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Conscious experiences during non-rapid eye movement sleep parasomnias

Anna Castelnovo, Francesca Siclari, Sara Spaggiari, Dolores Borth, Mauro Manconi, Isabelle Arnulf, Carlos H. Schenck

Neuroscience & Biobehavioral Reviews October 16, 2024 DOI: 10.1016/j.neubiorev.2024.105919 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Narrative review Qualitative Peer reviewed
Keywords Sleep system call Eye movement Audiology
Citations 12
Key findings Conscious experiences during Disorders of Arousal episodes are recalled by about 50-60% of adults immediately post-episode, challenging the traditional view of these disorders as unconscious states.

Abstract

Disorders of Arousal (DOA) are non-rapid eye movement (NREM) parasomnias traditionally regarded as unconscious states. However, recent research challenges this assumption. This narrative review aims to explore the presence and qualitative features of conscious experiences in patients with DOA during their episodes. The literature indicates a higher recall of conscious experiences during DOA episodes than previously believed, estimated at about 50-60 % in adults (immediately post-episode). Data on children are limited but suggest a lower recall rate (<30 % when interviewed retrospectively). Patient reports range from brief scenic fragments to elaborate scenarios with plot development, often fraught with negative emotions and misfortunes and with considerable correspondence between subjective experiences and observed behaviors. In many of the described cases, patients appear to enact their dreams, entering a hallucinatory state where internally generated images overlay external percepts. The potential implications for clinical management, research endeavors, and legal considerations regarding nocturnal violence, along with existing limitations and controversial points, are discussed.