Nocturnal Dreams Research Articles

Associations of sleep disorders with serum neurofilament light chain levels in Parkinson’s disease

BackgroundSleep disorders are a prevalent non-motor symptom of Parkinson’s disease (PD), although reliable biological markers are presently lacking.ObjectivesTo explore the associations between sleep disorders and serum neurofilament light chain (NfL) levels in individuals with prodromal and early PD.MethodsThe study contained 1113 participants, including 585 early PD individuals, 353 prodromal PD individuals, and 175 healthy controls (HCs). The correlations between sleep disorders (including rapid eye movement sleep behavior disorder (RBD) and excessive daytime sleepiness (EDS)) and serum NfL levels were researched using multiple linear regression models and linear mixed-effects models. We further investigated the correlations between the rates of changes in daytime sleepiness and serum NfL levels using multiple linear regression models.ResultsIn baseline analysis, early and prodromal PD individuals who manifested specific behaviors of RBD showed significantly higher levels of serum NfL. Specifically, early PD individuals who experienced nocturnal dream behaviors (β = 0.033; P = 0.042) and movements of arms or legs during sleep (β = 0.027; P = 0.049) showed significantly higher serum NfL levels. For prodromal PD individuals, serum NfL levels were significantly higher in individuals suffering from disturbed sleep (β = 0.038; P = 0.026). Our longitudinal findings support these baseline associations. Serum NfL levels showed an upward trend in early PD individuals who had a higher total RBDSQ score (β = 0.002; P = 0.011) or who were considered as probable RBD (β = 0.012; P = 0.009) or who exhibited behaviors on several sub-items of the RBDSQ. In addition, early PD individuals who had a high total ESS score (β = 0.001; P = 0.012) or who were regarded to have EDS (β = 0.013; P = 0.007) or who exhibited daytime sleepiness in several conditions had a trend toward higher serum NfL levels.ConclusionSleep disorders correlate with higher serum NfL, suggesting a link to PD neuronal damage. Early identification of sleep disorders and NfL monitoring are pivotal in detecting at-risk PD patients promptly, allowing for timely intervention. Regular monitoring of NfL levels holds promise for tracking both sleep disorders and disease progression, potentially emerging as a biomarker for evaluating treatment outcomes.

Striatal Dopaminergic Deficit and Sleep in Idiopathic Rapid Eye Movement Behaviour Disorder: An Explorative Study.

IntroductionIdiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) is increasingly recognised as an important precursor disease state of alpha-synucleinopathies. This parasomnia is characterized by a history of recurrent nocturnal dream enactment behaviour, loss of skeletal muscle atonia, and increased phasic muscle activity during REM sleep. Neuroimaging studies of striatal dopamine transporter uptake tracer signaling suggest increasing dopaminergic deficit across the continuum of the alpha-synucleinopathies, with early sleep dysfunction suggestive of early caudate dysfunction. Henceforth, we set out to investigate the relationship between early sleep changes and the striatal dopaminergic availability in iRBD.MethodsTwelve patients with iRBD, who had undergone a video polysomnography and a neuroimaging assessment of striatal dopamine transporter (DaT) uptake tracer signaling, and 22 matched controls who had similarly undergone a video polysomnography were retrospectively identified. Data were statistically analyzed to identify altered sleep parameters and correlate them with striatal dopamine transporter uptake tracer signaling.ResultsThe iRBD patients exhibited an increased number of periodic limb movements during sleep (P=0.001), compared to 22 age-matched healthy subjects. In addition, several significant links were found between regional DaT-uptakes and sleep architecture. Correlational analyses suggested a strong positive association between sleep fragmentation and dopamine deficiency in left caudate (r=−0.630, P=0.028), whilst an increased uptake in the whole striatum was strongly linked to the sleep efficiency, and to a lesser degree to the length of sleep duration.DiscussionTo the best of our knowledge, this is the first demonstration of a close relationship between dopaminergic availability in striatum and the quality of sleep in iRBD. Taken together, our exploratory findings suggest that subtle but functionally significant striatal changes in early stages of iRBD may contribute to the further shaping of sleep architecture.

The art of daydreaming: How Ernst Bloch and Mariette Lydis defied Freud and transformed their daydreams through writing and art

We all dream. Even my dog dreams; he whines when he dreams, perhaps because his dreams are as filled with anxiety as my own sometimes are. Dreams – bad dreams and nightmares, particularly – can be profoundly unsettling and disturbing. They can shock and terrify us because they cannot be controlled: they are their own narrators, and the only way we can resolve their penetrating stories is by attempting to interrupt them. Only by jolting ourselves and waking up, we can enlighten ourselves and come to light, and only by generating daydreams, we can counteract the malign influences of bad dreams and nightmares and take charge of our lives. Bad dreams and nightmares can bring dread and devastating realizations: they can leave us marooned in our past. Daydreams, by contrast, can generate options, and perhaps a renewed joy in life as well: they demand that, despite obstacles and despair, we move onwards into the future. They are artful stories; they are the art of utopia and are filled with our wishes and anticipatory illumination. They appeal to us to become artists and narrators of our lives. Participating in the creative arts – writing, painting, acting and making music – is to envision dream-like visions of where we want to go with our lives. Without the arts, without writing especially, and without our conscious picturing the ideal other life, there is little possibility that our desires will be fulfilled. We need hope, and we need daydreams to map our destiny. I believe we need to act on our daydreams, and not slumber into nocturnal nightmares. These beliefs and ideas have been informed by studying the work of Ernst Bloch and his notions about daydreams (not nocturnal dreams). He is a neglected, iconoclastic philosopher, and I believe brilliant. In this article, I propose to discuss his theories about daydreams and then turn to the neglected, Austrian-Jewish painter Mariette Lydis, who in her various works offers proof that daydreams play an immense and important role in our creative lives. Contemporaries, both Bloch (1885–1977) and Lydis (1887–1970) wrote and/or painted during the same century as Freud (1856–1939) and Jung (1875–1961). Both were of Jewish origin. Both survived the First World War, the Nazis and the Second World War. Both kept realizing their desires for a better world through writing and picturing their writing.

Les Esquimaux et les songes

The Eskimos’ waking dream would be to base their social organization on their nocturnal dreams. For them, it is neither gods nor unconscious desires which drive these shadowy visions. Rather, it is the construction of their own society which is at work.

Daydreams: Concealed and Revealed in Analysis.

Daydreams and night dreams are similar in that both share the wish fulfillment aspect of dreaming. Even though the difference between day and night dreams is obvious-daydreams happen when a person is awake (conscious) and night dreams happen when a person is asleep (unconscious)-the boundary between day and night dreams becomes blurred when the ego has been severely compromised. The focus of this paper is on the analysis of daydreaming and its relationship to the ego. As in the analysis of nocturnal dreams, analysis of daydreams provides another opportunity for discovery of repressed material. Analysis of daydream material also provides an opportunity to assess the development of a patient's ego. When development of the ego has been severely compromised, daydreaming may become a mechanism of defense. A literature review is presented, followed by discussion of daydreaming and the ego. Case examples illustrate major points in the discussion.

Balancing in dreams: Effects of playing games on the Wii balance board on dream content

Based on the continuity hypothesis of dreams, elements of waking life should be incorporated into nocturnal dreams. The purpose of the current research is to build upon previous studies and investigate the effect of a gross motor balancing task on dream content. Thirteen (13) university students played balancing games on the Wii balance board for two hours. They were then monitored in the laboratory during their sleep using polysomnography. Dream reports were collected from the participants’ second REM-phase onwards. A total of 36 dreams were collected. Of those, seven dreams (19.4%) were subjectively reported to contain elements of balance, but only two of them (5.6%) were confirmed by external judges. In contrast, 17 dreams (47.2%) contained laboratory references. Additionally, as an exploratory analysis, task performance before sleep and task performance after sleep were compared. The seven participants who reported dreams containing elements of balancing did not perform better than the other participants. Thus, the results obtained imply that the motor task had some influence on participants’ dreams (7 dreams), and in total, consolidation effects were limited.

Neurophysiological basis of rapid eye movement sleep behavior disorder: informing future drug development.

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a history of recurrent nocturnal dream enactment behavior and loss of skeletal muscle atonia and increased phasic muscle activity during REM sleep: REM sleep without atonia. RBD and associated comorbidities have recently been identified as one of the most specific and potentially sensitive risk factors for later development of any of the alpha-synucleinopathies: Parkinson’s disease, dementia with Lewy bodies, and other atypical parkinsonian syndromes. Several other sleep-related abnormalities have recently been identified in patients with RBD/Parkinson’s disease who experience abnormalities in sleep electroencephalographic frequencies, sleep–wake transitions, wake and sleep stability, occurrence and morphology of sleep spindles, and electrooculography measures. These findings suggest a gradual involvement of the brainstem and other structures, which is in line with the gradual involvement known in these disorders. We propose that these findings may help identify biomarkers of individuals at high risk of subsequent conversion to parkinsonism.

Synchronicity: did Jung have it right?

Synchronicity: did Jung have it right?

Dead Babies: Response to Orna Guralnik’s Paper

The author’s response to Orna Guralnik’s paper focuses on the patient’s dreams as potent carriers of disavowed histories, carrying within themselves the potential of symbolizing for the first time the unspeakable truths that are repressed and see their first shimmer of light in nocturnal dreams. In her discussion, the author links Freud’s concept of hypermnesic dreams to Lacan’s concept of the Real as an initial attempt to give words to the traumatic.

Early detection of dementia with Lewy bodies in patients with amnestic mild cognitive impairment using 123I-MIBG cardiac scintigraphy

Increasing clinical attention has been focused on cardiac sympathetic denervation for the differential diagnosis of dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) with the development of [123I] metaiodobenzylguanidine (MIBG) scintigraphy. Decreased MIBG uptake, which reflects cardiac sympathetic denervation, has been detected in DLB, but not in AD. However, the time course of detected cardiac sympathetic degeneration is poorly understood in DLB. Herein, the authors report two patients with a clinical diagnosis of amnestic mild cognitive impairment (MCI) who had cardiac sympathetic denervation, detected by cardiac 123I-MIBG scintigraphy, without the core clinical features of DLB. One amnestic MCI patient had nocturnal dream enactment behavior, consistent with clinically probable REM sleep behavior disorder (RBD), and converted to probable DLB with the development of recurrent visual hallucination and spontaneous parkinsonism two years after MCI is diagnosed. The other amnestic MCI patient exhibited occipital metabolic reduction on [18F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scan, which is the preferentially affected region in DLB patients, although she had no core or suggestive clinical features of DLB. Both patients had abnormal findings on electrocardiogram at annual health checkups despite having no cardiac-related symptoms. Detailed clinical examinations, including angiography and echocardiogram, revealed no overt etiology, supporting the idea that cardiac sympathetic denervation is due to underlying Lewy body disease. The clinical courses of these patients suggest that 123I-MIBG cardiac scintigraphy is useful for the detection of DLB in the predementia phase, even before core clinical features appear.

Practicing a Motor Task in a Lucid Dream Enhances Subsequent Performance: A Pilot Study

Nocturnal dreams can be considered as a kind of simulation of the real world on a higher cognitive level. Within lucid dreams, the dreamer is able to control the ongoing dream content and is free to do what he or she wants. In this pilot study, the possibility of practicing a simple motor task in a lucid dream was studied. Forty participants were assigned to a lucid dream practice group, a physical practice group and a control group. The motor task was to toss 10-cent coins into a cup and hit as many as possible out of 20 tosses. Waking performance was measured in the evening and on the next morning by the participants at home. The 20 volunteers in the lucid dream practice group attempted to carry out the motor task in a lucid dream on a single night. Seven participants succeeded in having a lucid dream and practiced the experimental task. This group of seven showed a significant improvement in performance (from 3.7 to 5.3); the other 13 subjects showed no improvement (from 3.4 to 2.9). Comparing all four groups, the physical practice group demonstrated the highest enhancement in performance followed by the successful lucid dream practice group. Both groups had statistically significant higher improvements in contrast to the nondreaming group and the control group. Even though the experimental design is not able to explain if specific effects (motor learning) or unspecific effects (motivation) caused the improvement, the results of this study showed that rehearsing in a lucid dream enhances subsequent performance in wakefulness. To clarify the factors which increased performance after lucid dream practice and to control for confounding factors, it is suggested that sleep laboratory studies should be conducted in the future. The possibilities of lucid dream practice for professional sports will be discussed.

Contextualized emotional images in children's dreams: Psychological adjustment in conditions of military trauma

This study examines the impact of military trauma on contextualized emotional images in children's dreams, and the function of the intensity and valence of the emotional images in protecting mental health from negative trauma impact. Participants were 345 Palestinian children and adolescents (aged 5—16 years) belonging to high trauma (Gaza) and non-trauma (Galilee) groups. They reported nocturnal dreams using a seven-night dream diary. The results show, as hypothesized, that the dreams of children exposed to severe military trauma incorporated more intense and more negative emotional images. High intensity and low negative, and high positive emotional images in dreams may protect children's mental health. Children in the trauma group showed relatively fewer post-traumatic symptoms if their dreams incorporated intensive and positive emotional images. Similarly, personal exposure to military trauma was not associated with anxiety and aggressiveness among children whose dreams had low negative valence, or with lower anxiety when dreams had intensive emotional images. The emotional qualities of dreams are discussed as possible indicators of children processing their traumatic experiences.

The phantom limb in dreams

Mulder and colleagues [ Mulder, T., Hochstenbach, J., Dijkstra, P. U., Geertzen, J. H. B. (2008). Born to adapt, but not in your dreams. Consciousness and Cognition, 17, 1266–1271. ] report that a majority of amputees continue to experience a normally-limbed body during their night dreams. They interprete this observation as a failure of the body schema to adapt to the new body shape. The present note does not question this interpretation, but points to the already existing literature on the phenomenology of the phantom limb in dreams. A summary of published investigations is complemented by a note on phantom phenomena in the dreams of paraplegic patients and persons born without a limb. Integration of the available data allows the recommendation for prospective studies to consider dream content in more detail. For instance, “adaptation” to the loss of a limb can also manifest itself by seeing oneself surrounded by amputees. Such projective types of anosognosia (“transitivism”) in nocturnal dreams should also be experimentally induced in normally-limbed individuals, and some relevant techniques are mentioned.

The Sense of Self in Lucid Dreams: “Self as Subject” vs. “Self as Agent” vs. “Self as Object”

Kunzendorf (1987-1988, 2000) asserts that nocturnal dream images are not accompanied by any definitive self-consciousness that one is imaging, rather than perceiving, and that “lucid” dreams are indiscriminatively inferred to be imaginary. Consistent with this assertion, 35% of the 93 lucid dreamers in this study knew it to be true that “[d]uring a lucid dream, [they] have heard a real noise (an alarm clock, e.g.) and have believed the noise to be part of [their] lucid dream … without any immediate self-awareness [of] actually perceiving the noise.” Also consistent with Kunzendorf's assertion, every participant reportedly inferred the imaginary nature of his or her lucid dreams—8% of the time because his or her “experience was too nightmarish to be real,” 6% of the time because his or her “secret wishes were realized in the dream,” and so on. Focusing on the sense of self as agent, rather than self-consciousness or the sense of self as subject, Georgieff and Jeannerod (1998) suggest that concordance between the wishes of the lucid dreamer and the actions in the lucid dream can be attributed to an illusory self as agent controlling the dreamed actions. Consistent with Georgieff and Jeannerod's suggestion, 34% of the 93 subjects knew themselves to be a self as agent “able to control” a lucid dream, whereas almost none of the subjects knew themselves to be a self as agent “able to control” a non-lucid dream.

Psychotic dream-related aggression: A critical review and proposal

The relationship among parasomnias, sleep-related violence (SRV), and psychosis has neither been reported nor studied. The authors introduce the phenomenon of psychotic dream-related aggression (PDRA) and, through a review of the research on manifest dreams, the continuity of thinking across the sleep–wake cycle, and SRV, argue for its inclusion alongside the parasomnias of DSM-IV. Five cases are presented that illustrate this phenomenon, usually a male diagnosed with paranoid schizophrenia whose violent act toward another was closely associated with the manifest content of his nocturnal dreams and his inability to test reality. Differential diagnostic criteria are proposed to separate PDRA from other parasomnias that may be related to violence. Treatment and forensic implications are discussed.

Dreams in obsessive-compulsive disorder: An analysis of semantic and emotional content compared to controls

Objective: We sought to investigate the content of the dreams of obsessive-compulsive outpatients in the light of the following postulate: if dreams play a role in the processing of information and mental storage of events of the day, the dream recollections of obsessive-compulsive disorder (OCD) patients should present evidence of diurnal obsessive or ritual themes. Method: On seven successive mornings, immediately after awakening in their home environment, 10 nondepressed OCD patients and 11 controls recorded their recollections of the night's dreams on an audiotape. After randomization of dreams, two judges were asked to carry out a blind evaluation of the emotional characteristics perceptible in these dreams and the presence of obsessive or ritual themes. Results: 47 dreams were collected in the OCD group and 55 in the control group. No differences were found between the two groups regarding anxiety, sadness, the theme of failure, or the presence of obsessive or ritual themes. About 60% of OCD patients and 73% of the control group recounted dreams expressing anxiety, sadness, or failure. Most surprisingly, in the control group as well as in the OCD group, about one-third of subjects presented obsessive or ritual themes in their dreams. Conclusion: These data suggest that there is no evident link between diurnal mental activity and the morning recollection of nocturnal dreams regarding anxiety, failure, sadness, and obsessive-compulsive themes.

Parapraxes in the Plays of William Shakespeare

Parapraxes in the psychopathology of everyday life are “mistakes” that reveal the workings of the unconscious. (Obviously they existed before Freud's time, but it was Freud who gave them a name and dissected their complex psychological meanings.) When they occur in a great work of art (as in Shakespeare's plays) they are obviously not “mistakes” at all but carefully planted details of the artist's over-all aesthetic conception. Just as fictional dreams, as in Jensen's Gradiva, seem to follow the rules of nocturnal dream process and can be subjected to psychoanalytic scrutiny, fictional parapraxes are doubly interesting because they not only express the inwardness of a protagonist but reveal something of the writer's aesthetic method as well. This paper attempts to address these double points of entry into the mystery of Shakespeare's plays, posing the question, “Can the seemingly trivial or irrelevant (a handful of parapraxes in 38 plays) shed any light on the most complex characters in Western literature and the extraordinary mind of their creator?”

Nightmares and Psychotic Decompensation: A Case Study

There have been numerous reports in the literature on the descriptive similarities between a severe nightmare and an acute psychotic episode. Nightmares may be a prelude to psychotic decompensation, and it has been suggested that frequent lifelong nightmares may even be diagnostic of an underlying vulnerability to psychosis. In this report, we present a case study of a 40-year old female experiencing chronic paranoid schizophrenia, whose two witnessed psychotic relapses in the hospital were immediately preceded by intense and vivid nightmare attacks. Significantly, the content of these nocturnal dreams was thematically consistent with her waking hallucinations, suggesting a direct continuity between these experiences. We propose that further systematic study of the dreams and nightmares of individuals diagnosed with schizophrenia may be particularly useful in understanding their phenomenological experience.

The effects of current-concern- and nonconcern-related waking suggestions on nocturnal dream content.

The effects of current-concern- and nonconcern-related waking suggestions on nocturnal dream content.

The Theme of Death in Dreams of Patients with Anorexia Nervosa: Four Selected Contemporaneous Case Histories

In the early literature on anorexia nervosa, attention was often given to death-related cognitions as revealed through the nocturnal dreams of patients. However, only recently has renewed interest been shown in the possible role that death preoccupations and concerns might play in both the aetiology and maintenance of anorexia nervosa. The present study discusses the significance of death-related themes revealed in the dreams of four patients who were under the consultant care of three of the senior co-authors.