A 7-year history of vivid, immersive dreaming perceived as continuous with waking life, accompanied by persistent dream-reality confusion, is described in a younger individual. The patient engaged in reality-testing behaviors and reported significant cognitive fatigue. Video-polysomnography confirmed REM sleep without atonia and a dream re-enactment episode. Neuropsychiatric evaluation ruled out dissociative or psychotic disorders, and no neurodegenerative disease was observed. The case suggests a potentially distinct, non-neurodegenerative REM parasomnia phenotype, highlighting the need to expand current classifications to capture cognitive and metacognitive dimensions of REM sleep disorders. Potential mechanisms involving melanin-concentrating hormone signaling are discussed.
Among older adults in a Tasmanian community cohort, 7.1% screened positive for probable REM sleep behavior disorder (pRBD). Females with pRBD reported more nightmares related to waking-life experiences than males. Compared to controls, the pRBD group recalled dreams more often, experienced more lucid dreams, and had more nightmares during childhood. The findings suggest that screening questionnaires focusing on aggressive dream features may miss females with RBD, and including questions about waking-life-related nightmares could improve detection.
A microscale biophysical network model of layer-5 pyramidal neurons reproduces coarse-sampled dynamics seen in macroscale electrophysiological recordings from macaques and humans. By inverting the model, the authors identify spike and burst dynamics that distinguish unconscious, dreaming, and awake arousal states and reveal their functional signatures. Neuromodulatory arousal shifts neuronal dynamics around a low-dimensional energy landscape, altering the model's response to external stimuli. The work demonstrates how multiscale modeling can connect theories of consciousness across spatiotemporal scales.