Howl: Nightmare or REM Sleep Behavior Disorder?
Maria Jose Abenza-Abildúa, Vanesa Lores-Gutiérrez, Guadalupe Gutiérrez-Cueto, Eugenio Suárez-Gisbert, Carlos Pérez-López
Neurology. Clinical practice February 1, 2023 DOI: 10.1212/cpj.0000000000200093 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 41-year-old man referred for vivid and unpleasant dreams |
| Topics | Dreaming |
| Key findings | Polysomnography confirmed REM sleep behavior disorder in a patient with atypical symptom of prolonged howling, emphasizing the need for polysomnography to diagnose and rule out other parasomnias. |
Abstract
Nightmare disorder consists of the appearance of unpleasant and vivid, repeated dreams, with a situation of discomfort and anguish on awakening. Its prevalence is 3%-4% in adults. They do not associate muscle mobilization during this phase. REM sleep behavior disorder (RSBD) is a rare parasomnia (0.5% of people older than 60 years of age), characterized by the presence of unpleasant dreams, with violent content, and vigorous movements of limbs (kicks and punches), reflecting a loss of muscle atony typical of the REM phase of sleep. Language (screams and words) can also be emitted. The same clinical manifestations of RSBD can appear in other sleep disorders. The diagnosis requires the performance of a polysomnography. We present the case of a 41-year-old man referred for vivid and unpleasant dreams, beginning in the last year, related to work stress. The polysomnography showed the loss of atony in the REM phase and emission of a prolonged howl after which the patient continues in the REM phase. Prolonged howling is a very rare symptom in sleep disorders, and very atypical in RSBD, so polysomnography is essential to confirm the diagnosis and rule out other parasomnias.
Comparable studies
Other case reports and case series on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lucid Dreaming as a Learnable Skill: A Case Study The author | 1980 | Case study | n = 1 |
| Lucid Dreaming as a Treatment for Recurrent Nightmares People with recurrent nightmares | 2010 | Case study | n = 5 |
| Treating Chronic Nightmares of Sexual Assault Survivors with an Intellectual Disability – Two Descriptive Case Studies Adults with learning disabilities suffering from post-traumatic nightmares | 2006 | Case study | n = 2 |
| Lucid dreaming: Correspondence between dreamed and actual events in one subject during rem sleep A lucid dreamer | 1984 | Case study | n = 1 |
| Lucid dreaming treatment for nightmares: A series of cases. Participants with nightmares | 2003 | Case series | n = 8 |