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) via OpenAlex
Summary
AI-generated from the abstractDisorders of Arousal (DOA), traditionally considered unconscious states, may involve conscious experiences more often than previously thought. A narrative review of the literature finds that about 50-60% of adults recall conscious experiences immediately after a DOA episode, while children have a lower recall rate (under 30% when interviewed retrospectively). Patient reports range from brief scenic fragments to elaborate scenarios with plot development, often involving negative emotions and misfortunes, and there is considerable correspondence between subjective experiences and observed behaviors. In many cases, patients appear to enact their dreams, entering a hallucinatory state where internally generated images overlay external percepts. The review discusses implications for clinical management, research, and legal considerations regarding nocturnal violence.
Study at a glance
| Characteristics | Narrative review Qualitative Peer reviewed |
|---|---|
| Keywords | Sleep system call Eye movement Psychology Neuroscience Audiology |
| Citations | 12 |
| Key finding | 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.