Frequent nightmares have a high prevalence and constitute a risk factor for psychiatric conditions, but their pathophysiology is poorly understood. Our aim was to examine sleep architecture and electroencephalographic markers-with a specific focus on state transitions-related to sleep regulation and hyperarousal in participants with frequent nightmares (NM participants) versus healthy controls....
This consensus paper provides an overview of the state of the art in research on the aetiology and treatment of nightmare disorder and outlines further perspectives on these issues. It presents a definition of nightmares and nightmare disorder followed by epidemiological findings, and then explains existing models of nightmare aetiology in traumatized and non-traumatized individuals. Chronic...
Abstract Conscious experience varies considerably, not only between wakefulness and sleep but also within sleep. Consciousness during sleep can be rich and vivid in its perceptual content but is typically poor in self-reflective consciousness/meta-consciousness. A notable exception is lucid dreaming: the phenomenon of becoming aware that one is dreaming while continuing to dream during ongoing...
Nightmares are associated with psychopathology and impaired coping in the general population. However, little is known about this association in a psychiatric population. In this study, we investigate whether patients with diverse psychiatric disorders have increased symptomatology and different coping styles if they suffer from comorbid nightmare disorder. Participants were 498 patients with...
Nightmares are a common problem with debilitating consequences. Meta-analyses have revealed that imagery rehearsal therapy (IRT), in which the storyline of the recurring nightmare is changed, is the treatment of choice for nightmares. In a randomized clinical trial, we recently demonstrated that IRT was also effective in a population of patients with diverse psychiatric disorders. In this...
Nightmares are associated with psychopathology and daily distress. They are highly prevalent in a psychiatric population (30%). Currently, imagery rehearsal therapy (IRT) is the treatment of choice for nightmares. With IRT, the script of the nightmare is changed into a new dream, which is imagined during the day. However, the effects of IRT in a psychiatric population remain unknown. The aim of...
The idea that dreaming can serve as a model for psychosis has a long and honourable tradition, however it is notoriously speculative. Here we demonstrate that recent research on the phenomenon of lucid dreaming sheds new light on the debate. Lucid dreaming is a rare state of sleep in which the dreamer gains insight into his state of mind during dreaming. Recent electroencephalogram (EEG) and...
Consciousness is a multifaceted concept; its different aspects vary across species, vigilance states, or health conditions. While basal aspects of consciousness like perceptions and emotions are present in many states and species, higher-order aspects like reflective or volitional capabilities seem to be most pronounced in awake humans. Here we assess the experience of volition across different...
STUDY OBJECTIVES: To investigate the neural correlates of lucid dreaming. DESIGN: Parallel EEG/fMRI recordings of night sleep. SETTING: Sleep laboratory and fMRI facilities. PARTICIPANTS: Four experienced lucid dreamers. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Out of 4 participants, one subject had 2 episodes of verified lucid REM sleep of sufficient length to be analyzed by fMRI. During...
Since the discovery of the close association between rapid eye movement (REM) sleep and dreaming, much effort has been devoted to link physiological signatures of REM sleep to the contents of associated dreams [1-4]. Due to the impossibility of experimentally controlling spontaneous dream activity, however, a direct demonstration of dream contents by neuroimaging methods is lacking. By...
Nightmares are a prevalent disorder leading to daily impairments. Two cognitive-behavioural self-help interventions--imagery rehearsal and exposure--recently showed short-term efficacy compared to a waiting-list and a group that recorded their nightmares. This paper reports the long-term results of the imagery rehearsal (n=103) and exposure (n=95) interventions. Participants were assigned...
Falling asleep is paralleled by a loss of conscious awareness and reduced capacity to process external stimuli. Little is known on sleep-associated changes of spontaneously synchronized anatomical networks as detected by resting-state functional magnetic resonance imaging (rs-fMRI). We employed functional connectivity analysis of rs-fMRI series obtained from 25 healthy participants, covering...
Nightmares are a common disorder with serious consequences. Recently, the cognitive behavioral interventions Imagery Rehearsal Therapy (IRT) and exposure proved effective in a self-help format. The aim of the current study was to compare the following self-help formats to a waiting-list: IRT; IRT with sleep hygiene; and IRT with sleep hygiene and a lucid dreaming section....
Several cognitive-behavioral techniques are effective in reducing nightmare frequency, but the therapeutic factor (e.g. cognitive restructuring, systematic desensitization) remains unclear. The aim of this study was to compare the nightmare treatments imagery rehearsal therapy (IRT), exposure, and recording (keeping a diary)--in a self-help format--with a waiting list. Participants were...
The aim of this review is to evaluate the effectiveness of cognitive behavioral therapy (CBT) on nightmare frequency and to determine which kind of CBT is the most effective treatment. A systematic literature search was carried out in PsychInfo and PubMed articles published on or before May 1, 2008. The inclusion criteria were: nightmare treatment study, use of nonpharmacological treatment, not...
Nightmares are a prevalent mental disorder resulting in disturbed sleep, distress, and impairment in daily functioning. Elaborating on previous theoretical models for anxiety disorders, sleep disorders and dreaming, this study introduces a cognitive model of recurrent nightmares, the central element of which concerns representation of the nightmare’s repetitive storyline in the memory as a...
The DSM-IV-TR definition of nightmares-extremely frightening dreams from which the person wakes up directly-is unnecessarily narrow. Other emotions (anger, grief) have also been reported in nightmares, and direct awakening from a bad dream seems to be unrelated to increased distress. In addition, assessment of nightmares is problematic. Polysomnographic recordings have an ameliorating effect on...
BACKGROUND: The goal of this pilot study was to evaluate the effects of the cognitive-restructuring technique 'lucid dreaming treatment' (LDT) on chronic nightmares. Becoming lucid (realizing that one is dreaming) during a nightmare allows one to alter the nightmare storyline during the nightmare itself. METHODS: After having filled out a sleep and a posttraumatic stress disorder questionnaire,...
Goal of this series of cases was to investigate lucid dreaming treatment for nightmares. Hypotheses were that lucid dreaming treatment would decrease nightmare frequency and state/trait anxiety, and improve the quality of sleep. Eight participants received a one-hour individual session, which consisted of lucid dreaming exercises and discussing possible constructive solutions for the nightmare....