DESIGN Controlled study. PARTICIPANTS Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder. INTERVENTION The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested. RESULTS Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the "violence/handling" factor. CONCLUSION This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments.
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Affiliation(s)
- Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France
| | - Bin Zhang
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Centre, Guangzhou 510120, China
| | - Ginevra Uguccioni
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France
| | - Mathilde Flamand
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France
| | - Alix Noël de Fontréaux
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France
| | - Agnès Brion
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France
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Nielsen T, Powell RA, Kuiken D. Nightmare frequency is related to a propensity for mirror behaviors. Conscious Cogn 2013; 22:1181-8. [PMID: 24021846 DOI: 10.1016/j.concog.2013.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 07/17/2013] [Accepted: 08/13/2013] [Indexed: 11/28/2022]
Abstract
We previously reported that college students who indicated engaging in frequent dream-enacting behaviors also scored high on a new measure of mirror behaviors, which is the propensity to imitate another person's emotions or actions. Since dream-enacting behaviors are frequently the culmination of nightmares, one explanation for the observed relationship is that individuals who frequently display mirror behaviors are also prone to nightmares. We used the Mirror Behavior Questionnaire (MBQ) and self-reported frequencies of nightmares to assess this possibility. A sample of 480 students, consisting of 188 males (19.2±1.73 years) and 292 females (19.0±1.55 years) enrolled in a first-year university psychology course, participated for course credit. They completed a battery of questionnaires that included the 16-item MBQ, plus an item about nightmare frequency (NMF) in the past 30 days. NMF scores were split to create low, medium, and high NMF groups. MBQ total scores were significantly higher for female than for male subjects, but an interaction revealed that this was true only for Hi-NMF subjects. MBQ Factor 4, Motor Skill Imitation, paralleled this global interaction for females, whereas MBQ Factor 3, Sleepiness/Anger Contagion, was elevated only for Hi-NMF males. Item analyses indicated that Hi- and Med-NMF females scored higher than Lo-NMF females on the 3 items of Factor 4 that reflect voluntary imitation (imitating famous/cartoon voices, being a physically active spectator, and learning new skills by observing), as well as on 2 other items that reflect involuntary imitation (contagious yawning and self-rated empathy). Although Hi- and Lo-NMF males differed most clearly on the sleepiness item of Factor 3, all 3 items on this factor (including anger contagion and contagious yawning) are plausibly associated with perception of and response to social threat. Results provide evidence that among females nightmares are associated with voluntary and involuntary mirror behaviors during wakefulness, while among males nightmares are associated with threat-related mirror behaviors during wakefulness. They thus support the possibility that the association between mirror behaviors and dream-enacting behaviors is due to a common mirror neuron mechanism that underlies mirror behaviors and nightmares and that involves motor, rather than emotional, resonance. These results have implications for understanding the comorbidity of nightmares and other pathological symptoms such as imitative suicidal behaviors, the influence of observational learning on dissociative symptomatology, and the predominance of threat and aggression in the dream enacting behaviors of REM sleep behavior disorder.
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Affiliation(s)
- Tore Nielsen
- Dept. Psychiatry, Université de Montréal, Montréal, Québec, Canada.
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Lara-Carrasco J, Simard V, Saint-Onge K, Lamoureux-Tremblay V, Nielsen T. Maternal representations in the dreams of pregnant women: a prospective comparative study. Front Psychol 2013; 4:551. [PMID: 23986734 PMCID: PMC3753535 DOI: 10.3389/fpsyg.2013.00551] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 08/02/2013] [Indexed: 11/22/2022] Open
Abstract
Dreams are thought to respond to self- and socially-relevant situations that evoke strong emotions and require rapid adaptation. First pregnancy is such a situation during which maternal mental representations (MMR) of the unborn baby, the self and significant others undergo remodeling. Some studies suggest that dreams during pregnancy contain more MMR and are more dysphoric, but such studies contain important methodological flaws. We assessed whether dreamed MMR, like waking MMR, change from the 7th month of pregnancy to birth, and whether pregnancy–related themes and non-pregnancy characteristics are also transformed. Sixty non-pregnant and 59 pregnant women (37 early and 22 late 3rd trimester) completed demographic and psychological questionnaires and 14-day home dream logs. Dream reports were blindly rated according to four dream categories: (1) Dreamed MMR, (2) Quality of baby/child representations, (3) Pregnancy-related themes, (4) Non-pregnancy characteristics. Controlling for age, relationship and employment status, education level and state anxiety, women in both pregnant groups reported more dreams depicting themselves as a mother or with babies/children than did non-pregnant women (all p = 0.006). Baby/child representations were less specific in the late 3rd than in the early 3rd trimester (p = 0.005) and than in non-pregnant women (p = 0.01). Pregnant groups also had more pregnancy, childbirth and fetus themes (all p = 0.01). Childbirth content was higher in late than in early 3rd trimester (p = 0.01). Pregnant groups had more morbid elements than did the non-pregnant group (all p < 0.05). Dreaming during pregnancy appears to reflect daytime processes of remodeling MMR of the woman as a mother and of her unborn baby, and parallels a decline in the quality of baby/child representations in the last stage of pregnancy. More frequent morbid content in late pregnancy suggests that the psychological challenges of pregnancy are reflected in a generally more dysphoric emotional tone in dream content.
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Affiliation(s)
- Jessica Lara-Carrasco
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal Montréal, QC, Canada ; Department of Psychology, Université de Montréal Montréal, QC, Canada
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Nielsen T, Kuiken D. Relationships between non-pathological dream-enactment and mirror behaviors. Conscious Cogn 2013; 22:975-86. [PMID: 23871862 DOI: 10.1016/j.concog.2013.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 05/23/2013] [Accepted: 06/09/2013] [Indexed: 12/19/2022]
Abstract
Dream-enacting behaviors (DEBs) are behavioral expressions of forceful dream images often occurring during sleep-to-wakefulness transitions. We propose that DEBs reflect brain activity underlying social cognition, in particular, motor-affective resonance generated by the mirror neuron system. We developed a Mirror Behavior Questionnaire (MBQ) to assess some dimensions of mirror behaviors and investigated relationships between MBQ scores and DEBs in a large of university undergraduate cohort. MBQ scores were normally distributed and described by a four-factor structure (Empathy/Emotional Contagion, Behavioral Imitation, Sleepiness/Anger Contagion, Motor Skill Imitation). DEB scores correlated positively with MBQ total and factor scores even with social desirability, somnambulism and somniloquy controlled. Emotion-specific DEB items correlated with corresponding emotion-specific MBQ items, especially crying and smiling. Results provide preliminary evidence for cross-state relationships between propensities for dream-enacting and mirror behaviors--especially behaviors involving motor-affective resonance--and our suggestion that motor-affective resonance mediates dream-enactment imagery during sleep and emotional empathy during waking.
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Affiliation(s)
- Tore Nielsen
- Dept. Psychiatry, Université de Montréal, Montréal, Québec, Canada; Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
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Fight or flight? Dream content during sleepwalking/sleep terrors vs. rapid eye movement sleep behavior disorder. Sleep Med 2013; 14:391-8. [PMID: 23601752 DOI: 10.1016/j.sleep.2013.01.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 01/02/2013] [Accepted: 01/04/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Dreams enacted during sleepwalking or sleep terrors (SW/ST) may differ from those enacted during rapid eye movement sleep behavior disorder (RBD). METHODS Subjects completed aggression, depression, and anxiety questionnaires. The mentations associated with SW/ST and RBD behaviors were collected over their lifetime and on the morning after video polysomnography (PSG). The reports were analyzed for complexity, length, content, setting, bizarreness, and threat. RESULTS Ninety-one percent of 32 subjects with SW/ST and 87.5% of 24 subjects with RBD remembered an enacted dream (121 dreams in a lifetime and 41 dreams recalled on the morning). These dreams were more complex and less bizarre, with a higher level of aggression in the RBD than in SW/ST subjects. In contrast, we found low aggression, anxiety, and depression scores during the daytime in both groups. As many as 70% of enacted dreams in SW/ST and 60% in RBD involved a threat, but there were more misfortunes and disasters in the SW/ST dreams and more human and animal aggressions in the RBD dreams. The response to these threats differed, as the sleepwalkers mostly fled from a disaster (and 25% fought back when attacked), while 75% of RBD subjects counterattacked when assaulted. The dreams setting included their bedrooms in 42% SW/ST dreams, though this finding was exceptional in the RBD dreams. CONCLUSION Different threat simulations and modes of defense seem to play a role during dream-enacted behaviors (e.g., fleeing a disaster during SW/ST, counterattacking a human or animal assault during RBD), paralleling and exacerbating the differences observed between normal dreaming in nonrapid eye movement (NREM) vs rapid eye movement (REM) sleep.
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The prevalence and associated risk factors of sleep disorder-related symptoms in pregnant women in China. Sleep Breath 2012; 17:951-6. [PMID: 23132352 DOI: 10.1007/s11325-012-0783-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 08/29/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The sleep disorder in pregnant women remains unfamiliar to perinatal care providers, resulting in lack of appropriate care. This study was designed to investigate the prevalence of sleep disorder-related symptoms in pregnant women and to identify the associated risk factors. METHODS Married pregnant women were enrolled from their first trimester and followed up until delivery. Nonpregnant married healthy women were selected as controls. A survey questionnaire was administered to each of them. RESULTS We successfully performed a survey to 1,993 pregnant women and 598 nonpregnant women. The overall prevalence of sleep disorder-related symptoms in pregnant women was significantly higher than the controls (56.1 vs. 29.9 %, P < 0.05). There was higher prevalence of snoring (30.2 %), observed sleep apnea (1.1 %), mouth breathing (23.7 %), nocturnal arousal (46.5 %), insomnia (35.1 %), and daytime sleepiness (52.6 %) in pregnant women. There were no significant differences of the prevalence of bruxism (7.0 vs. 6.7 %), sleep talking (8.1 vs. 7.2 %), and sleep walking (0.4 vs. 0.2 %) between the two groups (P > 0.05). Nocturnal sleep time (8.0 ± 1.3 h) was less in the third trimester compared with the nonpregnant women (8.2 ± 1.1 h) (P < 0.05). Smoking (OR = 3.39), drinking (OR = 2.40), allergic rhinitis/asthma (OR = 1.71), an obvious difference in neck circumference (OR = 1.11), and waistline (OR = 1.07) changes between the first and third trimesters were the risk factors for sleep disorder-related problems. CONCLUSIONS There is a high prevalence of sleep disorder-related symptoms in pregnant women. Our data may provide a baseline for prevention and treatment of sleep disturbances in pregnant women.
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Abstract
Parasomnias are abnormal behaviors emanating from or associated with sleep. Sleepwalking and related disorders result from an incomplete dissociation of wakefulness from nonrapid eye movement (NREM) sleep. Conditions that provoke repeated cortical arousals, or promote sleep inertia lead to NREM parasomnias by impairing normal arousal mechanisms. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking disorders. Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after an arousal from sleep. SRED is often associated with the use of sedative-hypnotic medications; in particular, the widely prescribed benzodiazepine receptor agonists. Recently, compelling evidence suggests that nocturnal eating may in some cases be a nonmotor manifestation of Restless Legs Syndrome (RLS). rapid eye movement (REM) Sleep Behavior Disorder (RBD) is characterized by a loss of REM paralysis leading to potentially injurious dream enactment. The loss of atonia in RBD often predates the development of Parkinson's disease and other disorders of synuclein pathology. Parasomnia behaviors are related to an activation (in NREM parasomnias) or a disinhibition (in RBD) of central pattern generators (CPGs). Initial management should focus on decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders. Clonazepam and melatonin appear to be effective therapies in RBD, whereas paroxetine has been reported effective in some cases of sleep terrors. At this point, pharmacotherapy for other parasomnias is less certain, and further investigations are necessary.
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Affiliation(s)
- Michael J Howell
- Department of Neurology, University of Minnesota Medical Center, Sleep Disorders Center, University of Minnesota, Minnesota, MN, USA.
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Abstract
STUDY OBJECTIVES Determine the prevalence and gender distributions of behaviors enacted during dreaming ("dream-enacting [DE] behaviors") in a normal population; the independence of such behaviors from other parasomnias; and the influence of different question wordings, socially desirable responding and personality on prevalence. DESIGN 3-group questionnaire study. SETTING University classrooms PARTICIPANTS Three undergraduate samples (Ns = 443, 201, 496; mean ages = 19.9 +/- 3.2 y; 20.1 +/- 3.4 y; 19.1 +/- 1.6 y). INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Subjects completed questionnaires about DE behaviors and Social Desirability. Study 1 employed a nonspecific question about the behaviors, Study 2 employed the same question with examples, and Study 3 employed 7 questions describing specific behavior subtypes (speaking, crying, smiling/laughing, fear, anger, movement, sexual arousal). Somnambulism, somniloquy, nightmares, dream recall, alexithymia, and absorption were also assessed. Factor analyses were conducted to determine relationships among DE behaviors and their independence from other parasomnias. Prevalence increased with increasing question specificity (35.9%, 76.7%, and 98.2% for the 3 samples). No gender difference obtained for the nonspecific question, but robust differences occurred for more specific questions. Females reported more speaking, crying, fear and smiling/laughing than did males; males reported more sexual arousal. When controlling other parasomnias and dream recall frequency, these differences persisted. Factor solutions revealed that DE behaviors were independent of other parasomnias and of dream recall frequency, except for an association between dream-talking and somniloquy. Sexual arousal was related only to age. Behaviors were independent of alexithymia but moderately related to absorption. CONCLUSIONS Dream-enacting behaviors are prevalent in healthy subjects and sensitive to question wording but not social desirability. Subtypes are related, differ with gender and occur independently of other parasomnias.
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Affiliation(s)
- Tore Nielsen
- Dream Nightmare Laboratory, Sacré-Coeur Hospital of Montreal, Montreal, Canada.
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