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Altered parasympathetic activity during sleep and emotionally arousing wakefulness in frequent nightmare recallers

Vivien Tomacsek, Borbála Blaskovich, Anna Király, Richárd Reichardt, Péter Simor

European Archives of Psychiatry and Clinical Neuroscience March 2, 2023 DOI: 10.1007/s00406-023-01573-2 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Peer reviewed
Sample size 54
Population Frequent nightmare recallers (NM) and healthy controls (CTL)
Topics Dreaming
Keywords Heart rate variability Wakefulness Arousal Sleep system call Eye movement Electroencephalography Blood pressure
Citations 8
Key findings Nightmare recallers show higher heart rate during sleep and altered heart rate variability in response to emotion-evoking pictures, indicating parasympathetic dysregulation.

Abstract

Nightmare disorder is characterized by dysfunctional emotion regulation and poor subjective sleep quality reflected in pathophysiological features such as abnormal arousal processes and sympathetic influences. Dysfunctional parasympathetic regulation, especially before and during rapid eye movement (REM) phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers (NM). We hypothesized that cardiac variability is attenuated in NMs as opposed to healthy controls (CTL) during sleep, pre-sleep wakefulness and under an emotion-evoking picture-rating task. Based on the polysomnographic recordings of 24 NM and 30 CTL participants, we examined HRV during pre-REM, REM, post-REM and slow wave sleep, separately. Additionally, electrocardiographic recordings of resting state before sleep onset and under an emotionally challenging picture-rating task were also analyzed. Applying repeated measures analysis of variance (rmANOVA), a significant difference was found in the HR of NMs and CTLs during nocturnal segments but not during resting wakefulness, suggesting autonomic dysregulation, specifically during sleep in NMs. As opposed to the HR, the HRV values were not significantly different in the rmANOVA in the two groups, implying that the extent of parasympathetic dysregulation on a trait level might depend on the severeness of dysphoric dreaming. Nonetheless, in the group comparisons, the NM group showed increased HR and reduced HRV during the emotion-evoking picture-rating task, which aimed to model the nightmare experience in the daytime, indicating disrupted emotion regulation in NMs under acute distress. In conclusion, trait-like autonomic changes during sleep and state-like autonomic responses to emotion-evoking pictures indicate parasympathetic dysregulation in NMs.

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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