Rapid eye movement sleep,non-rapid eye movement sleep,dreams, and hallucinations |
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Authors: | Raffaele Manni |
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Institution: | (1) Istituto Neurologico “C. Mondino” Via Mondino 2, 27100 Pavia, Italy |
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Abstract: | After the discovery of rapid eye movement (REM) sleep in 1953, oneiric activity was long thought to be associated uniquely
with REM sleep. Subsequent evaluation of sleep in humans combining neurophysiologic, psychophysiologic, and, more recently,
functional neuroimaging investigations, has instead shown that dreaming also occurs during non-REM (NREM) sleep. It has been
documented that hallucinatory activity during sleep is a normal phenomenon that is not constant throughout the night but increases
toward morning when it tends to become present to the same extent in REM and NREM sleep. The role of sleep mechanisms in the
generation of visual hallucinations is well-recognized in narcolepsy in the case of hypnagogic hallucinations, which are thought
to derive from a REM-dissociation state in which dream imagery intrudes into wakefulness. Similar mechanisms have been hypothesized
to play a role in the physiopathogenesis of visual hallucinations in various neuropsychiatric disorders. Furthermore, a growing
body of evidence indicates that not only REM but also NREM processes, such as arousal-related processes, may play a role in
the physiopathogenesis of hallucinations in the aforementioned disorders. The role of these processes has been most extensively
documented in visual hallucinations occurring in the context of delirium tremens and Parkinson’s disease. |
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