Disorders of arousal (DoA) episodes, such as sleepwalking, are not a uniform state but involve varying levels of consciousness and responsiveness. In a retrospective questionnaire, 81% of 61 adult patients reported occasional conversations during episodes. Auditory stimulation during N3 sleep triggered episodes in only 7 of 157 trials, and only one patient indirectly responded to verbal prompts. Analysis of 364 home video-recorded episodes from 19 patients found 37 instances of discussion with a bed partner. Patients' ongoing mental content influenced their responses and perception of the outside world. These findings highlight limitations in current diagnostic criteria for DoA.
Dreams during REM sleep are emotionally fluid and fast-changing, with positive and negative emotions alternating frequently. In a study of 24 lucid dreamers with narcolepsy who reported emotional valence in real-time using facial codes during daytime naps monitored with polysomnography, 62 of 126 naps contained at least one emotional code during REM sleep, yielding 191 codes total. Positive and negative codes were evenly balanced per nap, and over half of naps with at least two codes showed opposite valences. The average duration of a given emotional valence was about one minute, with positive emotions emerging earlier than negative ones. These findings suggest that the emotional dynamics of REM sleep dreams may contribute to understanding how dreams help regulate emotions.