Sleep and dream disturbances associated with dissociative experiences

Some dissociative experiences may be related, in part, to REM intrusion into waking consciousness. If so, some aspects of dream content may be associated with daytime dissociative experiences. We tested the hypothesis that some types of dream content would predict daytime dissociative symptomology. As part of a longitudinal study of the impact of dreams on everyday behavior we administered a battery of survey instruments to 219 volunteers. Assessments included the Dissociative Experiences Scale (DES), along with other measures known to be related to either REM intrusion effects or dissociative experiences. We also collected dream reports and sleep measures across a two-week period from a subgroup of the individuals in the baseline group. Of this subgroup we analyzed two different subsamples; 24 individuals with dream recall for at least half the nights in the two-week period; and 30 individuals who wore the DREEM Headband which captured measures of sleep architecture. In addition to using multiple regression analyses to quantify associations between DES and REM intrusion and dream content variables we used a split half procedure to create high vs low DES groups and then compared groups across all measures. Participants in the high DES group evidenced significantly greater nightmare distress scores, REM Behavior Disorder scores, paranormal beliefs, lucid dreams, and sleep onset times. Validated measures of dreamed first person perspective and overall dream coherence in a time series significantly predicted overall DES score accounting for 26% of the variance in dissociation. Dream phenomenology and coherence of the dreamed self significantly predicts dissociative symptomology as an individual trait. REM intrusion may be one source of dissociative experiences. Attempts to ameliorate dissociative symptoms or to treat nightmare distress should consider the stability of dream content as a viable indicator of dissociative tendencies.

Nightmare distress is related to traumatic childhood experiences, critical life events and emotional appraisal of a dream rather than to its content

Nightmares are a substantial burden for sleep quality. Previous studies have shown that traumatic experiences can increase the probability of nightmares, and also waking-life distress can enhance this effect. There is evidence that the intensity of negative dream emotions is more responsible for rating a dream as a nightmare than threatening dream contents. However, there is still a lack of research concerning effects on nightmare distress. We hypothesise that traumatic childhood experiences (such as emotional abuse, obtained by the Childhood Trauma Questionnaire), critical life events (obtained by the Social Readjustment Rating Scale) and threatening dream contents are associated with nightmare distress. A sample of N = 103 participants kept a dream diary over 28 consecutive days. About 60% of the sample were frequent nightmare dreamers. The participants recorded their violent dream contents and dream emotions in their diary. To predict nightmare distress, regression models were constructed; nightmare distress was measured with the Nightmare Distress Questionnaire. Results showed that emotional abuse in childhood and critical life events predicted nightmare distress. Moreover, violent dream contents were associated with nightmare distress but, after we controlled for nightmare frequency and the intensity of negative dream emotions, the significant impact of violent dream contents decreased. The results suggest that the emotional appraisal of a dream has a substantial influence on nightmares in addition to traumatic childhood experiences and critical life events.

Emotion dysregulation in idiopathic rapid eye movement sleep behavior disorder

STUDY OBJECTIVES

To characterize emotion regulation strategies in patients with idiopathic REM sleep behavior disorder (iRBD) and to explore whether these strategies are associated with clinical symptoms.

METHODS

In this cross-sectional multicenter study, a total of 94 polysomnography-confirmed iRBD patients (mean age, 67.6 years; men, 56%) and 50 healthy controls (mean age, 65.4 years; men, 48%) completed the Cognitive Emotion Regulation Questionnaire (CERQ), the Korean version of the RBD questionnaire-Hong Kong (RBDQ-KR), the Buss-Durkee Hostility Inventory (BDHI), the second edition of the Beck Depression Inventory (BDI-II), and the Korean version of the Montreal Cognitive Assessment (MoCA-K).

RESULTS

The iRBD group had lower CERQ adaptive scores than the control group, whereas the CERQ maladaptive scores were not significantly different between the groups. Among the CERQ adaptive subscales, the scores for positive refocusing, refocusing on planning, and positive reappraisal were significantly lower in the iRBD group than in the control group. Higher CERQ adaptive scores were correlated with lower scores on RBDQ-KR factor 1 (dream-related) and the BDI-II and higher MoCA-K scores but were not correlated with RBDQ-KR factor 2 (behavioral manifestation) or BDHI scores. Among the dream content-related items of RBDQ-KR factor 1, the CERQ adaptive score was associated only with frequent nightmares. No correlation was found between CERQ maladaptive scores and any variable except for a positive correlation with BDI-II scores.

CONCLUSIONS

Our results provide evidence of emotion regulation deficits in iRBD patients. Furthermore, these results were linked to dream-related factors, especially nightmares, along with depressive symptoms and cognitive impairment.

Supernatural Agent Cognitions in Dreams

Purpose:To test the hypothesis that supernatural agents (SAs) appear in nightmares and dreams in association with evidence of diminished agency within the dreamer/dream ego.

Methods:Content analyses of 120 nightmares and 71 unpleasant control dream narratives.

Results:We found that SAs overtly occur in about one quarter of unpleasant dreams and about half of nightmares. When SAs appear in a dream or nightmare they are reliably associated with diminished agency in the dreamer. Diminished agency within the dreamer occurs in over 90% of dreams (whether nightmares or unpleasant dreams) that have overt SAs. In about half of nightmare reports the SA appears suddenly with no clear emergence pattern. In some two thirds of unpleasant dreams, however, the SA emerged from a human character. The SA’s gender was indeterminate in most dreams with SAs but the SA communicated with the dreamer in 24% of nightmares and only 13% of unpleasant dreams. In most nightmares, the SA intended to harm the dreamer and in one third of nightmares the dreamer was the victim of physical agression by the SA. SA intentions in unpleasant dreams were more varied and actually benign in 13% of cases.

Conclusion:Supernatural agents reliably appear in nightmares and unpleasant dreams in association with diminished agency in the dreamer. Diminished agency in an individual may facilitate supernatural agent cognitions.