Sleep and dreaming are for important matters

Sensational Dreams: The Prevalence of Sensory Experiences in Dreaming

Dreaming, a widely researched aspect of sleep, often mirrors waking-life experiences. Despite the prevalence of sensory perception during wakefulness, sensory experiences in dreams remain relatively unexplored. Free recall dream reports, where individuals describe their dreams freely, may not fully capture sensory dream experiences. In this study, we developed a dream diary with direct questions about sensory dream experiences. Participants reported sensory experiences in their dreams upon awakening, over multiple days, in a home-based setting (n = 3476 diaries). Our findings show that vision was the most common sensory dream experience, followed by audition and touch. Olfaction and gustation were reported at equally low rates. Multisensory dreams were far more prevalent than unisensory dreams. Additionally, the prevalence of sensory dream experiences varied across emotionally positive and negative dreams. A positive relationship was found between on the one hand sensory richness and, on the other emotional intensity of dreams and clarity of dream recall, for both positive and negative dreams. These results underscore the variety of dream experiences and suggest a link between sensory richness, emotional content and dream recall clarity. Systematic registration of sensory dream experiences offers valuable insights into dream manifestation, aiding the understanding of sleep-related memory consolidation and other aspects of sleep-related information processing.

The Ponto-Geniculo-Occipital (PGO) Waves in Dreaming: An Overview

Rapid eye movement (REM) sleep is the main sleep correlate of dreaming. Ponto-geniculo-occipital (PGO) waves are a signature of REM sleep. They represent the physiological mechanism of REM sleep that specifically limits the processing of external information. PGO waves look just like a message sent from the pons to the lateral geniculate nucleus of the visual thalamus, the occipital cortex, and other areas of the brain. The dedicated visual pathway of PGO waves can be interpreted by the brain as visual information, leading to the visual hallucinosis of dreams. PGO waves are considered to be both a reflection of REM sleep brain activity and causal to dreams due to their stimulation of the cortex. In this review, we summarize the role of PGO waves in potential neural circuits of two major theories, i.e., (1) dreams are generated by the activation of neural activity in the brainstem; (2) PGO waves signaling to the cortex. In addition, the potential physiological functions during REM sleep dreams, such as memory consolidation, unlearning, and brain development and plasticity and mood regulation, are discussed. It is hoped that our review will support and encourage research into the phenomenon of human PGO waves and their possible functions in dreaming.

Dream interpretation and empirical dream research - an overview of research findings and their connections with psychoanalytic dream theories

The paper confronts psychoanalytic dream theories with the findings of empirical dream research. It summarizes the discussion in psychoanalysis around the function of dreams (e.g. as the guardian of sleep), wish-fullfilment or compensation, whether there is a difference between latent and manifest content, etc. In empirical dream research some of these questions have been investigated and the results can provide clarifications for psychoanalytic theorizing. The paper provides an overview of empirical dream research and its findings, as well as of clinical dream research in psychoanalysis, which was mainly conducted in German-speaking countries. The results are used to discuss the major questions in psychoanalytic dream theories and points out some developments in contemporary approaches which have been influenced by these insights. As a conclusion the paper attempts to formulate a revised theory of dreaming and its functions, which combines psychoanalytic thinking with research.

The Impact of Sleep on Fear Extinction

Sleep plays a crucial role in the consolidation of memories, including those for fear acquisition and extinction training. This chapter reviews findings from studies testing this relationship in laboratory, naturalistic, and clinical settings. While evidence is mixed, several studies in humans have linked fear and extinction recall/retention to both rapid eye-movement and slow wave sleep. Sleep appears to further aid in the processing of both simulated and actual trauma and improves psychotherapeutic treatment outcomes in those with anxiety and trauma- and stressor-related disorders. This chapter concludes with a discussion of the current challenges facing sleep and emotional memory research in addition to suggestions for improving future research.

What are the neural mechanisms and physiological functions of dreams?

Dreams are mental experiences, including perceptions, thoughts, and emotions, that occur during sleep. In dreams, hallucinatory perceptions, particularly visual and motoric, are often accompanied by negative emotions. When people dream, they perceive them as real even though they are bizarre and distorted in time and space. People often cannot recall their dreams, even though people dream every night. Dreaming is a strange physiological phenomenon. Research has demonstrated that dreaming is closely associated with rapid eye movement (REM) sleep. It is known that dreaming also occurs during non-REM (NREM) sleep, but the content appears to be different. Dreams during REM sleep tend to be longer, more vivid, more story-like, and more bizarre than those during NREM sleep. In this review, the neural circuits underlying dreaming and the physiological functions associated with it are summarized. Two major theories have been proposed regarding the neural circuits involved in dreaming. One is that dreams are generated by the activation of neural activity in the brainstem and its signal transmission to the cortex. The other is that dreams are caused by forebrain activation by dopamine. Whereas the physiological function of dreams remains unclear, several hypotheses have been proposed that are associated with memory and emotions.

Rapid Eye Movement Sleep during Early Life: A Comprehensive Narrative Review

The ontogenetic sleep hypothesis suggested that rapid eye movement (REM) sleep is ontogenetically primitive. Namely, REM sleep plays an imperative role in the maturation of the central nervous system. In coincidence with a rapidly developing brain during the early period of life, a remarkably large amount of REM sleep has been identified in numerous behavioral and polysomnographic studies across species. The abundant REM sleep appears to serve to optimize a cerebral state suitable for homeostasis and inherent neuronal activities favorable to brain maturation, ranging from neuronal differentiation, migration, and myelination to synaptic formation and elimination. Progressively more studies in Mammalia have provided the underlying mechanisms involved in some REM sleep-related disorders (e.g., narcolepsy, autism, attention deficit hyperactivity disorder (ADHD)). We summarize the remarkable alterations of polysomnographic, behavioral, and physiological characteristics in humans and Mammalia. Through a comprehensive review, we offer a hybrid of animal and human findings, demonstrating that early-life REM sleep disturbances constitute a common feature of many neurodevelopmental disorders. Our review may assist and promote investigations of the underlying mechanisms, functions, and neurodevelopmental diseases involved in REM sleep during early life.

Effects of quilts on comfortable indoor temperatures and human thermal responses during sleep

Quilts play a vital role in the thermal comfort of sleeping people. This study aims to investigate the comfortable indoor temperatures and thermal responses when people sleep in different quilts. The experiment tested three kinds of quilts (down, silk, and polyester), and each kind of quilt involved six filling weights. Sixteen participants (eight males and eight females) conducted whole-night sleeping trials to acquire skin temperatures, bedding temperatures, and thermal perceptual responses. The lower and upper limits of air temperatures ( T lower $$ {T}_{lower} $$ and T upper $$ {T}_{upper} $$ ) for comfortable sleeping were obtained. The results indicated that thermal sensation votes were in the range from 0.1 (close to "neutral") to 1.3 (close to "slightly warm") when participants felt comfortable and preferred "no change" in thermal preference. The corresponding comfortable mean skin and bedding temperatures were 34.6 ~ 35.2°C and 31.2 ~ 32.7°C, respectively. T lower $$ {T}_{lower} $$ and T upper $$ {T}_{upper} $$ had good linear correlations with bedding insulations. For the same bedding insulation, the T lower $$ {T}_{lower} $$ and T upper $$ {T}_{upper} $$ were highest for using silk quilts, followed by down and polyester quilts. The comfort ranges of air temperatures and quilt insulations were finally determined. The findings may benefit understanding the thermal requirement of quilts and help people select and design quilts to achieve thermal comfort.

Sleep quality in the chronic stage of concussion is associated with poorer recovery: A systematic review

Background

Recovery from a concussion varies based on a multitude of factors. One such factor is sleep disturbances. In our prior review, it was observed that in the acute phase, sleep disturbances are predictive of poor outcomes following a concussion. The literature gap remains on how sleep in the chronic phase of recovery affects outcomes.

Objective

To examine the association between sleep quality during the chronic stage of concussion and post-concussion outcomes. Literature Survey: Literature searches were performed during 1 July to 1 August 2019 in selected databases along with searching grey literature. Out of the 733 results, 702 references were reviewed after duplicate removal.

Methods

Three reviewers independently reviewed and consented on abstracts meeting eligibility criteria ( n = 35). The full-text articles were assessed independently by two reviewers. Consensus was achieved, leaving four articles. Relevant data from each study was extracted using a standard data-extraction table. Quality appraisal was conducted to assess potential bias and the quality of articles.

Results

One study included children (18–60 months) and three studies included adolescents and/or adults (ranging 12–35 years). The association between sleep and cognition (two studies), physical activity (one study), and emotion symptoms (one study) was examined. Sleep quality was associated with decreased cognition and emotional symptoms, but not with meeting physical activity guidelines six months post-concussion injury.

Conclusions

The heterogeneity in age of participants and outcomes across studies and limited number of included studies made interpretations difficult. Future studies may consider if addressing sleep quality following concussion will improve outcomes.

Orchestration of dreams: a possible tool for enhancement of mental productivity and efficiency

Deciphering the significance of dreams, remains a dream till date. A little is known about its underlying mechanism, brain regions involved and implications with wake life. This review is aimed to investigate the latest developments to summarize the differences in nature of dreams in Rapid eye movement and Non rapid eye movement sleep, possible role of dreams in day to day life with larger focus on Lucid Dreaming- its significant role in elevating productivity and efficiency. To carry out this review, combination of keywords like Lucid Dreaming, Rapid eye movement, Non rapid eye movement, Sleep Cycle, Dream Patterns, molecular mechanism of dreaming etc. were entered in databases like National library of Medicine, Google Scholar etc. Nature and composition of dreams are distinct in different sleep phases and it tends to influence cognitive skills, memory consolidation, mood and personal temperaments. It was observed that dreams in distinct phases, can be directly/indirectly related to development of cognition, skill enhancements, learning, healing, and even stress management affecting overall performance and productivity of an individual. Understanding the nature of dream contents in different phases can possibly inculcate insights for not only recovery aid in several mental illnesses but for elevated efficiency and productivity in normal individuals as well. Realising dreams as an effective tool for its contribution in daily activities might help organising our mood and overall mental well-being, a foremost component to thrive in the contemporary world which is currently undergoing the chaos of Novel Coronavirus Disease 2019.

Recent Advances in Marine-Based Nutraceuticals and Their Health Benefits

The oceans have been the Earth's most valuable source of food. They have now also become a valuable and versatile source of bioactive compounds. The significance of marine organisms as a natural source of new substances that may contribute to the food sector and the overall health of humans are expanding. This review is an update on the recent studies of functional seafood compounds (chitin and chitosan, pigments from algae, fish lipids and omega-3 fatty acids, essential amino acids and bioactive proteins/peptides, polysaccharides, phenolic compounds, and minerals) focusing on their potential use as nutraceuticals and health benefits.

REM sleep stabilizes hypothalamic representation of feeding behavior

During rapid eye movement (REM) sleep, behavioral unresponsiveness contrasts strongly with intense brain-wide neural network dynamics. Yet, the physiological functions of this cellular activation remain unclear. Using in vivo calcium imaging in freely behaving mice, we found that inhibitory neurons in the lateral hypothalamus (LHvgat) show unique activity patterns during feeding that are reactivated during REM, but not non-REM, sleep. REM sleep-specific optogenetic silencing of LHvgat cells induced a reorganization of these activity patterns during subsequent feeding behaviors accompanied by decreased food intake. Our findings provide evidence for a role for REM sleep in the maintenance of cellular representations of feeding behavior.

Neural circuits linking sleep and addiction: Animal models to understand why select individuals are more vulnerable to substance use disorders after sleep deprivation

Individuals differ widely in their drug-craving behaviors. One reason for these differences involves sleep. Sleep disturbances lead to an increased risk of substance use disorders and relapse in only some individuals. While animal studies have examined the impact of sleep on reward circuitry, few have addressed the role of individual differences in the effects of altered sleep. There does, however, exist a rodent model of individual differences in reward-seeking behavior: the sign/goal-tracker model of Pavlovian conditioned approach. In this model, only some rats show the key behavioral traits associated with addiction, including impulsivity and poor attentional control, making this an ideal model system to examine individually distinct sleep-reward interactions. Here, we describe how the limbic neural circuits responsible for individual differences in incentive motivation overlap with those involved in sleep-wake regulation, and how this model can elucidate the common underlying mechanisms. Consideration of individual differences in preclinical models would improve our understanding of how sleep interacts with motivational systems, and why sleep deprivation contributes to addiction in only select individuals.

Fear in dreams and in wakefulness: Evidence for day/night affective homeostasis

Recent neuroscientific theories have proposed that emotions experienced in dreams contribute to the resolution of emotional distress and preparation for future affective reactions. We addressed one emerging prediction, namely that experiencing fear in dreams is associated with more adapted responses to threatening signals during wakefulness. Using a stepwise approach across two studies, we identified brain regions activated when experiencing fear in dreams and showed that frightening dreams modulated the response of these same regions to threatening stimuli during wakefulness. Specifically, in Study 1, we performed serial awakenings in 18 participants recorded throughout the night with high‐density electroencephalography (EEG) and asked them whether they experienced any fear in their dreams. Insula and midcingulate cortex activity increased for dreams containing fear. In Study 2, we tested 89 participants and found that those reporting higher incidence of fear in their dreams showed reduced emotional arousal and fMRI response to fear‐eliciting stimuli in the insula, amygdala and midcingulate cortex, while awake. Consistent with better emotion regulation processes, the same participants displayed increased medial prefrontal cortex activity. These findings support that emotions in dreams and wakefulness engage similar neural substrates, and substantiate a link between emotional processes occurring during sleep and emotional brain functions during wakefulness.

Sleep deprivation, effort allocation and performance

Sleep deprivation causes physiological alterations (e.g., decreased arousal, intrusion of micro-sleeps), that negatively affect performance on a wide range of cognitive domains. These effects indicate that cognitive performance relies on a capacity-limited system that may be more challenged in the absence of sleep. Additionally, sleep loss can result in a lower willingness to exert effort in the pursuit of performance goals. Such deficits in motivation may interact with the effects of capacity limitations to further stifle cognitive performance. When sleep-deprived, cognitive performance is experienced as more effortful, and intrinsic motivation to perform dwindles. On the other hand, increasing motivation extrinsically (e.g., by monetary incentives) can inspire individuals to allocate more task-related effort, and can partially counter performance deficits associated with sleep deprivation. In this chapter, we review current research on the interplay between sleep deprivation, effort and performance. We integrate these findings into an effort-based decision-making framework in which sleep-related performance impairments may result from a voluntary decision to withdraw effort. We conclude with practical implications of this framework for performance in healthy populations (e.g., work productivity) and clinical conditions.

The Functional Role of Dreaming in Emotional Processes

Dream experience (DE) represents a fascinating condition linked to emotional processes and the human inner world. Although the overlap between REM sleep and dreaming has been overcome, several studies point out that emotional and perceptually vivid contents are more frequent when reported upon awakenings from this sleep stage. Actually, it is well-known that REM sleep plays a pivotal role in the processing of salient and emotional waking-life experiences, strongly contributing to the emotional memory consolidation. In this vein, we highlighted that, to some extent, neuroimaging studies showed that the processes that regulate dreaming and emotional salience in sleep mentation share similar neural substrates of those controlling emotions during wakefulness. Furthermore, the research on EEG correlates of the presence/absence of DE and the results on EEG pattern related to the incorporated memories converged to assign a crucial role of REM theta oscillations in emotional re-processing. In particular, the theta activity is involved in memory processes during REM sleep as well as during the waking state, in line with the continuity hypothesis. Also, the gamma activity seems to be related to emotional processes and dream recall as well as to lucid dreams. Interestingly, similar EEG correlates of DE have been found in clinical samples when nightmares or dreams occur. Research on clinical samples revealed that promoting the rehearsal of frightening contents aimed to change them is a promising method to treat nightmares, and that lucid dreams are associated with an attenuation of nightmares. In this view, DE can defuse emotional traumatic memories when the emotional regulation and the fear extinction mechanisms are compromised by traumatic and frightening events. Finally, dreams could represent a sort of simulation of reality, providing the possibility to create a new scenario with emotional mastery elements to cope with dysphoric items included in nightmares. In addition, it could be hypothesized that the insertion of bizarre items besides traumatic memories might be functional to "impoverish" the negative charge of the experiences.

The Phenomenal Contents and Neural Correlates of Spontaneous Thoughts across Wakefulness, NREM Sleep, and REM Sleep

Thoughts occur during wake as well as during dreaming sleep. Using experience sampling combined with high-density EEG, we investigated the phenomenal qualities and neural correlates of spontaneously occurring thoughts across wakefulness, non-rapid eye movement (NREM) sleep, and REM sleep. Across all states, thoughts were associated with activation of a region of the midcingulate cortex. Thoughts during wakefulness additionally involved a medial prefrontal region, which was associated with metacognitive thoughts during wake. Phenomenologically, waking thoughts had more metacognitive content than thoughts during both NREM and REM sleep, whereas thoughts during REM sleep had a more social content. Together, these results point to a core neural substrate for thoughts, regardless of behavioral state, within the midcingulate cortex, and suggest that medial prefrontal regions may contribute to metacognitive content in waking thoughts.

On Dreams and Motivation: Comparison of Freud's and Hobson's Views

The merits of Freudian dream theory continue to be debated and both supporters and critics appeal to empirical evidence to support their respective positions. What receives much less attention is the theoretical coherency of either Freudian dream theory or alternative perspectives. This paper examines Freudian dream theory and J. Allan Hobson's alternative position by addressing the role of motivation in dreams. This paper first discusses motivation in Freudian theory and its relation to dreams and disguise-censorship. The role of motivation in Hobson's theory is then considered. Hobson's claim that dream plot and content selection is random and based on design error and functional imbalance is then discussed in relation to the protoconsciousness theory proposal that dreams serve an adaptive function. While there are apparent inconsistencies in Hobson's position, his appeal to emotions and instincts provides a preliminary platform for understanding the role of motivation in dreams that is consonant with the Freudian position.

Consciousness across Sleep and Wake: Discontinuity and Continuity of Memory Experiences As a Reflection of Consolidation Processes

The continuity hypothesis (1) posits that there is continuity, of some form, between waking and dreaming mentation. A recent body of work has provided convincing evidence for different aspects of continuity, for instance that some salient experiences from waking life seem to feature in dreams over others, with a particular role for emotional arousal as accompanying these experiences, both during waking and while asleep. However, discontinuities have been somewhat dismissed as being either a product of activation-synthesis, an error within the consciousness binding process during sleep, a methodological anomaly, or simply as yet unexplained. This paper presents an overview of discontinuity within dreaming and waking cognition, arguing that disruptions of consciousness are as common a feature of waking cognition as of dreaming cognition, and that processes of sleep-dependent memory consolidation of autobiographical experiences can in part account for some of the discontinuities of sleeping cognition in a functional way. By drawing upon evidence of the incorporation, fragmentation, and reorganization of memories within dreams, this paper proposes a model of discontinuity whereby the fragmentation of autobiographical and episodic memories during sleep, as part of the consolidation process, render salient aspects of those memories subsequently available for retrieval in isolation from their contextual features. As such discontinuity of consciousness in sleep is functional and normal.

Sleep as spatiotemporal integration of biological processes that evolved to periodically reinforce neurodynamic and metabolic homeostasis: The 2m3d paradigm of sleep

Sleep continues to perplex scientists and researchers. Despite decades of sleep research, we still lack a clear understanding of the biological functions and evolution of sleep. In this review, we will examine sleep from a functional and phylogenetic perspective and describe some important conceptual gaps in understanding sleep. Classical theories of the biology and evolution of sleep emphasize sensory activation, energy balance, and metabolic homeostasis. Advances in electrophysiology, functional neuroimaging, and neuroplasticity allow us to view sleep within the framework of neural dynamics. With this paradigm shift, we have come to realize the importance of neurodynamic homeostasis in shaping the biology of sleep. Evidently, animals sleep to achieve neurodynamic and metabolic homeostasis. We are not aware of any framework for understanding sleep where neurodynamic, metabolic, homeostatic, chronophasic, and afferent variables are all taken into account. This motivated us to propose the two-mode three-drive (2m3d) paradigm of sleep. In the 2m3d paradigm, local neurodynamic/metabolic (N/M) processes switch between two modes-m0 and m1-in response to three drives-afferent, chronophasic, and homeostatic. The spatiotemporal integration of local m0/m1 operations gives rise to the global states of sleep and wakefulness. As a framework of evolution, the 2m3d paradigm allows us to view sleep as a robust adaptive strategy that evolved so animals can periodically reinforce neurodynamic and metabolic homeostasis while remaining sensitive to their internal and external environment.

Dream to Predict? REM Dreaming as Prospective Coding

The dream as prediction seems inherently improbable. The bizarre occurrences in dreams never characterize everyday life. Dreams do not come true! But assuming that bizarreness negates expectations may rest on a misunderstanding of how the predictive brain works. In evolutionary terms, the ability to rapidly predict what sensory input implies-through expectations derived from discerning patterns in associated past experiences-would have enhanced fitness and survival. For example, food and water are essential for survival, associating past experiences (to identify location patterns) predicts where they can be found. Similarly, prediction may enable predator identification from what would have been only a fleeting and ambiguous stimulus-without prior expectations. To confront the many challenges associated with natural settings, visual perception is vital for humans (and most mammals) and often responses must be rapid. Predictive coding during wake may, therefore, be based on unconscious imagery so that visual perception is maintained and appropriate motor actions triggered quickly. Speed may also dictate the form of the imagery. Bizarreness, during REM dreaming, may result from a prospective code fusing phenomena with the same meaning-within a particular context. For example, if the context is possible predation, from the perspective of the prey two different predators can both mean the same (i.e., immediate danger) and require the same response (e.g., flight). Prospective coding may also prune redundancy from memories, to focus the image on the contextually-relevant elements only, thus, rendering the non-relevant phenomena indeterminate-another aspect of bizarreness. In sum, this paper offers an evolutionary take on REM dreaming as a form of prospective coding which identifies a probabilistic pattern in past events. This pattern is portrayed in an unconscious, associative, sensorimotor image which may support cognition in wake through being mobilized as a predictive code. A particular dream illustrates.

The effectiveness of oral appliances for obstructive sleep apnea syndrome: A meta-analysis

OBJECTIVE

To evaluate the effectiveness of oral appliances (OAs) for managing patients with obstructive sleep apnea (OSA).

METHODS

PubMed, Embase, Web of Science, CENTRAL and SIGLE were electronically searched from January 1980 to September 2015 for randomized or nonrandomized controlled trials that assessed the effectiveness of OAs on OSAS. The processes of study search, selection, data extraction, assessment of risk of bias and evaluation of evidence quality were conducted independently by two reviewer authors. Meta-analyses were performed in Review Manager 5, Stata11.0 and StatsDirect 2.7.9.

RESULTS

Finally, we included 17 eligible studies which compared OAs and placebo or blank control. Six outcomes were assessed in this meta-analysis, i.e., apnea hypopnea index (AHI), respiratory arousal index (RAI), minimum oxygen saturation(MinSaO2), rapid eye movement (REM) sleep, sleep efficiency and Epworth Sleepiness Scale (ESS). Meta-analysis revealed that the pooled mean differences were -10.26 [95% CI: (-12.59, -7.93)], -9.03 [95% CI: (-11.89, -6.17)], 3.08 [95% CI: (1.97, 4.19)], 0.36 [95% CI: (-0.30, 1.02)], 1.34 [95% CI: (-0.05, 2.73)] and -1.76 [95% CI: (-2.57, -0.94)], respectively. The sensitivity analysis and subgroup analysis displayed generally robust results except for MinSaO2, REM sleep and sleep efficiency. Furthermore, publication bias was detected in RAI and MinSaO2.

CONCLUSIONS

The available evidence indicates benefits in respiration and sleep quality with oral appliances as compared to placebo devices or blank control, while we cannot determine its effectiveness in sleep efficiency and sleep architecture alterations. However, due to low evidence quality as revealed by GRADE, this finding should be interpreted with caution.

CLINICAL SIGNIFICANCE

Through critical meta-analyses, we found that oral appliances are effective in respiration improving and sleep quality. The existing evidence supports the employment of OAs as a recommendable treatment option for OSA. This meta-analysis helps to direct clinical practice and future research, and promises to be of great interest for both practitioners and researchers.

Sleep enhances a spatially mediated generalization of learned values

Sleep is thought to play an important role in memory consolidation. Here we tested whether sleep alters the subjective value associated with objects located in spatial clusters that were navigated to in a large-scale virtual town. We found that sleep enhances a generalization of the value of high-value objects to the value of locally clustered objects, resulting in an impaired memory for the value of high-valued objects. Our results are consistent with (a) spatial context helping to bind items together in long-term memory and serve as a basis for generalizing across memories and (b) sleep mediating memory effects on salient/reward-related items.

Metaphor and hyperassociativity: the imagination mechanisms behind emotion assimilation in sleep and dreaming

In this paper we propose an emotion assimilation function of sleep and dreaming. We offer explanations both for the mechanisms by which waking-life memories are initially selected for processing during sleep, and for the mechanisms by which those memories are subsequently transformed during sleep. We propose that emotions act as a marker for information to be selectively processed during sleep, including consolidation into long term memory structures and integration into pre-existing memory networks; that dreaming reflects these emotion assimilation processes; and that the associations between memory fragments activated during sleep give rise to measureable elements of dream metaphor and hyperassociativity. The latter are a direct reflection, and the phenomenological experience, of emotional memory assimilation processes occurring during sleep. While many theories previously have posited a role for emotion processing and/or emotional memory consolidation during sleep and dreaming, sleep theories often do not take enough account of important dream science data, yet dream research, when conducted systematically and under ideal conditions, can greatly enhance theorizing around the functions of sleep. Similarly, dream theories often fail to consider the implications of sleep-dependent memory research, which can augment our understanding of dream functioning. Here, we offer a synthesized view, taking detailed account of both sleep and dream data and theories. We draw on extensive literature from sleep and dream experiments and theories, including often-overlooked data from dream science which we believe reflects sleep phenomenology, to bring together important ideas and findings from both domains.

Comparing personal insight gains due to consideration of a recent dream and consideration of a recent event using the Ullman and Schredl dream group methods

There have been reports and claims in the psychotherapeutic literature that the consideration of recent dreams can result in personal realizations and insight. There is theoretical support for these claims from work on rapid eye movement (REM) sleep having a function of the consolidation of emotional memories and the creative formation of connections between new and older memories. To investigate these claims, 11 participants (10 females, one male) reported and considered a recent home dream in a dream discussion group that following the “Appreciating dreams” method of Montague Ullman. The group ran 11 times, each participant attending and participating once. A further nine participants (seven females, two males) reported and considered a recent home dream in a group that followed the “Listening to the dreamer” method of Michael Schredl. The two studies each had a control condition where the participant also reported a recent event, the consideration of which followed the same technique as was followed for the dream report. Outcomes of the discussions were assessed by the participants on the Gains from Dream Interpretation (GDI) scale, and on its counterpart, the Gains from Event Interpretation scale. High ratings on the GDI experiential-insight subscale were reported for both methods, when applied to dreams, and for the Ullman method Exploration-Insight ratings for the dream condition were significantly higher than for the control event condition. In the Ullman method, self-assessment of personal insight due to consideration of dream content was also significantly higher than for the event consideration condition. The findings support the view that benefits can be obtained from the consideration of dream content, in terms of identifying the waking life sources of dream content, and because personal insight may also occur. To investigate the mechanisms for the findings, the studies should be repeated with REM and non-REM dream reports, hypothesizing greater insight from the former.

Not only … but also: REM sleep creates and NREM Stage 2 instantiates landmark junctions in cortical memory networks

This article argues both rapid eye movement (REM) and non-rapid eye movement (NREM) sleep contribute to overnight episodic memory processes but their roles differ. Episodic memory may have evolved from memory for spatial navigation in animals and humans. Equally, mnemonic navigation in world and mental space may rely on fundamentally equivalent processes. Consequently, the basic spatial network characteristics of pathways which meet at omnidirectional nodes or junctions may be conserved in episodic brain networks. A pathway is formally identified with the unidirectional, sequential phases of an episodic memory. In contrast, the function of omnidirectional junctions is not well understood. In evolutionary terms, both animals and early humans undertook tours to a series of landmark junctions, to take advantage of resources (food, water and shelter), whilst trying to avoid predators. Such tours required memory for emotionally significant landmark resource-place-danger associations and the spatial relationships amongst these landmarks. In consequence, these tours may have driven the evolution of both spatial and episodic memory. The environment is dynamic. Resource-place associations are liable to shift and new resource-rich landmarks may be discovered, these changes may require re-wiring in neural networks. To realise these changes, REM may perform an associative, emotional encoding function between memory networks, engendering an omnidirectional landmark junction which is instantiated in the cortex during NREM Stage 2. In sum, REM may preplay associated elements of past episodes (rather than replay individual episodes), to engender an unconscious representation which can be used by the animal on approach to a landmark junction in wake.

Human REM sleep: influence on feeding behaviour, with clinical implications

Rapid eye movement (REM) sleep shares many underlying mechanisms with wakefulness, to a much greater extent than does non-REM, especially those relating to feeding behaviours, appetite, curiosity, exploratory (locomotor) activities, as well as aspects of emotions, particularly 'fear extinction'. REM is most evident in infancy, thereafter declining in what seems to be a dispensable manner that largely reciprocates increasing wakefulness. However, human adults retain more REM than do other mammals, where for us it is most abundant during our usual final REM period (fREMP) of the night, nearing wakefulness. The case is made that our REM is unusual, and that (i) fREMP retains this 'dispensability', acting as a proxy for wakefulness, able to be forfeited (without REM rebound) and substituted by physical activity (locomotion) when pressures of wakefulness increase; (ii) REM's atonia (inhibited motor output) may be a proxy for this locomotion; (iii) our nocturnal sleep typically develops into a physiological fast, especially during fREMP, which is also an appetite suppressant; (iv) REM may have 'anti-obesity' properties, and that the loss of fREMP may well enhance appetite and contribute to weight gain ('overeating') in habitually short sleepers; (v) as we also select foods for their hedonic (emotional) values, REM may be integral to developing food preferences and dislikes; and (vii) REM seems to have wider influences in regulating energy balance in terms of exercise 'substitution' and energy (body heat) retention. Avenues for further research are proposed, linking REM with feeding behaviours, including eating disorders, and effects of REM-suppressant medications.

REM sleep and memory reorganization: Potential relevance for psychiatry and psychotherapy

Sleep can foster the reorganization of memory, i.e. the emergence of new memory content that has not directly been encoded. Current neurophysiological and behavioral evidence can be integrated into a model positing that REM sleep particularly promotes the disintegration of existing schemas and their recombination in the form of associative thinking, creativity and the shaping of emotional memory. Particularly, REM sleep related dreaming might represent a mentation correlate for the reconfiguration of memory. In a final section, the potential relevance for psychiatry and psychotherapy is discussed.

Sleep, recovery, and metaregulation: explaining the benefits of sleep

A commonly held view is that extended wakefulness is causal for a broad spectrum of deleterious effects at molecular, cellular, network, physiological, psychological, and behavioral levels. Consequently, it is often presumed that sleep plays an active role in providing renormalization of the changes incurred during preceding waking. Not surprisingly, unequivocal empirical evidence supporting such a simple bi-directional interaction between waking and sleep is often limited or controversial. One difficulty is that, invariably, a constellation of many intricately interrelated factors, including the time of day, specific activities or behaviors during preceding waking, metabolic status and stress are present at the time of measurement, shaping the overall effect observed. In addition to this, although insufficient or disrupted sleep is thought to prevent efficient recovery of specific physiological variables, it is also often difficult to attribute specific changes to the lack of sleep proper. Furthermore, sleep is a complex phenomenon characterized by a multitude of processes, whose unique and distinct contributions to the purported functions of sleep are difficult to determine, because they are interrelated. Intensive research effort over the last decades has greatly progressed current understanding of the cellular and physiological processes underlying the regulation of vigilance states. Notably, it also highlighted the infinite complexity within both waking and sleep, and revealed a number of fundamental conceptual and technical obstacles that need to be overcome in order to fully understand these processes. A promising approach could be to view sleep not as an entity, which has specific function(s) and is subject to direct regulation, but as a manifestation of the process of metaregulation, which enables efficient moment-to-moment integration between internal and external factors, preceding history and current homeostatic needs.

Correlates of polysomnographic sleep changes in cocaine dependence: self-administration and clinical outcomes

BACKGROUND

Abstinence from chronic cocaine use is associated with abnormal sleep architecture. As sleep abnormalities are associated with clinical outcome in alcohol dependence, we hypothesized a similar relationship in cocaine dependence.

METHODS

We report data from a cocaine self-administration study (N=12) and the placebo arm of a randomized clinical trial (N=20). Self-administration participants underwent three cocaine self-administration sessions during a three-week inpatient stay. Treatment participants underwent two weeks of inpatient followed by six weeks of outpatient treatment including once-weekly cognitive behavioral therapy. Measurements included polysomnography from early and late in abstinence during the inpatient stays. Clinical outcomes included amount of cocaine self-administered, urine tests, and self-reported use and withdrawal symptoms.

RESULTS

Change in slow-wave sleep from early to late abstinence (ΔSWS; p=0.05), late abstinence rapid eye movement sleep (REM; p=0.002), and late abstinence total sleep time (p=0.02) were negatively correlated with the amount of cocaine self-administered. Early abstinence REM was positively correlated with withdrawal symptoms (p=0.02). Late abstinence REM was positively correlated with percent negative urines and maximum consecutive number of days abstinent (both p<0.001). ΔSWS was positively correlated with percent negative urines (p=0.03) and participants with increased SWS had greater percent negative urines (p=0.008) and maximum consecutive number of days abstinent (p=0.009).

CONCLUSIONS

Correlations between sleep deficits and amount of cocaine self-administered, clinical outcomes, and severity of withdrawal symptoms underscore the relevance of sleep in clinical outcomes in the treatment of cocaine dependence.

Looking beyond Fear and Extinction Learning: Considering Novel Treatment Targets for Anxiety

Fear conditioning studies provide valuable insight into how fears are learned and extinguished. Previous work focuses on fear and extinction learning to understand and treat anxiety disorders. However, a cascade of cognitive processes that extend beyond learning may also yield therapeutic targets for anxiety disorders. Throughout this review, we will discuss recent findings of fear generalization, memory consolidation, and reconsolidation. Factors related to effectiveness, efficiency and durability of extinction-based treatments will be addressed. Moreover, adolescence may be a key developmental stage when threat-related perturbations emerge; therefore, targeting interventions during adolescence when these nascent processes are more malleable may alter the trajectory of anxiety disorders.

NREM and REM Sleep: Complementary Roles in Recovery after Wakefulness

The overall function of sleep is hypothesized to provide "recovery" after preceding waking activities, thereby ensuring optimal functioning during subsequent wakefulness. However, the functional significance of the temporal dynamics of sleep, manifested in the slow homeostatic process and the alternation between non-rapid eye movement (NREM) and REM sleep remains unclear. We propose that NREM and REM sleep have distinct and complementary contributions to the overall function of sleep. Specifically, we suggest that cortical slow oscillations, occurring within specific functionally interconnected neuronal networks during NREM sleep, enable information processing, synaptic plasticity, and prophylactic cellular maintenance ("recovery process"). In turn, periodic excursions into an activated brain state-REM sleep-appear to be ideally placed to perform "selection" of brain networks, which have benefited from the process of "recovery," based on their offline performance. Such two-stage modus operandi of the sleep process would ensure that its functions are fulfilled according to the current need and in the shortest time possible. Our hypothesis accounts for the overall architecture of normal sleep and opens up new perspectives for understanding pathological conditions associated with abnormal sleep patterns.