Circadian and ultradian influences on dreaming: a dual rhythm model

The dual rhythm model of dreaming states that, under high sensory thresholds, heightened general cortical activation common to both REM/NREM and circadian-driven activation cycles sums to produce the main characteristics of dreaming. In addition, the unique pattern of regional brain activation characteristic of REM sleep amplifies the emotional intensity of the dream. Subjects were awakened from REM and NREM sleep once near the nadir of the core body temperature rhythm, where circadian-driven cortical activation was assumed to be low, and again in the late morning, where this activation was presumed to be high. As predicted, changes in the central characteristics of dream reports mirrored REM/NREM and circadian-driven fluctuations in general activation, while at the same time, the regional activation pattern unique to REM sleep amplified dream emotionality selectively in REM reports.     

Epidemiology of disturbing dreams in a diverse US sample

Study objectivesDisturbing dreams are a common complaint among trauma survivors, but little epidemiological research exists to document the frequency in the general population. In addition, information about their occurrence in diverse adults is lacking.MethodsUsing the Collaborative Psychiatric Epidemiology Surveys we had the unique opportunity to examine disturbing dreams in a diverse sample of adults in the US. Disturbing dreams were measured in three different variables including trauma dreams, dreams of the worst event, and dreams of separation. A fourth variable was created to assess for any disturbing dream reported across the three categories.ResultsDisturbing dream prevalence varied in the overall sample (N = 20,013) based on the assessment question. Dreams of trauma was 2.01% in the overall sample, dreams of the worst event was 7.21% and dreams of separation was 1.73%. Prevalence rates of all dream variables varied by racial and ethnic group membership, gender, and age. Odds ratios were also calculated for the three variables of interest by racial and ethnic group with significant differences emerging. Women had significantly higher rates of disturbing dreams in all variables assessed (p < 0.01). Older adults reported significantly lower rates of disturbing dreams compared to younger and middle-aged adults (p < 0.001).ConclusionsThis study establishes prevalence rates for disturbing dreams in a diverse sample of US adults. Understanding the prevalence can aid in reducing barriers to care for evidence-based treatments currently underutilized.     

Pandemic dreams: quantitative and qualitative features of the oneiric activity during the lockdown due to COVID-19 in Italy

ObjectiveThe lockdown due to COVID-19 pandemic had a strong impact on daily habits, emotional experience, mental health and sleep. A large body of evidence suggests that dreams are affected by both waking experiences and sleep pattern. In this view, the lockdown should have induced intense modifications in dreaming activity. The aim of the study was to assess dream features during the lockdown in Italy.MethodsWe used an online survey to collect self-reported demographic, clinical, sleep and dream data. Our sample included 1091 participants.ResultsResults point to an increased dream frequency, emotional load, vividness, bizarreness and length during the lockdown, compared to a pre-lockdown period. Higher dream frequency and specific qualitative features were found in females and subjects with poor sleep quality, nocturnal disruptive behaviours and depressive symptoms. Most of the dream features assessed during the lockdown were predicted by age, gender, depressive symptoms, presence/absence of other people at home, and territorial area. A specific focus on sleep features revealed that sleep duration and several sleep quality indexes were the best predictors of dream variables. During the lockdown, dreams were also characterized by increased negative emotions, which were particularly frequent in females, younger adults, and participants with poor sleep quality, nocturnal disruptive behaviours, anxiety and depressive symptoms.ConclusionsOur results confirm the hypothesis of a strong influence of the pandemic on dreaming, supporting both the hypothesis of continuity between wake and sleep mental processes and the view of a crucial influence of sleep quality and duration on dreaming activity.     

Metodeutvikling ved etterundersøkelse av kvinner med alkoholproblemer

Artikkelen beskriver de vansker som er forbundet med langtidsstudier av en så stigmatisert pasientgruppe som kvinnelige alkoholmisbrukere er. Hovedvekten er lagt på beskrivelse av kontaktetablering, metodeutvikling og aweining mellom forskningsmessige og etiske hensyn.

Forfatteren er spesialist i psykiatri. Hun var i tidsrommet 1976–81 overlege ved Blå Kors Sosialbygg, Bergen, som mottar klienter med alkoholproblemer til avrusning og videreformidling i behandlingsapparatet. De siste to årene hat forfatteren vært NAVF- stipendiat rned henblikk på å gjøre en personlig etterundersøkelse av kvinnelige alkoholmisbrukere.

The article presents some of the ethical, practical and methodological problems of a personal, long-term follow-up study of 53 women treated for alcohol dependence.

The author describes the problems of establishing contact with this client group. Passive avoidance is the most frequent response to a written request about a research interview. This is an understandable reaction to any kind of research involving sensitive personal matters. But, especially in this group, it also means activation of feelings of shame as well as fantasies about being exploited or controlled. To overcome this difficulty, the researcher has to go and see the informant in her home. In a face-to-face situation, the researcher and the client have an opportunity to discuss more directly the clients feelings and the ethics involved. Following this procedure, 80% of the identified women were willing to participate in the follow-up interview.

The actual patient group is socially unstable and difficult to trace by the public census. The necessity of gaining access to informal information on their actual living place, is stressed.

Most of the interviews took place in the clients' home. This interview situation facilitated an atmosphere of openness and self-reflection on the part of the clients. On the other hand, it also created a tendency which favored small talk on everyday problems. Thus the interview situation put demands upon the researcher to keep a delicate balance between the necessary control of the interview versus a spontaneous conversation, the needs of the client to talk for her own sake versus the researcher's scientific curiosity, and professional distance versus personal closeness.

If the researcher is an experienced clinician, a follow-up interview in many cases will have positive therapeutical implications for the actual client group.

Planning for the possibility of follow-up studies as part of the administrative organization of the treatment, patient consent can be obtained for using a stable contact person in her social network as a helper in the process of longer term follow-up and, thus, will facilitate the present studies.     

Patients' dreams and unreal experiences following intensive care unit admission

Dreams and unreal experiences occur commonly in critically ill patients admitted to intensive care unit. This study describes 31 patients' dreams and explores the relationship between patients' subjective recall 12-18 months after intensive care unit discharge and their observed behaviour during their intensive care unit stay. Semi-structured interviews revealed that 74% of longer-term ICU patients (> or = 3 days) reported dreaming, with the majority also describing frightening hallucinations. Only two patients reported long-term negative psychological sequelae, but the short-term consequence of hallucinations may also have an undiscovered impact on patients' recovery.     

Similarity of Eye Movement Characteristics in REM Sleep and the Awake State

The eye movements of REM (Rapid Eye Movement) sleep have been reported to be slower, i.e., to show reduced velocities, compared to those of the awake state. We demonstrated that REM sleep eye movements are in fact similar in velocity to awake state eye movements under the condition of no visual input (eyes open or closed). Furthermore, we observed that oculomotor velocities and trajectories in REM sleep are more similar to head-unrestrained (normal vision) than head-restrained (bite board) conditions in the awake state. The DC electro-oculogram (EOG) was utilized for all measurements. Both head-unrestrained and REM sleep eye movements contained looped trajectories not present when the head was immobilized. Eyelid closure had little effect beyond that of total darkness. Recumbent body position did not significantly alter velocity characteristics. These data indicate that the eye movements of REM sleep are more congruent with the hallucinated locomotor activity of the dream than with the postural immobility’ of the dreamer.     

The relationship between nightmares and psychotic experiences in young adults

BackgroundThere is indication that frequent nightmares are an early indicator of psychotic disorders in adolescents and young adults. Yet which aspects of nightmares are relevant and how they contribute to psychotic experiences has remained unclear.MethodsWe conducted a cross-sectional online survey in a community sample of young adults between the ages of 18 and 27 (n = 486) to identify aspects of nightmares (nightmare frequency (NF), nightmare distress (ND), nightmare contents), that are related to specific psychotic experiences (paranoid thoughts, hallucinations, negative symptoms) after controlling for sleep quality, and examined factors that potentially mediate this relationship (stress, depression).ResultsNightmare frequency and -distress were significantly associated with paranoid thoughts, hallucinations and negative symptoms (NF: r_s = 0.293 – 0.139; ND: r_s = 0.411 – 0.166). Nightmares significantly added to explaining paranoid thoughts and hallucinations, over and above sleep quality, but not to explaining negative symptoms. The relations between nightmare distress and psychotic experiences were partially mediated by stress (percentage mediated for paranoid thoughts: 38.20%; for hallucinations: 11.77%) and depression (percentage mediated for paranoid thoughts: 56.61%; for hallucinations: 28.02%). The most commonly reported nightmare contents revolved around being chased, falling and losing a close relative and specific contents were significantly related to the frequency of hallucinations (eg, threatening surroundings, OR = 1.73) or paranoia (eg, workspace bullying, OR = 2.02).ConclusionsThorough assessments of nightmares and sleep disturbances in young individuals could facilitate early detection of those at risk and help to target preventive treatments. However, longitudinal studies are needed to test for a causal relationship between nightmares and the development of psychotic symptoms.     

Working with Remembered Childhood Nightmares in Adult Psychotherapy

This essay explores work with adult clients who have a particular attachment to their childhood nightmares. The essay argues that in the remembered nightmares, we have access to particularly well preserved dynamics and memories that can aid work and understanding. It is interesting that in cases where so much may have been forgotten, particularly in cases that involve trauma, memories of these dreams have endured. There is the somewhat tragic sense that some of the problems that have gone on to trouble the client's life were visible in the nightmares, and there to be addressed all those years ago. How different a life might have been if the issues in the childhood nightmares had been addressed at the time when they were first dreamt. The essay pursues the idea that remembered childhood nightmares can supply us with, firstly, important information that can support understanding of clinical work; and secondly, the possibility of assisting someone in carrying out work that has been long neglected.     

Consciousness

For decades Allan Hobson has proclaimed Freud's dream theory as thoroughly mistaken. He has also suggested that Freud's use of the mistaken tenets of 19th-century neurology undermined not just that theory, but also the fundamental psychoanalytic propositions of Freud's (1900/1950b) mental apparatus as conceptualized in Chapter 7 of The Interpretation of Dreams. He is wrong on both accounts! Freud's theory of dreams remains an accurate general framework in which to understand and explore the origins, nature, and meaning of dreams. In addition, embodied within Freud's model of the mental apparatus are inferences about brain processes not just relevant to dreams but also to conscious perception, memory, reality testing, and creativity that are remarkably consonant with modern neuroscientific understanding.     

基于《黄帝内经》探究“梦”的发生机制

基于《黄帝内经》对梦的性质、分类、产生、治则进行全面探究,着重分析梦的发生机制。在生理方面认为常梦(生理性质的梦)的发生与气(魂魄)、津血、心神有关;在病理方面,认为坏梦(病理性质的梦)的发生与外邪扰乱营卫和内里气虚不充有关。根据坏梦产生的不同原因,将坏梦进一步分为由外因引起的盛梦和不足梦,由内因引起的妄梦和迷梦,根据坏梦的两个临证特点即外邪侵淫脏腑、扰动营卫形成营卫不和之证及五脏内里不充、少气气虚、津血难生形成气阴两虚之证,总结出“调和营卫”“补气生阴”基本治则。