Brain : a journal of neurology
July 1, 2019
Célia Lacaux, Charlotte Izabelle, Giulio Santantonio et al.
47 citations
People with narcolepsy, who enter REM sleep abnormally quickly and often experience lucid dreaming, show higher creativity than healthy controls. In a study of 185 narcolepsy patients and 126 controls, those with narcolepsy scored higher on the Test of Creative Profile (58.9 vs. 55.1) and the Creativity Achievement Questionnaire (10.4 vs. 6.4). Objective tests of creative performance in 30 patients and 30 controls also favored the narcolepsy group (4.3 vs. 3.7). Most narcolepsy symptoms—sleepiness, hypnagogic hallucinations, sleep paralysis, lucid dreaming, and REM sleep behavior disorder—were linked to higher creativity scores, suggesting that lifelong heightened REM sleep access may enhance creative potential.
Brain Sciences
October 20, 2021
Serena Scarpelli, Valentina Alfonsi, Maurizio Gorgoni et al.
23 citations
During the second wave of the COVID-19 pandemic, people reported lower dream recall, fewer nightmares, less frequent lucid dreams, and reduced emotional intensity in dreams compared to the first wave. Dreams during the second wave had a more negative tone. Changes in dream frequency between the two waves were linked to post-traumatic growth, sleep-related PTSD symptoms, and sleep quality. Emotional features of dreams correlated with pandemic-related factors such as job changes, forced quarantine, having infected relatives or friends, and seeking mental health help. The findings partly support the continuity hypothesis, which links dream content to waking experiences.
Nature and Science of Sleep
January 1, 2020
Anita D'Anselmo, Sergio Agnoli, Marco Filardi et al.
19 citations
People with type 1 narcolepsy who experience hypnagogic hallucinations (vivid dream-like sensations at sleep onset) show greater creative achievement and potential. In a study of 66 patients, spontaneous mind wandering was linked to creative success, but this link was strengthened by the presence of both sleep paralysis and hypnagogic hallucinations. These hallucinations also shaped patients' creative identity, which in turn predicted higher creative performance on a divergent thinking test (generating original solutions) and real-world creative achievement. The findings suggest that hypnagogic hallucinations trigger mind-wandering processes and influence self-concept, together boosting creativity in narcolepsy.
Frontiers in Psychology
January 1, 2021
Serena Scarpelli, Valentina Alfonsi, Anita D'Anselmo et al.
18 citations
During the Italian COVID-19 lockdown, people with narcolepsy type-1 (NT1) reported more lucid dreams than matched controls, and those lucid dreams were linked to greater creativity and problem-solving during waking hours. The study compared 43 NT1 patients with 86 controls. NT1 patients had higher sleepiness, while controls had more sleep disturbances—a difference that disappeared after accounting for medication. Among NT1 patients, nightmare frequency correlated with female gender, longer sleep, and more wakefulness within sleep; dream recall, nightmares, and lucid dreams all correlated with sleepiness. The findings confirm a connection between lucidity and creativity in NT1 but cannot establish causality due to the small sample and cross-sectional design.
Nature and Science of Sleep
August 1, 2022
Brigitte Holzinger, Franziska Nierwetberg, Frances Chung et al.
16 citations
High nightmare frequency (≥1–2 nights/week) rose from 13.24% to 22.35% during the COVID-19 pandemic. Factors associated with high nightmare frequency included self-reported post-traumatic stress symptoms (OR=2.11), other mental disorders, sleep problems, financial burden, confinement, having had COVID-19, and work situation. Post-traumatic stress symptoms partly mediated the relationship between pandemic-related stressors and nightmare frequency. The authors conclude that the pandemic caused traumatization in a substantial proportion of society and suggest that health care workers screen for nightmares as an indicator of post-traumatic stress symptoms and other disorders.
Frontiers in Neurology
January 1, 2020
Baland Jalal, Ludovico Moruzzi, Andrea Zangrandi et al.
13 citations
A small pilot study tested Meditation-Relaxation (MR) therapy for sleep paralysis (SP) in ten patients with narcolepsy. Over eight weeks, the six patients receiving MR therapy showed a 50% reduction in days with SP and a 54% reduction in total SP episodes in the last month, with large within-group effect sizes. The four patients in the control group (deep breathing) did not show similar improvement. These preliminary findings provide the first proof-of-concept evidence that MR therapy may reduce frequent SP, and the authors cautiously suggest the approach might generalize to people with isolated SP.
Nature and Science of Sleep
January 1, 2023
Serena Scarpelli, Valentina Alfonsi, Milena Camaioni et al.
3 citations
Dream recall, nightmares, lucid dreams, and emotional intensity all decreased between the first and third waves of the COVID-19 pandemic in a large Italian sample. People whose general psychological distress improved during that period reported fewer nightmares and less nightmare distress than those whose distress stayed the same or worsened. Poor sleep hygiene was a strong predictor of nightmare distress among the group that did not improve. The findings suggest that people adapted to the pandemic over time and that nightmares are closely tied to well-being, with both stable traits (age, sex) and sleep-related factors influencing nightmare features.
Journal of Sleep Research
April 1, 2026
Severin Ableidinger, Luigi De Gennaro, Sérgio Mota-Rolim et al.
During the COVID-19 pandemic, about 30% of people frequently knew they were dreaming (lucid dreaming), and roughly half of those (17%) could influence their dreams (lucid dreaming with agency). Female gender and anxiety symptoms were linked to less ability to influence dreams, while dream recall, nightmares, insomnia, dream enactment behavior, sleep vocalization, short and long COVID, and PTSD were linked to more ability. Older age, dream recall, nightmares, and anxiety were linked to lucid dreaming without agency, while short sleep, being an evening type, and short COVID were linked to less of it. The different patterns suggest lucid dreaming with and without agency may be distinct sleep states, and this is the first study showing COVID-19 and long COVID are associated with lucid dreaming.
Journal of Sleep Research
February 1, 2026
Courtney J Bolstad, Bjørn Bjorvatn, Ngan Yin Chan et al.
In a large multi-country survey of 15,854 adults, frequent dream recall (at least weekly) was reported by 54.0% of participants in 2021 and 51.1% in 2019. Frequent nightmares rose from 6.9% in 2019 to 11.0% in 2021, suggesting an increase during the COVID-19 pandemic. Dream recall showed a linear relationship with sleep duration, while nightmare frequency had a quadratic relationship. Prevalence rates varied by age, gender, and country. This is the first multi-continent study to provide these prevalence estimates across 16 countries, including some never studied before.
Journal of Sleep Research
October 1, 2024
Courtney J Bolstad, Brigitte Holzinger, Serena Scarpelli et al.
During the COVID-19 pandemic, suicidal ideation was 2% lower overall than before, while nightmare frequency increased by 4.50%. Data from 9328 individuals across 16 countries showed that suicidal ideation decreased significantly in Austria, Sweden, and Bulgaria but rose non-significantly in Italy and Portugal. Participants with long-COVID reported higher rates of suicidal ideation (21.10%) than those with short-COVID (12.40%), though ideation did not differ by COVID-19 history alone. Nightmare frequency was higher in those with prior COVID-19 (14.50% vs. 10.70%), during active infection (23.00% vs. 8.10%), and in long-COVID (18.00% vs. 8.50%). Frequent nightmares during the pandemic increased the odds of suicidal ideation (OR = 1.
Nature and Science of Sleep
January 1, 2022
Serena Scarpelli, Michael R Nadorff, Bjørn Bjorvatn et al.
People reported more dream activity during the pandemic than before it. Those who had COVID-19 reported significantly more nightmares during the pandemic than matched controls who had not had COVID-19, while dream recall frequency did not differ between the groups. COVID-19 participants also had higher anxiety, depression, and PTSD symptom scores, and lower quality of life and well-being scores than controls. Nightmare frequency was predicted by dream recall frequency, PTSD, anxiety, insomnia, COVID-19 severity, sleep duration, and age. The findings suggest that the more severely people were affected by COVID-19, the greater the impact on dream activity and quality of life.
Journal of Sleep Research
October 1, 2021
Serena Scarpelli, Valentina Alfonsi, Anastasia Mangiaruga et al.
During the COVID-19 lockdown, a large Italian sample reported more frequent nightmares and dreams compared to a population-based sample. Predictors of high dream recall included young age, female gender, not having children, and sleep duration. High nightmare frequency was predicted by young age, female gender, changes in napping, sleep duration, intrasleep wakefulness, sleep problem index, anxiety, and depression. Higher emotional features of dream activity occurred in workers who stopped working, people with relatives or friends infected by or who died from COVID-19, and those who changed sleep habits. These findings support the continuity hypothesis linking daily experiences to sleep mentation and the arousal-retrieval model linking poor sleep to nightmares.
Nature and Science of Sleep
January 1, 2021
Eirin Fränkl, Serena Scarpelli, Michael R Nadorff et al.
Dream recall frequency increased during the COVID-19 pandemic compared to pre-pandemic levels across four continents. In a cross-sectional web survey of 19,355 individuals from 14 countries, high dream recall (three or more nights per week) was associated with female gender, nightmares, sleep talking, sleep maintenance problems, symptoms of REM sleep behavior disorder, and repeated disturbing thoughts indicative of PTSD. Older adults aged 55-64 reported less high dream recall than younger participants. While unadjusted analyses showed associations between depression, anxiety, and dream recall, adjusted analyses revealed negative associations: depression and anxiety were linked to lower odds of high dream recall. The findings suggest that the pandemic's emotional intensity is reflected in dreams.
Sleep
August 12, 2020
Carlo Cipolli, Fabio Pizza, Claudia Bellucci et al.
People with narcolepsy type 1 recalled detailed dream experiences after 75% of naps that included sleep onset REM periods (SOREMPs) and after 25% of naps without REM sleep. Story-grammar analysis showed that dreams from daytime SOREMP naps are organized as hierarchically ordered sequences of events, called dream-stories, which are longer and more complex in the first and fourth SOREMP naps and comparable in structure to dreams from nighttime REM sleep. This similar structural organization suggests that the cognitive processes underlying dreaming are highly, though not uniformly, effective during daytime SOREMP sleep, and investigating these dreams may clarify links between brain physiology and psychological processes in REM dreaming.
Frontiers in Neuroscience
January 1, 2020
Carlo Cipolli, Fabio Pizza, Claudia Bellucci et al.
People with narcolepsy type 1 (NT1) report dreams after about 80% of naps that begin with REM sleep (SOREMP naps), as often as healthy people report dreams after nighttime REM sleep. However, after NREM naps, NT1 patients report dreams only about 30% of the time, compared to 60% for healthy subjects. This study tested whether the low NREM dream recall in NT1 is due to a failure to generate dreams or a failure to recall them. Seventeen NT1 patients and 25 subjects with excessive daytime sleepiness took multiple daytime naps and reported dreams, white dreams (sense of having dreamed but no content), or no dreams. White dreams were more frequent in NT1 patients (42.86% vs. 17.
Annals of Clinical and Translational Neurology
March 1, 2019
Aurora D'Atri, Serena Scarpelli, Cinzia Schiappa et al.
In drug-free adults with narcolepsy type 1, successful dream recall after naps is linked to a more activated brain state during both REM and NREM sleep. Using scalp EEG, the study found that recall was associated with lower delta power over centro-parietal areas in both sleep stages, higher beta power in those areas during NREM, and a lower delta/beta ratio across most scalp locations during NREM. These results suggest that a more desynchronized, activated electrophysiological milieu promotes dream recall, and that parietal areas are important not only for generating dream experiences but also for the memory processes that enable recall.
Sleep Medicine Reviews
October 1, 2017
Carlo Cipolli, Michele Ferrara, Luigi De Gennaro et al.
Recent advances in electrophysiological techniques, video-polysomnography, transcranial stimulation, and neuroimaging allow more accurate investigation of the neural correlates of dreaming in healthy individuals and patients with brain damage, neurodegenerative diseases, sleep disorders, or parasomnias. Convergent evidence has led to reformulation of unresolved issues of dream generation and recall within more comprehensive models of human consciousness. These studies are casting new light on the neural bases—particularly activity in dorsal medial prefrontal cortex, hippocampus, and amygdala—of inter- and intra-individual differences in dream recall, temporal location of dream content, and memory processing during sleep. Hd-EEG techniques appear able to provide further insights into how the brain generates dreaming and dreamlike waking experiences.
Sleep Medicine Reviews
August 1, 2016
Elena Antelmi, Raffaele Ferri, Alex Iranzo et al.
State dissociation disorders occur when features of one state of being—wakefulness, REM sleep, or NREM sleep—intrude into another. Examples include cataplexy, sleep paralysis, REM sleep behavior disorder, and disorders of arousal. The most extreme form, status dissociatus, involves a breakdown of all recognizable states; it can occur intermittently in conditions like narcolepsy type 1 or continuously in agrypnia excitata. This review classifies the full range of diseases and disorders associated with state dissociation and status dissociatus.
Brain Research Bulletin
January 15, 2010
Michela Mazzetti, Claudia Bellucci, Katia Mattarozzi et al.
People with narcolepsy-cataplexy (NC) produce longer and more complex dream reports after the first REM period of the night than healthy controls, suggesting their dream-generation cognitive processes reach optimal functioning earlier. In a study of 14 NC patients and matched controls, dream recall rates were similar (about 90%), but NC patients' spontaneous reports after the first REM awakening were longer and more structurally complex, and half also provided prompted reports of additional dream content. After the third REM awakening, both groups gave prompted reports at similar rates. The findings indicate that in NC the brain mechanisms for constructing dream narratives become fully active earlier in the night, and raise the question of whether prompted and spontaneous reports describe the same or different dreams.
Brain Research Bulletin
October 22, 2008
Carlo Cipolli, Claudia Bellucci, Katia Mattarozzi et al.
People with narcolepsy with cataplexy (NC) experience longer and more complex dream stories during the first REM sleep period of the night compared to healthy individuals. Dream recall rates were similar between groups, at about 85%. The findings suggest that the cognitive processes that generate dreams reach their optimal functioning earlier in the night in NC patients than in normal subjects.