Nightmares are overrepresented in psychiatric disorders and are strongly associated with suicidality, especially in Major Depressive Episode (MDE). This study had two main objectives: (1) to determine an optimal diagnostic cutoff for the Nightmare Severity Index (NSI) to identify Nightmare Disorder (ND), and (2) to compare the clinical profiles of MDE patients with ND (MDE-ND) and without ND...
Hyperonirism, or "epic dreaming," is an emerging clinical phenomenon characterized by excessive, vivid, and continuous dream activity associated with non-restorative sleep and daytime fatigue. Despite historical descriptions, it remains poorly defined and unrecognized by current nosological systems. We describe four patients assessed in expert sleep and psychiatry centers, presenting with...
Julia Maruani, Pierre A Geoffroy; Nightmare-Focused Interventions and Suicide Prevention: Clarifying the Role of Imagery Rehearsal Therapy and Prazosin, Sl
BACKGROUND: Nightmare complaints are common among individuals with psychiatric disorders and are associated with significant emotional distress and functional impairment. Despite their clinical relevance, they remain frequently under-recognized and under-treated in psychiatric settings. OBJECTIVE: To offer a pragmatic, clinician-oriented framework for the evaluation and management of nightmare...
Nightmares are repeated and lengthy dreams, extremely dysphoric, with clear memory, typically involving life-threatening threats to safety or physical integrity. These nightmares lead to significant distress upon awakening and may substantially impact daytime functioning. Both the experience of these dreams and the sleep disruption produced by the ensuing awakening cause significant impairment...
Nightmare Disorder characterized by recurrent dysphoric dreams is strongly associated with major depressive episodes (MDE) and suicidal risk. Imagery rehearsal therapy (IRT) is the standard treatment for nightmares, but its effectiveness in individuals with MDE remain understudied. This study evaluated whether IRT is associated with greater improvement in nightmare symptoms compared to sleep...
INTRODUCTION: Premenstrual syndrome (PMS) affects nearly half of women worldwide and is associated with sleep disturbances, though the specific relationship between PMS and nightmares remains underexplored. Clinical observations suggest a potential link, leading this study to investigate whether women with PMS experience more frequent or intense nightmares compared to those without PMS....
This exploratory study aimed to investigate the relationship between interoceptive sensibility and quality of consciousness in individuals with insomnia disorder, in order to understand how the modulation of internal states may contribute to modifying the experience of consciousness during sleep difficulties. A total of 37 patients with insomnia disorder (mean age = 46.05 ± 18.16) and 41...
This psychometric pilot study aims to evaluate a new multidimensional simple scale, named the nightmare severity index (NSI) - close to the existing insomnia (ISI) and hypersomnia (HSI) severity indexes. The NSI encompasses all main dimensions of nightmare disorder, evaluating four subdimensions: frequency, emotional impact, diurnal impact, and nocturnal impact of nightmares. The NSI was...
Introduction Sleep and circadian markers are of increasingly growing interest to help better predicting suicide. Indeed, specific sleep disorders and circadian rhythm disorders have been associated to suicidal behaviors, and the most replicated findings are insomnia and nightmares. Nevertheless, these interesting preliminary studies did not examine the chronology and trajectories of these dream...
Objective: Nightmares seem to predict suicidal behaviors, and the aim of this study is to explore the chronology and trajectories of alterations in dream contents before a suicidal crisis, distinguishing 3 different experiences: bad dreams, nightmares, and suicidal scenarios during dreams. Methods: This naturalistic study included individuals hospitalized between January 2021 and May 2021 in a...