Journal of Sleep Research
January 29, 2019
Annika Gieselmann, Malik Ait Aoudia, Michelle Carr et al.
192 citations
Chronic nightmares arise from an interaction between elevated hyperarousal and impaired fear extinction, facilitated by trait affect distress from traumatic experiences, early childhood adversity, trait susceptibility, elevated thought suppression, and potentially sleep-disordered breathing. Treatment options target nightmare meaning, chronic repetition, or maladaptive beliefs. The paper reviews epidemiological findings, aetiology models for traumatized and non-traumatized individuals, and evidence-based interventions, noting gaps in healthcare provider knowledge and delivery. Future perspectives for nightmare treatment and aetiology research are outlined.
Journal of Sleep Research
May 29, 2012
Ursula Voss, Clemens Frenzel, Judith Koppehele-Gossel et al.
76 citations
Lucid dreaming is common in young children, with its incidence dropping around age 16. A survey of students aged 6-19 found that those in higher-level schools reported more lucid dreams than those in lower-level schools. The authors propose a link between the natural occurrence of lucid dreaming and brain maturation, considering methodological issues.
Journal of Sleep Research
July 27, 2016
Dan Denis, Giulia Poerio
70 citations
Sleep paralysis and lucid dreaming are both dissociated states linked to REM sleep. A survey of 1928 adults (ages 18–82, 53% female) found that more frequent lucid dreaming is associated with more frequent sleep paralysis, especially episodes involving vestibular-motor hallucinations. Dissociative experiences during wakefulness predicted both phenomena. However, sleep paralysis was predicted by poor sleep quality, anxiety, and life stress, whereas lucid dreaming was predicted by a tendency toward positive, constructive daydreaming and vivid sensory imagery. The findings suggest that dissociative tendencies during wakefulness extend into REM sleep, but sleep paralysis reflects sleep and well-being issues, while lucid dreaming may stem from greater imaginative capacity and positive imagery in waking life.
Journal of Sleep Research
April 13, 2022
Serena Scarpelli, Valentina Alfonsi, Maurizio Gorgoni et al.
64 citations
Dream research has moved beyond the simple REM-NREM sleep dichotomy to focus on specific brain features that predict dreaming. Trait-like factors (stable personal characteristics) and state-like factors (electrophysiological activity just before awakening) both influence dream recall. Dreaming connects to waking life: the continuity hypothesis suggests dreams can be modulated by sensory stimulations. Parasomnia episodes may offer direct access to dream content, as recent findings show greater concordance between such events and dream narratives. Nightmares and oneiric activity hold potential clinical value in psychotherapy. Future work needs uniform protocols, advanced manipulation techniques, clarification of parasomnia-dream links, and determination of dreams' clinical relevance.
Journal of Sleep Research
February 1, 2022
Serena Scarpelli, Maurizio Gorgoni, Valentina Alfonsi et al.
37 citations
During the Italian COVID-19 lockdown, 90 participants kept a sleep-dream diary for two weeks: the first week under full lockdown and the second week after restrictions eased. Compared to post-lockdown, the lockdown period was associated with more awakenings, greater difficulty falling asleep, higher dream recall, and more frequent lucid dreams. After restrictions eased, participants reported more dreams about being in crowded places. Poorer sleep quality during lockdown aligns with earlier findings. The increase in lucid dreams during confinement may reflect an attempt to cope with pandemic experiences, while the crowded-place dreams after lockdown support the continuity hypothesis of dreaming.
Journal of Sleep Research
June 1, 2023
Shuyue Tan, Jialin Fan
35 citations
Lucid dreams are dreams where the dreamer knows they are dreaming. A review of 19 peer-reviewed studies from the past decade identified 14 lucid dream induction techniques. The mnemonic induction of lucid dreams technique was the most effective. Two newer techniques—the senses-initiated lucid dream technique and galantamine intervention—also show promise but require further replication. The overall methodological quality of the studies was higher than in a previous review: 17 studies had moderate quality, and only three had poor quality. The review also proposes a modified classification for induction techniques: cognitive techniques, external stimulation, substance intervention, and cortical stimulation.
Journal of Sleep Research
August 26, 2022
Romain Ghibellini, Beat Meier
29 citations
The hypnagogic state is the transitional period between wakefulness and sleep during which sensory perceptions can occur. This review compiles recent scientific literature on hypnagogia, discussing terminology and distinguishing it from related phenomena, and reports its prevalence. It evaluates six future directions proposed by Schacter (1976) and adds three new ones: understanding the emotional quality of hypnagogic states, why they occur so often in visual and kinaesthetic modalities, and their purpose. Research has advanced greatly, bringing us closer to demystifying this state.
Journal of Sleep Research
June 16, 2021
Nelson B Rodrigues, Roger S McIntyre, Orly Lipsitz et al.
28 citations
Sleep disturbances are common in treatment-resistant depression (TRD). Intravenous (IV) ketamine improved sleep symptoms, which partially mediated its antidepressant and anti-suicidal effects. In 323 adults with TRD receiving four IV ketamine infusions, self-reported improvements in insomnia, night-time restlessness, hypersomnia, early morning waking, and total sleep partially explained reductions in depression severity. Insomnia, night-time restlessness, early morning waking, and total sleep improvements also mediated reductions in suicidal ideation. Each point improvement in total sleep score was associated with 3.29 times higher odds of achieving response or remission (95% confidence interval 2.00–5.41).
Journal of Sleep Research
August 18, 2021
Kathryn Kennedy, Célyne Bastien, Perrine Ruby et al.
25 citations
During the COVID-19 pandemic, people experiencing greater general stress, worse sleep, or more middle-of-the-night insomnia were more likely to have nightmares about specific themes such as confinement, failure, helplessness, anxiety, war, separation, totalitarianism, sickness, death, COVID, and an apocalypse. Those with worsened sleep also reported nightmares about oppression, disaster, evil forces, and domestic abuse. The findings suggest that pandemic-related stress may trigger negatively-toned dreams of particular themes, and future research could explore whether such nightmares reflect an emotion regulation mechanism or its failure.
Journal of Sleep Research
June 1, 2021
Monika Kliková, Brian A Sharpless, Jitka Bušková
17 citations
About 23% of people with recurrent sleep paralysis report pleasant episodes, though these often include some fear. Pleasant episodes are more likely to involve illusory body movements (vestibular-motor sensations), and some individuals can intentionally induce these hallucinations. The ability to lucid dream and higher openness to new experiences are associated with pleasant episodes. Lower trauma symptoms or higher life satisfaction did not predict pleasant sleep paralysis.
Journal of Sleep Research
April 22, 2018
Jean-Baptiste Eichenlaub, Elaine Van Rijn, Mairéad Phelan et al.
17 citations
Details from personally significant waking-life events are most likely to appear in REM-sleep dreams on the first two nights after the event and again five to seven nights later, a pattern known as the day-residue and dream-lag effects. In a 14-day diary study with 38 participants, only personally significant events showed this pattern, and only among the 19 participants who had fewer total correspondences between daily events and dreams. Major daily activities and major concerns did not show the effect. The U-shaped timeline may reflect REM-sleep-dependent memory consolidation, possibly linked to emotional memory processing. This study analyzed more dreams than any previous dream-lag study with trained participants.
Journal of Sleep Research
February 1, 2023
Nerea L Herrero, Francisco T Gallo, Miguel Gasca-Rolín et al.
15 citations
Sleep paralysis involves an inability to move during sleep/wake transitions and often brings negative emotions, while out-of-body experiences—the sensation of perceiving the world from outside the physical body—tend to be more pleasant. An online survey of 329 participants found that positive emotions were more frequent during out-of-body experiences, whereas negative emotions dominated sleep paralysis episodes. People who reported being able to induce out-of-body experiences also experienced more positive emotions during episodes. Auditory, tactile, and visual sensations often preceded sleep paralysis, suggesting an "aura" that could be recognized. Those who had out-of-body experiences without feeling sleep paralysis reported tactile and visual sensations similar to those who felt paralysis, indicating that recognizing this aura might help induce out-of-body experiences in patients to reduce negative symptoms.
Journal of Sleep Research
June 14, 2022
Hailey Meaklim, M Burge, Flora Le et al.
12 citations
People with insomnia, especially those who developed it during the pandemic, reported more negative and vivid dream changes than good sleepers. In a global survey of 2240 participants followed over 12 months, 45% reported dream changes at baseline. Those with new-onset insomnia were most likely to report dream changes (55%), compared to those with pre-existing insomnia (45%) or good sleepers (36%). Dream themes included increased activity, vividness, negative emotions, survival, and poor sleep quality. Individuals with insomnia used more anxious and death-related words to describe their dreams. Dream activity decreased by 3-month follow-up. Dream changes were linked to worse mental health over time, especially for those with insomnia.
Journal of Sleep Research
February 1, 2025
Francesca Siclari
11 citations
Non-REM sleep parasomnias like sleepwalking and sleep terrors involve a variable spectrum of consciousness, not just automatic or unconscious behavior. In interviews with 35 adult patients, consciousness during episodes ranged from minimal or absent (frequently or always present in 36%) to preserved conscious experiences with delusional thinking (65%), hallucinations (53%), impaired insight (77%), negative emotions (75%), and variable amnesia (30%). Patients described feeling as if they were in a dream while awake, a state termed "awake dreaming." Surroundings could be perceived realistically, misinterpreted, or entirely hallucinated, depending on the delusion. These findings suggest that consciousness, amnesia, and sensory disconnection during episodes are graded and variable, and full-fledged experiences share core features of dreams, offering a model for studying consciousness and sensory disconnection.
Journal of Sleep Research
February 1, 2024
David A Kalmbach, Anthony N Reffi, Jason C Ong et al.
9 citations
A mindfulness sleep program for pregnant women with insomnia, combining behavioral sleep strategies and meditation, led to large increases in everyday mindfulness and medium-large increases in maternal-fetal attachment. Participants also reported large reductions in anxiety, repetitive thinking, insomnia-focused rumination, and sleep-related daytime impairment. These preliminary results from a small trial of 11 women suggest that such a program may benefit multiple aspects of maternal wellbeing beyond sleep and depressed mood.
Journal of Sleep Research
August 1, 2023
Betul Rauf, Rotem Perach, Juan J Madrid-Valero et al.
8 citations
Poor sleep quality significantly correlates with stronger beliefs in paranormal phenomena. In a survey of 8,853 participants, those experiencing insomnia, longer sleep latency, and shorter sleep duration were more likely to believe in concepts like ghosts (62%), the soul living on after death (58%), and alien encounters (45%). Additionally, episodes of exploding head syndrome and isolated sleep paralysis were linked to beliefs in aliens visiting Earth. These findings highlight the complex relationship between sleep disturbances and anomalistic experiences, suggesting avenues for enhanced psychoeducation on sleep health.
Journal of Sleep Research
June 1, 2025
Jennifer M Mundt, Kristi E. Pruiksma, Karen R Konkoly et al.
7 citations
A small trial tested cognitive behavioral therapy for nightmares (CBT-N), adapted for people with narcolepsy, with or without targeted lucidity reactivation (TLR) to enhance lucid dreaming. Six adults who had frequent nightmares (at least 3 per week) received seven treatment sessions. Nightmare frequency dropped from an average of 8.38 per week to 2.25 per week, a large improvement. Nightmare severity and symptoms such as sleep paralysis, hallucinations, and dream enactment also improved. The three participants who received TLR all recalled dreams related to their rescripted nightmare. Participants reported reduced shame and anxiety about sleep and nightmares. The findings offer preliminary evidence that CBT-N and TLR may help manage narcolepsy-related nightmares.
Journal of Sleep Research
February 9, 2025
Lampros Perogamvros, Vincent Rochas, Jean‐Baptiste Beau et al.
5 citations
Dreams may help regulate emotions by reducing negative feelings. A new concept, the cathartic dream, is defined as a dream with a dynamic plot and emotional twists where negative emotions are expressed and ultimately decreased, reflecting psychological relief akin to Aristotelian catharsis. Using a large language model to categorize dream diaries, researchers detected cathartic dreams in both healthy individuals and patients with nightmares. Their prevalence increased during two weeks of imagery rehearsal therapy and targeted memory reactivation during REM sleep. The increase in cathartic dreams correlated with decreased depression scores in nightmare patients, suggesting a functional role in well-being.
Journal of Sleep Research
June 1, 2025
Liborio Parrino, Francesco Rausa, Giulia Balella et al.
4 citations
REM sleep plays a crucial role in emotional recovery, with studies showing that 60% of participants experience REM rebound after deprivation. Historical discoveries by pioneers like Aserinsky and Kleitman established its unique characteristics, including a blend of brain activation and muscle atonia. The review emphasizes REM sleep homeostasis and its periodicity within ultradian rhythms. It also explores the complex relationship between arousals, sleep, and consciousness, highlighting notable distinctions between non-REM and REM sleep-related arousals, revealing their similarities to wakefulness.
Journal of Sleep Research
April 1, 2025
Jean-Baptiste Eichenlaub, Romain Bouet, Mathieu Pinelli et al.
3 citations
Among 1,151 preteens aged about 11, nearly half recalled dreams several times a week or almost every morning. About 52% had nightmares less than once a month or never, and 45% had lucid dreams at the same low frequency. No gender differences appeared in dream habits. Nocturnal awakenings were linked to all dream variables (recall, nightmares, lucid dreams, emotional intensity). Shorter sleep duration and lower sleep efficiency were associated with more frequent nightmares and stronger dream emotions, but not with dream recall or lucid dream frequency; Bayesian analyses supported these null findings.
Journal of Sleep Research
August 1, 2025
Marta Spinoni, Serena Scarpelli, Ilaria Di Pasquale Benedetti et al.
2 citations
Pregnant women often experience heightened dream recall, which can serve as a mechanism for emotional regulation. In a study of 118 women in their first trimester, increased depressive symptoms correlated with more frequent nightmares and distress from those dreams. Notably, higher levels of alexithymia—difficulty identifying emotions—predicted greater nightmare frequency and distress. Additionally, unplanned pregnancies were linked to increased nightmare distress. These findings suggest that addressing emotional regulation could be crucial for supporting maternal mental health during pregnancy.
Journal of Sleep Research
May 10, 2025
Brooke A Prakash, Ishani Shah, Guohao Ni et al.
2 citations
The development of sleep medicines has evolved from ancient herbal sedatives to modern synthetic drugs, driven by deeper understanding of sleep mechanisms. Barbiturates and bromides in the 19th century gave way to benzodiazepines, which promote gamma-amino butyric acid release to inhibit brain signaling. Newer therapies more specifically target the wake-inducing neurotransmitter orexin, reducing side effects. Kinases are predicted to be the next targets for breakthroughs in sleep medicine. Sleep disruptions contribute to the buildup of pathological neuronal proteins in neurodegenerative disorders, so sleep medicine could improve prognosis in such conditions, but medicines that do not fully mimic sleep might worsen disease progression.
Journal of Sleep Research
April 3, 2025
Nadia Malek, Anthony Santistevan, Leslie Yack et al.
2 citations
Among trauma-exposed veterans and civilians, poor mood before bed increases the risk of having at least one distressing dream, which in turn leads to poor mood the following morning. That negative mood carries over into the next evening, further raising the risk of another distressing dream. Individuals with better emotion regulation have a lower incidence of distressing dreams and better mood on average, after adjusting for sex, age, and PTSD severity. The findings suggest that mood and distressing dreams form a bidirectional cycle, and that emotion regulation abilities may help mitigate this risk.
Journal of Sleep Research
October 3, 2024
Carlotta Mutti, Francesca Siclari, Ivana Rosenzweig
2 citations
Dreaming is an involuntary cognitive process that occurs during sleep. While dreams have been studied since ancient times and became important in psychoanalysis, scientific research accelerated after the discovery of rapid eye movement (REM) sleep in the 1950s. This review brings together current findings on the neurobiological and psychological aspects of dreaming, covering what affects dream recall and content, the brain activity associated with dreaming, experimental models used to study dreams, and what these insights mean for clinical practice.
Journal of Sleep Research
September 11, 2025
Darren M. Lipnicki
1 citation
In about 13% of adult REM dreams, the dreamer is absent or an uninvolved observer rather than a participant. These observer dreams can be as elaborate and narratively structured as participatory dreams. Three types are described: no embodied self-representation (Type I), a disembodied self that watches events from within the dream environment (Type II), and an embodied self that observes events virtually, often on TV (Type III). Type I was the most common (8.0% of all reports). Observer dreams appear more frequent in children and older adults than in young adults. Direct physical aggression occurred in around 20% of observer dreams, which may relate to the threat simulation hypothesis. The findings suggest observer dreams deserve greater theoretical integration.