Sleep apnea, narcolepsy, and dreaming: Regional cerebral hemodynamics
John Stirling Meyer, Fumihiko Sakai, Ismet Karacan, Sabri Derman, Masahiro Yamamoto
Annals of Neurology May 1, 1980 DOI: 10.1002/ana.410070515 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Population | Patients with narcolepsy and patients with sleep apnea |
| Intervention | Methylphenidate hydrochloride (Ritalin) |
| Measures | regional cerebral blood flow (xenon 133 inhalation), polysomnography |
| Topics | Dreaming |
| Citations | 81 |
| Key findings | Awake brainstem-cerebellar gray matter blood flow was below normal in both narcolepsy and sleep apnea, and in sleep apnea bihemispheric flow was also reduced. After sleep onset, flow increased paradoxically in narcolepsy but decreased further in sleep apnea, with maximal changes in brainstem-cerebellar regions. Methylphenidate increased resting awake flow in narcoleptics but attenuated the sleep-onset increase, suggesting impaired sleep-wake and REM control that methylphenidate partially counteracts. |
Abstract
Regional cerebral flow after inhalation of xenon 133 as well as polysomnography were recorded during daytime sleep and the awake state in patients with narcolepsy and sleep apnea. Brainstem-cerebellar (BSC) gray matter blood flow (Fg) values in the awake state were reduced below normal (p less than 0.05) in both narcolepsy and sleep apnea; in sleep apnea, bihemispheric Fg values were also reduced in the awake state. After sleep onset, Fg paradoxically increased in narcolepsy but decreased further in sleep apnea. Maximal regional Fg changes occurred in BSC regions in both groups of patients. Oral administration of methylphenidate hydrochloride (Ritalin) increased resting Fg values in awake narcoleptics, particularly in BSC regions, but attentuated Fg increases during sleep onset. Regional Fg values during visual dreaming or hypnagogic hallucinations in narcoleptics were maximally increased in right parietooccipital regions. In narcoleptics, impaired control of sleep-wake and REM mechanisms is attentuated by methylphenidate. In patients with sleep apnea, brainstem functional activity is low in the awake state but becomes critically reduced during sleep, culminating in apnea-stimulated arousal followed by repetitive cycles as sleep recurs.
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 |
| The prevalence of nightmares and their independence from anxiety. Undergraduates | 1990 | Observational study using daily dream logs | n = 220 |