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“Silent Echoes of the Day: Dream Content Analysis in Amyotrophic Lateral Sclerosis”

Alessandro Bombaci, Alessandra Giordano, Ilaria Lavalle, Alice Magnino, Andrea Calvo, Adriano Chiò, Alessandro Cicolin

Brain and Behavior May 1, 2026 DOI: 10.1002/brb3.71387 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Peer reviewed
Sample size 68
Population ALS patients
Topics Dreaming
Keywords Dream Amyotrophic lateral sclerosis Content measure theory Population Internalization Audiology Content analysis
Key findings Dream content in ALS patients differs from that of healthy subjects, with gender-specific patterns including reduced social and aggressive elements and increased family and familiar settings.

Abstract

Background: Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disorder characterized by the degeneration of upper and lower motor neurons, leading to muscle atrophy, weakness, and respiratory failure. Numerous studies evaluated the impact of diseases on dream content, and the dream content analysis may be considered an interesting tool in the study of the internalization of the consequences of significant life changes. The study of ALS patients' dream content has been mostly neglected in the literature. This study investigated the dream content in a population affected by ALS. MATERIAL AND

Methods: We evaluated all consecutive outpatients referred to our ALS Centre using a weekly diary of dreams. Dream contents were coded according to the Hall and Van de Castle coding system.

Results: Sixty-eight patients completed the study. We collected 127 dreams (females 39.4%) (males 60.6%). Males showed a reduced presence of friends, anatomical elements, aggression, friendship, and sexuality. Instead, we found an increased presence of family members, situations in which the dreamer initiates aggressive action and familiar settings. In the female sample, we found a decreased presence of friends, aggressive and friendly elements, sex-related content, and misfortune, while an increase in animal content.

Conclusions: Our results demonstrate that dream content in ALS patients differs from that of healthy subjects, and we noticed some gender differences among ALS patients. The dream content can offer insights into ALS patients' mental state and may improve clinicians' ability to support their patients during their therapeutic course.

Comparable studies

Other observational and cohort studies on dreaming, most cited first.

Study Year Design Participants
Lucid Dreaming: a State of Consciousness with Features of Both Waking and Non-Lucid Dreaming Student volunteers trained to become lucid and signal lucidity with horizontal eye... 2009 Observational study n = 6
Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Young adults with a mean age of 20 years 2002 Prospective observational study n = 116
Long-term effects of extreme situational stress on sleep and dreaming Survivors of traumatic events who complained of sleep disturbances, compared with... 1987 Case-control study n = 11
The relationship of nightmare frequency and nightmare distress to well‐being Adults who reported dreams 2004 Observational cohort n = 147
Dreaming in NREM Sleep: A High-Density EEG Study of Slow Waves and Spindles Healthy human subjects 2018 Observational cohort n = 14

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