Waking Dream

The association between nightmare frequency (NMF) and suicidal ideation (SI) is well known, yet the impact of the COVID-19 pandemic on this relation is inconsistent. This study aimed to investigate changes in NMF, SI, and their association during the COVID-19 pandemic. Data were collected in 16 countries using a harmonised questionnaire. The sample included 9328 individuals (4848 women; age M[SD] = 46.85 [17.75] years), and 17.60% reported previous COVID-19. Overall, SI was significantly 2% lower during the pandemic vs...

This review critically analyzes the forensic application of the Parasomnia Defense in homicidal incidents, drawing from medical literature on disorders of arousal (DOA) and rapid-eye-movement sleep behavior disorder (RBD). A systematic search of PubMed, Scopus, Embase, and Cochrane databases was conducted until October 16, 2022. We screened English-language articles in peer-reviewed journals discussing murders committed during sleep with a Parasomnia Defense. We followed PRISMA guidelines, extracting event details, diagnosis methods, factors influencing the acts, perpetrator behavior, timing, motives, concealment, mental experiences, victim demographics, and court verdicts...

Parasomnias are due to a transient unstable state dissociation during entry into sleep, within sleep, or during arousal from sleep, and manifest with abnormal sleep related behaviors, perceptions, emotions, dreams, and autonomic nervous system activity. Rapid eye movement (REM) parasomnias include REM sleep behavior disorder (RBD), isolated recurrent sleep paralysis and nightmare disorder. Neurophysiology is key for diagnosing these disorders and provides insights into their pathophysiology. RBD is very well characterized from a neurophysiological point of view, also thank to the fact that polysomnography is needed for the diagnosis...

Coronavirus disease 2019 (COVID‑19), a systemic illness caused by severe acute respiratory distress syndrome 2 (SARS‑CoV‑2), has triggered a worldwide pandemic with symptoms ranging from asymptomatic to chronic, affecting practically every organ. Melatonin, an ancient antioxidant found in all living organisms, has been suggested as a safe and effective therapeutic option for the treatment of SARS‑CoV‑2 infection due to its good safety characteristics and broad‑spectrum antiviral medication properties...

INTRODUCTION: Salivary alpha-amylase (sAA) is considered a marker of autonomic nervous system activity in stress research, and atypical waking sAA responses have been reported for traumatized individuals. Lucid dreams, characterized by a dreamer's awareness of their dream state while remaining asleep, have shown promising preliminary evidence of their potential to enhance mental health. This study's objective was to evaluate sAA in relation to healing lucid dreams. METHODS: Participants experiencing PTSD symptoms attended a six-day workshop delivered via live video designed to teach techniques for transforming trauma through dreamwork and dream lucidity...

BACKGROUND: Human consciousness is generally thought to emerge from the activity of intrinsic connectivity networks (resting-state networks [RSNs]) of the brain, which have topological characteristics including, among others, graph strength and efficiency. So far, most functional brain imaging studies in anesthetized subjects have compared wakefulness and unresponsiveness, a state considered as corresponding to unconsciousness. Sedation and general anesthesia not only produce unconsciousness but also phenomenological states of preserved mental content and perception of the environment (connected consciousness), and preserved mental content but no perception of the environment (disconnected consciousness)...

Introduction  Chronic nightmares are a common and disabling feature of posttraumatic stress disorder (PTSD) for which broadly effective treatments are still lacking. While imagery rehearsal therapy (IRT) demonstrates benefits for patients with idiopathic nightmares and some patients with PTSD-related nightmares, research indicates it may be less beneficial for veterans. Narrative therapy (NT) is a form of psychotherapy which is client-centered and value-focused and has demonstrated benefits for PTSD patients...

Objective  When metacognition arises during rapid eye movement (REM) sleep, people experience lucid dreaming (LD). Studies on this phenomenon face different obstacles. For example, its standard verification protocol requires at least three types of sensors. We hypothesized that preagreed frontalis movements (PAFMs), as a sign of lucidity, could be seen on electroencephalography (EEG) during REM sleep. In this case, only one EEG sensor would be needed to verify LD. Method  Under laboratory observation, five volunteers were instructed to induce LD, during which they needed to use the standard verification protocol with pre-agreed eye movements (PAEMs) and then immediately raise their eyebrows three times as a PAFM...

The boundaries between waking and sleeping-when falling asleep (hypnagogic) or waking up (hypnopompic)-can be challenging for our ability to monitor and interpret reality. Without proper understanding, bizarre but relatively normal hypnagogic/hypnopompic experiences can be misinterpreted as psychotic hallucinations (occurring, by definition, in the fully awake state), potentially leading to stigma and misdiagnosis in clinical contexts and to misconception and bias in research contexts. This Perspective proposes that conceptual and practical understanding for differentiating hallucinations from hypnagogic/hypnopompic experiences may be offered by lucid dreaming, the state in which one is aware of dreaming while sleeping...

Rapid eye movement sleep behavior disorder (RBD) is a sleep disturbance characterized by the absence of regular paralysis during REM sleep, accompanied by dream enactment behavior. The available pharmacotherapy options for treating RBD are limited, and the utilization of antidepressants has yielded mixed results. We report three cases of isolated RBD improved with trazodone. Doses of trazodone 50-100 mg at bedtime over 4-6 months resulted in significant clinical improvement. These cases highlight that trazodone could serve as a treatment for isolated RBD that does not respond to traditional treatments at submaximal dosages...

The author seeks to explore the development and treatment of dissociative symptoms emerging in a 17-year-old nonbinary individual throughout two inpatient psychiatric hospitalizations. The patient endorsed the presence of multiple selves that remained connected with reality and internally with each other, emphasizing their existence in spatial allocations within the patient's mind both while dreaming and in waking life. The author highlights the therapeutic space as an opportunity to allow the interaction between dissociated selves surging from violent childhood experiences in hopes of allowing the integration of the fragmented parts of the main self...

INTRODUCTION: The brain waves pattern in primary insomniacs is different from healthy subjects. Studies have shown that binaural beats can alter the pattern of brain waves in healthy individuals; however, the efficacy of binaural beats in altering the pattern of brain waves in primary insomniacs has not yet been investigated. This study aims to evaluate the efficacy of theta binaural beat on the absolute power of theta activity in primary insomniacs. METHODS: This study was a randomized clinical trial with experimental and control groups...

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Acetylcholine is a neurotransmitter and neuromodulator involved in a variety of cognitive functions. Additionally, acetylcholine is involved in the regulation of REM sleep: cholinergic neurons in the brainstem and basal forebrain project to and innervate wide areas of the cerebral cortex, and reciprocally interact with other neuromodulatory systems, to produce the sleep-wake cycle and different sleep stages. Consciousness and cognition vary considerably across and within sleep stages, with metacognitive capacity being strikingly reduced even during aesthetically and emotionally rich dream experiences...

Isolated rapid eye movement (REM) sleep behaviour disorder (iRBD) is a sleep disorder that is characterised by dream enactment episodes during REM sleep. It is the strongest known predictor of α-synuclein-related neurodegenerative disease (αNDD), such that >80% of people with iRBD will eventually develop Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy in later life. More research is needed to understand the trajectory of phenoconversion to each αNDD. Only five 'gold standard' prevalence studies of iRBD in older adults have been undertaken previously, with estimates ranging from 0...

Mind-wandering is a mental state in which attention shifts from the present environment or current task to internally driven, self-referent mental content. Homeostatic sleep pressure seems to facilitate mind-wandering as indicated by studies observing links between increased mind-wandering and impaired sleep. Nevertheless, previous studies mostly relied on cross-sectional measurements and self-reports. We aimed to combine the accuracy of objective sleep measures with the use of self-reports in a naturalistic setting in order to examine if objective sleep parameters predict the tendency for increased mind-wandering on the following day...

Wakefulness, non-rapid eye-movement (NREM) and rapid eye-movement (REM) sleep differ from each other along three dimensions: behavioral, phenomenological, physiological. Although these dimensions often fluctuate in step, they can also dissociate. The current paradigm that views sleep as made of global NREM and REM states fail to account for these dissociations. This conundrum can be dissolved by stressing the existence and significance of the local regulation of sleep. We will review the evidence in animals and humans, healthy and pathological brains, showing different forms of local sleep and the consequences on behavior, cognition, and subjective experience...

Dreaming is a complex phenomenon that occurs during sleep, involving various conscious dream experiences. Lucid dreams (LDs) involve heightened awareness within the dream environment, while out-of-body experiences (OBEs) involve the sensation of being outside one's physical body. OBEs occur during sleep paralysis (SP), where voluntary movements are inhibited during sleep/wake transitions while remaining aware of the surroundings. The relationship between LDs and OBEs is debated, with some viewing them as distinct phenomena and others considering them different manifestations of the same underlying experience...

OBJECTIVE: Nightmares are dysphoric dreams present in both clinical and non-clinical populations. Physiological activity underlies their emotional reactivity. Therefore, the objective of this study was to investigate the role of interoceptive processes (interoceptive sensibility and nociception) in nightmares in the general population. METHOD: 542 French participants were recruited from the general population to complete an online survey. Interoceptive sensibility, nociception, nightmare frequency and nightmare distress were assessed through online scales and questionnaires...

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream-enactment behaviors that emerge during a loss of REM sleep atonia. Untreated RBD carries risks for physical injury from falls or other traumatic events during dream enactment as well as risk of injury to the bed partner. Currently, melatonin and clonazepam are the mainstay pharmacological therapies for RBD. However, therapeutic response to these medications is variable. While older adults are most vulnerable to RBD, they are also particularly vulnerable to the adverse effects of benzodiazepines, including increased risk of falls, cognitive impairment, and increased risk of Alzheimer's disease...