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Siclari F. Consciousness in non-REM-parasomnia episodes. J Sleep Res 2024:e14275. [PMID: 38952031 DOI: 10.1111/jsr.14275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 06/02/2024] [Accepted: 06/06/2024] [Indexed: 07/03/2024]
Abstract
Sleepwalking and related parasomnias are thought to result from incomplete awakenings out of non-rapid eye movement (non-REM) sleep. Non-REM parasomnia behaviours have been described as unconscious and automatic, or related to vivid, dream-like conscious experiences. Similarly, some observations have suggested that patients are unresponsive during episodes, while others that they can interact with their surroundings. To better grasp and characterise the full spectrum of consciousness and environmental (dis)connection associated with behavioural episodes, 35 adult patients with non-REM sleep parasomnias were interviewed in-depth about their experiences. The level of consciousness during parasomnia episodes was reported to be variable both within and between individuals, ranging from minimal or absent consciousness and largely automatic behaviours (frequently/always present in 36% of patients) to preserved conscious experiences characterised by delusional thinking to varying degrees of specificity (65%), often about impending danger, variably formed, uni- or multisensory hallucinations (53%), impaired insight (77%), negative emotions (75%), and variable, but often pronounced, amnesia (30%). Patients described their experiences as a dream scene during which they felt awake ("awake dreaming"). The surroundings were either realistically perceived, misinterpreted (in the form of perceptual illusions or misidentifications of people), or entirely hallucinated as a function of the prevailing delusion. These observations suggest that the level of consciousness, amnesia and sensory disconnection during non-REM parasomnia episodes is variable and graded. In their full-fledged expression, non-REM parasomnia experiences feature several core features of dreams. They therefore represent a valuable model for the study of consciousness, sleep-related sensory disconnection and dreaming.
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Affiliation(s)
- Francesca Siclari
- The Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Center for Investigation and Research on Sleep, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
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Cataldi J, Stephan AM, Haba-Rubio J, Siclari F. Shared EEG correlates between non-REM parasomnia experiences and dreams. Nat Commun 2024; 15:3906. [PMID: 38724511 PMCID: PMC11082195 DOI: 10.1038/s41467-024-48337-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
Sleepwalking and related parasomnias result from incomplete awakenings out of non-rapid eye movement sleep. Behavioral episodes can occur without consciousness or recollection, or in relation to dream-like experiences. To understand what accounts for these differences in consciousness and recall, here we recorded parasomnia episodes with high-density electroencephalography (EEG) and interviewed participants immediately afterward about their experiences. Compared to reports of no experience (19%), reports of conscious experience (56%) were preceded by high-amplitude EEG slow waves in anterior cortical regions and activation of posterior cortical regions, similar to previously described EEG correlates of dreaming. Recall of the content of the experience (56%), compared to no recall (25%), was associated with higher EEG activation in the right medial temporal region before movement onset. Our work suggests that the EEG correlates of parasomnia experiences are similar to those reported for dreams and may thus reflect core physiological processes involved in sleep consciousness.
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Affiliation(s)
- Jacinthe Cataldi
- Center for Investigation and Research on Sleep, Lausanne University Hospital, Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
| | - Aurélie M Stephan
- Center for Investigation and Research on Sleep, Lausanne University Hospital, Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
- The Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - José Haba-Rubio
- Center for Investigation and Research on Sleep, Lausanne University Hospital, Lausanne, Switzerland
| | - Francesca Siclari
- Center for Investigation and Research on Sleep, Lausanne University Hospital, Lausanne, Switzerland.
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland.
- The Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.
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See QR, Raheel K, Duncan I, Biabani N, Di Giulio I, Romigi A, Kumari V, O’Regan D, Cairney S, Urso D, Chaudhuri KR, Gnoni V, Drakatos P, Rosenzweig I. Dreaming Characteristics in Non-Rapid Eye Movement Parasomnia and Idiopathic Rapid Eye Movement Sleep Behaviour Disorder: Similarities and Differences. Nat Sci Sleep 2024; 16:263-277. [PMID: 38482468 PMCID: PMC10933526 DOI: 10.2147/nss.s435201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
Background Speech graph analysis (SGA) of dreams has recently shown promise as an objective and language-invariant diagnostic tool that can aid neuropsychiatric diagnosis. Whilst the notion that dreaming mentations reflect distinct physiologic processes is not new, such studies in patients with sleep disorders remain exceptionally scarce. Here, using SGA and other dream content analyses, we set to investigate structural and thematic differences in morning dream recalls of patients diagnosed with Non-Rapid Eye Movement Parasomnia (NREMP) and Idiopathic REM Sleep Behavior Disorder (iRBD). Methods A retrospective cross-sectional study of morning dream recalls of iRBD and NREMP patients was undertaken. Traditional dream content analyses, such as Orlinsky and Hall and Van de Castle analyses, were initially conducted. Subsequently, SGA was performed in order to objectively quantify structural speech differences between the dream recalls of the two patient groups. Results Comparable rate of morning recall of dreams in the sleep laboratory was recorded; 25% of iRBD and 18.35% of NREMP patients. Aggression in dreams was recorded by 28.57% iRBD versus 20.00% in NREMP group. iRBD patients were more likely to recall dreams (iRBD vs NREMP; P = 0.007), but they also had more white dreams, ie having a feeling of having dreamt, but with no memory of it. Visual and quantitative graph speech analyses of iRBD dreams suggested stable sequential structure, reflecting the linearity of the chronological narrative. Conversely, NREMP dream reports displayed more recursive, less stable systems, with significantly higher scores of graph connectivity measures. Conclusion The findings of our exploratory study suggest that iRBD and NREMP patients may not only differ on what is recalled in their dreams but also, perhaps more strikingly, on how dreams are recalled. It is hoped that future SGA-led dream investigations of larger groups of patients will help discern distinct mechanistic underpinnings and any associated clinical implications.
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Affiliation(s)
- Qi Rui See
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Kausar Raheel
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Iain Duncan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Nazanin Biabani
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Irene Di Giulio
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K
| | - Andrea Romigi
- IRCCS Neuromed Istituto Neurologico Mediterraneo Pozzilli (IS), Pozzilli, Italy
| | - Veena Kumari
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, U.K
| | - David O’Regan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K
| | - Scott Cairney
- Department of Psychology, University of York and York Biomedical Research Institute, University of York, York, U.K
| | - Daniele Urso
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
- Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, U.K
| | - K Ray Chaudhuri
- Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, U.K
| | - Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
| | - Panagis Drakatos
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K
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Longe O, Omodan A, Leschziner G, Rosenzweig I. Non-REM parasomnias: a scoping review of dreams and dreamlike mentation. Croat Med J 2022; 63. [PMID: 36597564 PMCID: PMC9837726 DOI: 10.3325/cmj.2022.63.525] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AIM To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the current understanding of this topic. METHODS A scoping review of available evidence on dreams and dreamlike mentation in NREM parasomnias was conducted in accordance with the PRISMA-ScR guidelines. We searched peer-reviewed literature using Google Scholar, PubMed, Ovid (Embase), Ovid Medline®, Global Health, and APA Psych Info. The Mixed Method Appraisal Tool (MMAT) was used to appraise the quality of selected articles. RESULTS The final analysis included 16 studies. All of the studies were from high-income countries. The studies reported on dreams and dreamlike mentation in NREM parasomnias, but there was scarcity of literature for sexsomnia, sleep-related eating disorder, and confusional arousal. All of the studies had the highest quality as shown by the MMAT (76%-100%). Emotions such as apprehension and misfortune were associated with sleepwalking and sleep terrors. CONCLUSION Sleep studies involving collection of dream content immediately following NREM parasomnia could significantly minimize reporting bias and improve dream data quality.
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Affiliation(s)
- Omolade Longe
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Abiola Omodan
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Guy Leschziner
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ivana Rosenzweig
- Centre for Neuroimaging, Sleep and Brain Plasticity Centre, IoPPN, King's College London, London, United Kingdom
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5
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Longe O, Omodan A, Leschziner G, Rosenzweig I. Non-REM parasomnias: a scoping review of dreams and dreamlike mentation. Croat Med J 2022; 63:525-535. [PMID: 36597564 PMCID: PMC9837726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
AIM To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the current understanding of this topic. METHODS A scoping review of available evidence on dreams and dreamlike mentation in NREM parasomnias was conducted in accordance with the PRISMA-ScR guidelines. We searched peer-reviewed literature using Google Scholar, PubMed, Ovid (Embase), Ovid Medline®, Global Health, and APA Psych Info. The Mixed Method Appraisal Tool (MMAT) was used to appraise the quality of selected articles. RESULTS The final analysis included 16 studies. All of the studies were from high-income countries. The studies reported on dreams and dreamlike mentation in NREM parasomnias, but there was scarcity of literature for sexsomnia, sleep-related eating disorder, and confusional arousal. All of the studies had the highest quality as shown by the MMAT (76%-100%). Emotions such as apprehension and misfortune were associated with sleepwalking and sleep terrors. CONCLUSION Sleep studies involving collection of dream content immediately following NREM parasomnia could significantly minimize reporting bias and improve dream data quality.
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Affiliation(s)
- Omolade Longe
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Abiola Omodan
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Guy Leschziner
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ivana Rosenzweig
- Centre for Neuroimaging, Sleep and Brain Plasticity Centre, IoPPN, King's College London, London, United Kingdom
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6
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Gnoni V, Duncan I, Wasserman D, Higgins S, Drakatos P, Birdseye A, Pérez-Carbonell L, Nesbitt A, Koutroumanidis M, Leschziner G, Rosenzweig I. Nocturnal visual hallucinations in patients with disorders of arousal: a novel behavioral and EEG pattern. Croat Med J 2022; 63. [PMID: 36325668 PMCID: PMC9648088 DOI: 10.3325/cmj.2022.63.438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate clinical and video-polysomnography (VPSG) findings of hallucinatory experiences in patients suffering from disorders of arousal (DOA) in the absence of other pathologies. METHODS The authors retrospectively reviewed the records of 370 adults with DOA. Thirty (8.1%) patients concomitantly reported complex nocturnal visual hallucinations. VPSG recordings were scrutinized, and motor behavioral and electroencephalogram (EEG) patterns were classified according to previous descriptions of DOA. RESULTS Thirty DOA patients reported seeing images of objects, people, and animals; either distorted, static, or mobile. The images disappeared with increased illumination in 80% of patients, and 23.3% reported preceding dream imagery. In addition to the classical DOA patterns on VPSG, a distinct pattern of behavioral and EEG manifestation associated with complex hallucinatory episodes was identified in 16 (53.3%) DOA patients. This consisted of low-voltage mixed-frequency EEG activity before eye opening that persisted while patients were observed staring or visually tracking before the onset of motor behavior. CONCLUSION A novel, distinct behavioral and EEG pattern in patients with DOA and history of reported complex nocturnal visual hallucinations was identified. This may represent a unique phenotype of dissociation between sleep states that merits further investigation.
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Affiliation(s)
- Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
| | - Iain Duncan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
| | - Danielle Wasserman
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sean Higgins
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
| | - Panagis Drakatos
- Sleep Disorders Centre, Guy's Hospital, London, UK,Faculty of Life Sciences and Medicine King’s College London, London, UK
| | | | | | - Alexander Nesbitt
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK,Department of Neurology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Guy Leschziner
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK,Department of Neurology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
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Couto RAS, Moreira Gonçalves L. A medical algorithm for Cotard delusion based on more than 300 literature cases. Int J Psychiatry Clin Pract 2021; 25:220-232. [PMID: 32935595 DOI: 10.1080/13651501.2020.1819335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Cotard delusion (CD) is a rare psychiatric disorder in which the patient believes to be dead, i.e., the patient holds nihilistic delusions concerning his/her own existence. Taking into account its rarity, and possible subdiagnosis due to unawareness, most of the literature consists of case studies, complicating a more systematic approach and leading to difficulties in deciding the best clinical guidance to offer the patient suffering from CD. The objective of this work is to review the literature and propose an algorithm to help the differential diagnosis and the management of this condition. METHOD To do so, an extensive literature research was performed using several bibliographic databases. Since data on this topic is scarce, references in every article were cross-checked, aiming to obtain all available peer-reviewed works on CD. RESULTS Research resulted in 328 cases. Several treatment modalities were reported to improve the symptoms of CD, from pharmacotherapy - mainly consisting of antipsychotics and antidepressants - to electroconvulsive therapy. CONCLUSIONS Despite its challenging diagnosis, the delusion can be treated with readily available care. Hopefully, this work can be a useful tool to doctors when encountering this odd affliction.
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Affiliation(s)
- Rosa A S Couto
- School of Medicine, University of Minho, Braga, Portugal.,REQUIMTE, LAQV, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luís Moreira Gonçalves
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo (USP), São Paulo, Brazil
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O'Regan D, Nesbitt A, Biabani N, Drakatos P, Selsick H, Leschziner GD, Steier J, Birdseye A, Duncan I, Higgins S, Kumari V, Stokes PR, Young AH, Rosenzweig I. A Novel Group Cognitive Behavioral Therapy Approach to Adult Non-rapid Eye Movement Parasomnias. Front Psychiatry 2021; 12:679272. [PMID: 34276446 PMCID: PMC8281294 DOI: 10.3389/fpsyt.2021.679272] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/31/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Following the success of Cognitive Behavioral Therapy (CBT) for insomnia, there has been a growing recognition that similar treatment approaches might be equally beneficial for other major sleep disorders, including non-rapid eye movement (NREM) parasomnias. We have developed a novel, group-based, CBT-program for NREM parasomnias (CBT-NREMP), with the primary aim of reducing NREM parasomnia severity with relatively few treatment sessions. Methods: We investigated the effectiveness of CBT-NREMP in 46 retrospectively-identified patients, who completed five outpatient therapy sessions. The outcomes pre- and post- CBT-NREMP treatment on clinical measures of insomnia (Insomnia Severity Index), NREM parasomnias (Paris Arousal Disorders Severity Scale) and anxiety and depression (Hospital Anxiety and Depression Scale), were retrospectively collected and analyzed. In order to investigate the temporal stability of CBT-NREMP, we also assessed a subgroup of 8 patients during the 3 to 6 months follow-up period. Results: CBT-NREMP led to a reduction in clinical measures of NREM parasomnia, insomnia, and anxiety and depression severities [pre- vs. post-CBT-NREMP scores: P (Insomnia Severity Index) = 0.000054; P (Paris Arousal Disorders Severity Scale) = 0.00032; P (Hospital Anxiety and Depression Scale) = 0.037]. Improvements in clinical measures of NREM parasomnia and insomnia severities were similarly recorded for a subgroup of eight patients at follow-up, demonstrating that patients continued to improve post CBT-NREMP. Conclusion: Our findings suggest that group CBT-NREMP intervention is a safe, effective and promising treatment for NREM parasomnia, especially when precipitating and perpetuating factors are behaviorally and psychologically driven. Future randomized controlled trials are now required to robustly confirm these findings.
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Affiliation(s)
- David O'Regan
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Alexander Nesbitt
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Department of Neurology, Guy's Hospital, London, United Kingdom
| | - Nazanin Biabani
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Panagis Drakatos
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Hugh Selsick
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Insomnia Clinic, Royal London Hospital for Integrated Medicine, London, United Kingdom
| | - Guy D Leschziner
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Department of Neurology, Guy's Hospital, London, United Kingdom.,Basic and Clinical Neurosciences, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Joerg Steier
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Adam Birdseye
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom
| | - Iain Duncan
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom
| | - Seán Higgins
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Department of Neuroimaging, Sleep and Brain Plasticity Centre, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Veena Kumari
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.,Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Paul R Stokes
- Department of Psychological Medicine, King's College London & South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, Psychology and Neuroscience, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Allan H Young
- Department of Psychological Medicine, King's College London & South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, Psychology and Neuroscience, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Ivana Rosenzweig
- Sleep Disorder Centre, Nuffield House, Guy's Hospital, London, United Kingdom.,Department of Neuroimaging, Sleep and Brain Plasticity Centre, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
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