Nightmare Experience Research Articles

Altered parasympathetic activity during sleep and emotionally arousing wakefulness in frequent nightmare recallers

Nightmare disorder is characterized by dysfunctional emotion regulation and poor subjective sleep quality reflected in pathophysiological features such as abnormal arousal processes and sympathetic influences. Dysfunctional parasympathetic regulation, especially before and during rapid eye movement (REM) phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers (NM). We hypothesized that cardiac variability is attenuated in NMs as opposed to healthy controls (CTL) during sleep, pre-sleep wakefulness and under an emotion-evoking picture-rating task. Based on the polysomnographic recordings of 24 NM and 30 CTL participants, we examined HRV during pre-REM, REM, post-REM and slow wave sleep, separately. Additionally, electrocardiographic recordings of resting state before sleep onset and under an emotionally challenging picture-rating task were also analyzed. Applying repeated measures analysis of variance (rmANOVA), a significant difference was found in the HR of NMs and CTLs during nocturnal segments but not during resting wakefulness, suggesting autonomic dysregulation, specifically during sleep in NMs. As opposed to the HR, the HRV values were not significantly different in the rmANOVA in the two groups, implying that the extent of parasympathetic dysregulation on a trait level might depend on the severeness of dysphoric dreaming. Nonetheless, in the group comparisons, the NM group showed increased HR and reduced HRV during the emotion-evoking picture-rating task, which aimed to model the nightmare experience in the daytime, indicating disrupted emotion regulation in NMs under acute distress. In conclusion, trait-like autonomic changes during sleep and state-like autonomic responses to emotion-evoking pictures indicate parasympathetic dysregulation in NMs.

The psychological impact of COVID-19 duty among resident doctors working in a COVID-hospital: A short-term follow-up study.

There is a dearth of longitudinal research that measures the impact of the pandemic on the mental health of resident doctors. This study aimed to estimate depression, anxiety, stress, burnout, and sleep disturbances (insomnia and nightmares) among resident doctors after COVID-19 duty. The study was a prospective longitudinal study among resident doctors posted in COVID-19 wards in a tertiary hospital in North India. The participants were assessed at two points of time, two months apart, on a semistructured questionnaire and self-rated scales for depression, anxiety, stress, insomnia, sleep quality, nightmare experience, and burnout. A significant proportion of resident doctors working in a COVID hospital had symptoms of depression (29.6%), anxiety (28.6%), stress (18.1%), insomnia (22%), and burnout (32.4%), even after two months of being off COVID duty. It was seen that these psychological outcomes had a strong positive correlation with each other. Compromised sleep quality and burnout significantly predicted depression, anxiety, stress, and insomnia. The current study has added to the psychiatric aspects of COVID-19 among resident doctors and the changes in these symptoms with time and highlights the need for targeted interventions to decrease these adverse outcomes.

The Relationship between Nightmare Experience and Athletes' Personality Traits and Anxiety.

Objective: Frequent nightmare behavior or deep nightmare experiences may harm the physical and mental health and performance of athletes. This study explores the nightmare experiences of athletes, and includes non-athletes with similar experiences for comparison. Methods: The Nightmare Experience Questionnaire (NEQ); Zuckerman–Kuhlman–Aluja Personality Questionnaire, Shortened Form (ZKA-PQ/SF); and Self-Rating Anxiety Scale (SAS) were used. The subjects were 187 athletes (mean age = 20.44 years, SD = 0.85; 91 females, 96 males) and 90 non-athletes (mean age = 20.34 years, SD = 1.65; 52 females, 38 males) who reported having nightmares. Results: A total of 87 athletes (46.5%) reported having nightmare experiences. The athlete nightmare group scored significantly higher in neuroticism than the non-nightmare group, and their anxiety scores were significantly higher than those of non-athletes, who scored higher in aggressiveness, neuroticism, and sensation seeking. Moreover, anxiety, neuroticism, and sensation seeking positively predicted athletes’ nightmare experiences. Conclusions: Personality traits and anxiety levels can be effectively applied to predict athletes’ nightmare experiences.

Effect of cryoprecipitate transfusion without ABO group consideration: A nightmare experience

The cryoprecipitate is an essential blood product as they are rich in factor VIII, fibrinogen, von Willebrand factor, factor XIII, and fibronectin, and their volume is too small. They play a significant role in the management of massive transfusion nowadays. Usually, they are used without ABO group consideration. We here report a case in which immunohematological problems arose due to out-of-group transfusion of cryoprecipitate. We suggest that the possibility of incompatibility subsequently is to be kept in mind during transfusion of large quantity cryoprecipitate, and ABO group compatible may be preferred.

198 COVID-19 Pandemic Nightmares at the US-Mexico Border

IntroductionThe COVID-19 pandemic has impacted individuals in many ways, including anecdotal reports of nightmares. However, little data exists regarding the experience of COVID-related nightmares, especially among the distressed population at the US-Mexico Border. This is especially relevant given the clinical importance of nightmares as risk factors for poor mental health and sleep disturbances.MethodsParticipants were N=155 individuals who completed the Nogales Cardiometabolic Health and Sleep (NOCHES) and were contacted about completing a COVID sub-study (95% Hispanic/Latino). Participants were asked for the number of nightmares that they have experienced since the pandemic started. They were also asked whether they had nightmares about confinement, claustrophobia, suffocation, oppression, drowning, failure, helplessness, natural disasters, anxiety, evil forces, war, separation from loved ones, being chased, sickness, death, COVID, and apocalypse. They were also asked whether they experienced, due to the pandemic, increased general, financial, food, housing, familial, relationship, and media-related stress. Each of these items was coded from 0 (“Strongly Disagree”) to 3 (“Strongly Agree”), with total scores ranging from 0-21. Regression analyses (linear for frequency and binary logistic for content) examined stress score as independent variable, adjusted for age, sex, financial status, education, and mental health (PHQ4).ResultsThose who experienced greater pandemic-related stress reported more nightmares (age/sex-adjusted B=0.23, p<0.0005, fully-adjusted B=0.23, p<0.0005). They were also more likely to have nightmares about confinement (adjusted odds ratio [OR]=1.69, p=0.008), suffocation (OR=1.41, p=0.020), failure (OR=1.23, p=0.049), being chased (OR=1.24, p=0.013), sickness (OR=1.26, p=0.022), and COVID (OR=1.37, p=0.003).ConclusionThose who experienced more pandemic-related stress reported more nightmares, even after adjusting for depression/anxiety symptoms. In addition, those with more pandemic-related stress were more likely to have nightmares about COVID itself, as well as confinement and suffocation, being chased, failure, and sickness in general. Perhaps efforts to reduce pandemic-related stress will reduce these nightmare experiences, which may have beneficial effects on other areas of mental health.Support (if any)R01MD011600, R01DA051321

Prevalence and Detailed Experience of Nightmare and Nightmare Disorder in Chinese University Students

Nightmares influence the mental health of university students, but the prevalence of nightmare and nightmare disorder requires additional documentation. The data of detailed nightmare experience of nightmare disorder and related depressive mood in this population are also scarce. First, a total of 1,451 students in a comprehensive Chinese university were invited to report their nightmare frequency. Sixty-eight patients with nightmare disorder were diagnosed using a semi-structured clinical interview according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). Second, 60 patients with nightmare disorder (8 of 68 patients were dismissed due to data incompletion) and 124 gender-matched, healthy students were invited to answer the Nightmare Experience Questionnaire (NEQ) and the Plutchik-van Praag Depression Inventory (PVP). Of 1,451 students, 923 reported nightmares (its annual prevalence was 63.61%), and 68 were diagnosed with nightmare disorder (its prevalence was 4.69%), with a female preponderance. The mean PVP and four NEQ scale scores in patients were higher than those in healthy students. The PVP scores were correlated with NEQ Physical Effect in patients, and with Negative Emotion in healthy students. This is the first report regarding nightmare disorder prevalence and detailed nightmare experience in university students. The findings of a high prevalence of nightmare disorder in women and elevated scores of nightmare experience among patients in the university population might help address the mechanisms and the management of patients with nightmare disorder.

Examining the Factor Structure, Reliability, and Validity of the Disturbing Dreams and Nightmare Severity Index (DDNSI) Consequences Sub-component

ABSTRACT Background: The Disturbing Dreams and Nightmares Severity Index (DDNSI) is commonly used when assessing the experience of nightmares. It comprises two parts examining i) chronicity and ii) nightmare consequences. The primary aim of the present study was to explore the dimensional structure of the optional and currently unvalidated nightmare consequences component using exploratory factor analysis. Internal reliability and construct validity were also examined. A secondary aim explored the relationships between nightmare chronicity and perceived consequences with measures of anxiety, depression, stress, self-efficacy, and insomnia. Methods: A cross-sectional survey was conducted with complete data from N = 757 students from six UK-based universities. Participants completed the chronicity and consequences components of the DDNSI, alongside the Sleep Condition Indicator, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Perceived Stress Scale, and General Self-Efficacy Scale. Results: Two nightmare consequences factors emerged; ‘Sleep-Interference’ (four items; α =.848), and ‘Psychosocial Well-being’ (six items; α =.946). Significantly moderate correlations were observed between the two emerging factors and the nightmare chronicity component, as well as with insomnia, anxiety, depression, perceived stress, and self-efficacy. Perceived ‘Sleep-Interference’ (β =−.241) was the strongest predictor of insomnia, and ‘Psychosocial wellbeing’ was the strongest predictor of anxiety (β =.688) depression (β =.804) perceived stress and lower self-efficacy. Conclusions: The perceived nightmare consequences component of the DDSNI is a multidimensional construct comprising two internally consistent and distinct, but related dimensions. The potential importance of distinguishing between types of perceived nightmare consequences and the associations with mental health outcomes in a student population is highlighted.

The nature of posttraumatic nightmares and school functioning in war-affected youth.

Children and adolescents who have experienced traumatic events demonstrate a variety of posttraumatic symptoms, including recurrent nightmares, as well as adverse reactions in the school setting. The current study examined nightmare symptoms, posttraumatic stress, sleep disturbance, and self- and teacher-reported school functioning of 64 youths in the Gaza Strip, ages 12 to 16, who have lived through three wars and experience ongoing conflict and political insecurity. Students were treatment-seeking for sleep-problems and reported, on average, five nightmares per week for an average of three years, with concomitant disrupted sleep, fear of going to sleep, and not feeling rested in the morning. Both teachers and students reported that participants exhibited impaired academic functioning and daytime sleepiness. The content of the students’ nightmares demonstrated frightening themes of being under attack and loss of self-efficacy/control; threat levels were high, and almost 60% included the threat of death. Approximately half of the nightmares included surreal elements in addition to more realistic scenes of violence. Participants in the study demonstrated substantial posttraumatic sleep problems with intensely distressing, frequent and chronic nightmares, andnightmare symptoms were associated with impairment in school functioning. Given the disruptive and distressing nature of these students’ nightmare disturbance, we suggest that increasing self-efficacy in relation to the experience of recurrent nightmares may be a good point of intervention with these recurrently traumatized youth. Thus, increasing the understanding of students’ nightmare symptoms may lead to ameliorating the suffering of youths in war zones and may have positive effects on their school functioning.

Nightmare experience and personality disorder functioning styles in healthy volunteers and nightmare disorder patients.

Nightmares are prevalent in psychiatric disorders, and personality disorder features might be associated with nightmare experience, especially in nightmare disorder patients. The authors invited 219 healthy volunteers and 118 nightmare disorder patients to undergo tests of the Nightmare Experience Questionnaire (NEQ), the Parker Personality Measure (PERM), and the Plutchik-van Praag Depression Inventory. Compared to healthy volunteers, nightmare disorder patients scored significantly higher on annual nightmare frequency and NEQ Physical Effect, Negative Emotion, Meaning Interpretation, and Horrible Stimulation, and higher on PERM Paranoid, Schizotypal, Borderline, Histrionic, Narcissistic, Avoidant, and Dependent styles. Borderline, Schizotypal, and Passive-Aggressive styles in healthy volunteers and Dependent, Avoidant, Histrionic, and Paranoid in patients were significant predictors of some NEQ scales. Higher annual nightmare frequency, higher scale scores of nightmare experience and personality disorder styles, and more associations between the two were found in nightmare disorder patients, implying the need for personality-adjustment therapy for nightmare disorder.

Do specific types of sleep disturbances represent risk factors for poorer health-related quality of life in inflammatory bowel disease? A longitudinal cohort study.

Poor global sleep quality is commonly reported in people with inflammatory bowel disease (IBD) and is linked to poorer health-related quality of life (HRQoL). However, understanding is currently limited by a lack of: (1) longitudinal research and (2) research investigating the impact of specific types of problems sleeping on IBD-related outcomes, particularly on HRQoL. Observational longitudinal cohort study. N=276 participants with IBD completed measures at baseline (T1) and 4 weeks later at T2. Four specific sleep disturbances associated with IBD including sleep apnoea, insomnia, restless legs, and nightmares were measured alongside depression, anxiety and stress, and HRQoL. After controlling for participant demographics and clinical characteristics, T1 depression, anxiety, stress, and T1 HRQoL, more severe symptom severity of sleep apnoea (B=-0.30, p<.05) and insomnia symptoms (B=-0.23, p<.05) at T1 significantly predicted poorer HRQoL at T2. However, the experience of restless legs (B=-0.03, p>.87) and nightmares (B=-0.14, p>.11) at T1 did not predict HRQoL. Symptoms synonymous with sleep apnoea and insomnia might represent modifiable risk factors that provide independent contributions to HRQoL over time in those with IBD. These findings suggest that interventions designed to improve sleep apnoea and insomnia could confer benefits to HRQoL in those with IBD. However, more longitudinal research is needed to understand the contribution of sleep disturbances over the longer term, as well as more randomized controlled trials testing the effect of improving sleep on IBD-related outcomes.

Neurobehavioral symptoms by gender and experience of nightmares after traumatic brain injury.

The purpose of this study is to assess how neurobehavioral symptoms following traumatic brain injury (TBI) may differ based on gender and the experience of nightmares. Research Method/Design: This cross-sectional study of community-dwelling adults ≥ 3 months post-TBI (n = 110) assessed differences in neurobehavioral symptoms between women (n = 41) and men (n = 69) by experience of nightmares. Outcome measures included the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Behavioral Assessment Screening Tool subscales for negative affect, substance abuse, executive functioning, fatigue, impulsivity, and maladaptive coping. N = 22 participants (n = 7 women, n = 15 men) experienced nightmares at least "sometimes" over the past 2 weeks. Nightmares were associated with more substance abuse, negative affect, fatigue, maladaptive coping, depressive symptoms, and anxiety symptoms (ps < .02). Women reported more negative affect, maladaptive coping, depressive symptoms, and anxiety symptoms (ps < .05) than men. Men experiencing nightmares reported more substance use than men without nightmares (p = .036), a difference not seen in women (p = .233). Women experiencing nightmares reported more impulsivity than women without nightmares (p = .028), a difference not seen in men (p = .559). Nightmares, post-TBI, are associated with more neurobehavioral symptoms. However, symptom patterns associated with nightmares may differ by gender. Nightmares may be a symptom of, or contribute to, sleep disruptions post-TBI or may indicate other conditions, like posttraumatic stress disorder. Future research should examine gender differences in neurobehavioral symptoms post-TBI in the context of nightmares and/or sleep disorders. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Lucid Dreaming, Nightmares, and Sleep Paralysis: Associations With Reality Testing Deficits and Paranormal Experience/Belief.

Focusing on lucid dreaming, this paper examined relationships between dissociated experiences related to rapid eye movement (REM) sleep (lucid dreaming, nightmares, and sleep paralysis), reality testing, and paranormal experiences/beliefs. The study comprised a UK-based online sample of 455 respondents (110 males, 345 females, Mean age = 34.46 years, SD = 15.70), who had all previously experienced lucid dreaming. Respondents completed established self-report measures assessing control within lucid dreaming, experience and frequency of nightmares, incidence of sleep paralysis, proneness to reality testing deficits (Inventory of Personality Organization subscale, IPO-RT), subjective experience of receptive psi and life after death (paranormal experience), and paranormal belief. Analysis comprised tests of correlational and predictive relationships between sleep-related outcomes, IPO-RT scores, and paranormal measures. Significant positive correlations between sleep and paranormal measures were weak. Paranormal measures related differentially to sleep indices. Paranormal experience correlated with lucid dreaming, nightmares, and sleep paralysis, whereas paranormal belief related only to nightmares and sleep paralysis. IPO-RT correlated positively with all paranormal and sleep-related measures. Within the IPO-RT, the Auditory and Visual Hallucinations sub-factor demonstrated the strongest positive associations with sleep measures. Structural equation modeling indicated that Auditory and Visual Hallucinations significantly positively predicted dissociated experiences related to REM sleep, while paranormal experience did not. However, paranormal experience was a significant predictor when analysis controlled for Auditory and Visual Hallucinations. The moderate positive association between these variables explained this effect. Findings indicated that self-generated, productive cognitive-processes (as encompassed by Auditory and Visual Hallucinations) played a significant role in conscious control and awareness of lucid dreaming, and related dissociative sleep states (sleep paralysis and nightmares).

Nightmare experience and family relationships in healthy volunteers and nightmare disorder patients

BackgroundNightmares are associated with parental bonding styles and various psychiatric disorders, but the exact connections between different nightmare experience features and family relationships in healthy volunteers and nightmare disorder patients are still unclear.MethodsWe therefore invited 62 nightmare disorder patients and 135 healthy volunteers to undergo tests of the Nightmare Experience Questionnaire (NEQ), the Family Relationship Questionnaire (FRQ), and the Plutchik - van Praag Depression Inventory (PVP).ResultsBesides the higher nightmare frequency and the higher PVP and four NEQ scale scores, the nightmare disorder patients had higher scores of FRQ Paternal Abuse, and lower ones of General Attachment, Maternal Encouragement, Maternal Freedom Release, and Paternal Freedom Release. The PVP was correlated with some NEQ and FRQ scales in both healthy volunteers and patients, and it functioned as a mediator between Physical Effect and Maternal Dominance in patients. Regarding predicting NEQ by FRQ, Paternal Abuse predicted Physical Effect, Maternal Dominance predicted Physical Effect and Horrible Stimulation, General Attachment predicted Horrible Stimulation (−) in healthy volunteers; Maternal Dominance predicted Physical Effect, Meaning Interpretation, and Horrible Stimulation, Paternal Freedom Release predicted Physical Effect (−), and Paternal Dominance predicted Meaning Interpretation and nightmare frequency in patients.ConclusionsOur study has demonstrated that the inappropriate family relationships were linked with different aspects of nightmare experience, especially in nightmare disorder patients.

Post-TBI Gender Differences in Behavioral and Emotional Symptoms by Experience of Nightmares: A Follow-Up

To replicate previous findings examining differences in self-reported behavioral and emotional symptoms between men and women with a history of traumatic brain injury (TBI) who do and do not experience nightmares.

A brief self-report measure for frequent distressing nightmares: The Nightmare Experience Scale (NExS).

A brief self-report measure for frequent distressing nightmares: The Nightmare Experience Scale (NExS).

Gender Differences in Behavioral and Emotional Symptoms by Experience of Nightmares after Traumatic Brain Injury

To identify differences in self-reported behavioral and emotional symptoms between men and women with complicated mild to severe traumatic brain injury (TBI) who do and do not experience nightmares.

Nightmare experience in bipolar I and II disorders.

Nightmare experience in bipolar I and II disorders.

The Decibel Levels of TV and the Elusive Social Will

There is no dearth of media TV channels for the news of happenings around us. Through the din and noise of the TV commercials and the intermittent serials, we get news trickling down, often not any events or historic moments but the political cog mire of parliamentary or legislative arguments and the media interviews trying to brow beat any politician. Or the so called discussion in which the decibel levels of shouting matches take place! ; The media has a pet phrase ‘the public wants to know’, but often it may the least of interest for common people to know. The people at large would like to know if there is a fall in vegetable or grocery prices or improvement in industrial production or employment. But people often have to content with the Political or Advertisement Commercial noise! What people want to know is when this will stop and there will be realistic report of news. It is a nightmare experience for the TV and media viewers to contend with rising noise level often leading to switching off. Social will is absolutely necessary. This article is to find out if there is any solution for this problem!

Measurement of Nightmare Experience, and its Application in Research and Treatment of Psychiatric Disorders

Measurement of Nightmare Experience, and its Application in Research and Treatment of Psychiatric Disorders

Waking-hour cerebral activations in nightmare disorder: A resting-state functional magnetic resonance imaging study.

The purpose of the current study was to explore the cerebral areas involved in nightmare disorder. Fifteen nightmare disorder patients and 15 healthy volunteers were invited to undergo resting-state functional magnetic resonance imaging and to complete the Nightmare Experience Questionnaire. The nightmare disorder patients scored higher on the Physical Effect and Horrible Stimulation scales, had higher values of regional homogeneity in clusters within the left anterior cingulate cortex and right inferior parietal lobule, and lower regional homogeneity values within the left superior and inferior frontal gyri and bilateral middle occipital gyri. Physical Effect was negatively correlated with regional homogeneity values in anterior cingulate cortex and inferior parietal lobule in the nightmare disorder group, and was positively correlated with regional homogeneity value in the inferior frontal gyrus in the healthy control group. To our best knowledge, this is the first neuroimaging study on nightmare disorder, and we have characterized the cerebral activities underlying altered hyperarousal and emotion regulation in nightmare disorder at resting-state.