Delusional confusion of dreaming and reality in narcolepsy.

A distinctive feature of narcolepsy, termed 'dream delusions,' occurs when patients mistake the memory of a vivid dream for a real experience and form sustained false beliefs that can persist for days or weeks. In interviews with 46 narcolepsy patients with cataplexy and 41 healthy controls at academic medical centers in Boston and Leiden, dream delusions were surprisingly common and often severe, differing from fleeting hypnagogic or hypnopompic hallucinations. These false memories suggest source memory deficits in narcolepsy that have not yet been fully characterized.

Study at a glance

Abstract

We investigated a generally unappreciated feature of the sleep disorder narcolepsy, in which patients mistake the memory of a dream for a real experience and form sustained delusions about significant events. We interviewed patients with narcolepsy and healthy controls to establish the prevalence of this complaint and identify its predictors. Academic medical centers in Boston, Massachusetts and Leiden, The Netherlands. Patients (n = 46) with a diagnosis of narcolepsy with cataplexy, and age-matched healthy healthy controls (n = 41). N/A. "Dream delusions" were surprisingly common in narcolepsy and were often striking in their severity. As opposed to fleeting hypnagogic and hypnopompic hallucinations of the sleep/wake transition, dream delusions were false memories induced by the experience of a vivid dream, which led to false beliefs that could persist for days or weeks. The delusional confusion of dreamed events with reality is a prominent feature of narcolepsy, and suggests the possibility of source memory deficits in this disorder that have not yet been fully characterized.