Alexithymia associated with nightmare distress in idiopathic REM sleep behavior disorder.
Isabelle Godin, Jaques Montplaisir, Jean-François Gagnon, Tore Nielsen
Sleep December 1, 2013 DOI: 10.5665/sleep.3238 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case-control questionnaire study Peer reviewed |
|---|---|
| Sample size | 62 |
| Population | 32 clinically diagnosed idiopathic REM sleep behavior disorder patients and 30 healthy age- and sex-matched control participants |
| Measures | 20-item Toronto Alexithymia Scale (TAS-20), Dream Questionnaire, Beck Depression Inventory |
| Topics | Dreaming |
| Keywords | Humans Polysomnography Case-control studies Affective symptoms Dreams Middle aged Male Surveys and questionnaires Nightmares Alexithymia Dysautonomia |
| Key findings | iRBD patients reported higher alexithymia scores, especially difficulty identifying feelings, than controls, even when controlling for depressive symptoms, and more often met the suggested alexithymia cutoff. In both groups, difficulty identifying feelings correlated positively with nightmare distress, which the authors argue suggests a shared affect regulation disturbance. |
Abstract
Study
Objectives: Idiopathic REM sleep behavior disorder (iRBD) is characterized by atypical REM sleep motor activity, vivid dreams and nightmares, and dream-enacting behaviors that can result in injuries to the patient and bed partner. It is also a known predictor of Parkinson disease (PD). Alexithymia has been associated with disturbances in sleep and dreaming (e.g., nightmares) and is a non-motor symptom of PD. We assessed alexithymia and disturbed dreaming in iRBD patients with the aim of determining if these two factors are elevated and interrelated among this population.
Design: Questionnaire study of clinically diagnosed patients.
Setting: Clinical sleep disorders center. Patients or
Participants: Thirty-two iRBD patients and 30 healthy age- and sex-matched control participants. Measurements and
Results: Participants completed the 20-item Toronto Alexithymia Scale (TAS-20), the Dream Questionnaire, and the Beck Depression Inventory. iRBD patients obtained higher TAS-20 total scores (62.16 ± 13.90) than did controls (52.84 ± 7.62; F 1,59 = 10.44, P < 0.01), even when controlling for depressive symptoms, and more frequently attained the suggested cutoff for alexithymia than did controls (P < 0.01). iRBD patients obtained higher scores on the Difficulty Identifying Feelings alexithymia subscale. For both iRBD and control groups, the Difficulty Indentifying Feelings subscale correlated positively with the Nightmare Distress scale of the Dream Questionnaire.
Conclusions: Elevated alexithymia scores among idiopathic rapid eye movement sleep behavior disorder patients, and especially a difficulty in identifying feelings, parallels evidence of dysautonomia in this population. The higher incidence of distressing nightmares and the association of nightmares with alexithymia further extend similar findings for both clinical and non-clinical samples and suggest that an affect regulation disturbance may be common to the two sets of symptoms.
Comparable studies
Other cross-sectional and survey studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Insomnia Symptoms, Nightmares, and Suicidal Ideation in a College Student Sample Undergraduate students at a large, public university in the southeastern United States | 2011 | Observational cross-sectional survey | n = 583 |
| Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Middle-aged Hong Kong Chinese adults from the community, mean age 40.9 years (SD 5.5,... | 2010 | Cross-sectional survey with subsequent clinical evaluation (two-phase design) | n = 8,558 |
| Factors of home dream recall: a structural equation model Adults (general population sample) | 2003 | Cross-sectional survey with structural equation modeling | n = 444 |
| The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams | 2014 | Online survey | n = 684 |
| Frequency of Lucid Dreaming in a Representative German Sample Representative sample of German adults | 2011 | Cross-sectional survey | n = 919 |
Citations in the library
Cited by 7
- Alexithymia, Depression, Trait-anxiety and Their Relation to Self-reported Retrospective Dream Experience American Journal of Applied Psychology 2019
- The association between dream activity and alexithymia during pregnancy: A cross-sectional study in a sample of pregnant women. Journal of Sleep Research August 1, 2025
- Nightmares in Medical Practice Interactive science March 20, 2020
- Dream Recall, Nightmares, and Aggression-Related Dream Content in Patients with REM Sleep Behavior Disorder (RBD). Sleep Science August 18, 2025
- Reliability and validity of the Chinese version of the Nightmare disorder index in adolescents. Stress and Health October 1, 2023
and 2 more in the library
Cites 8
- Dreaming correlates of alexithymia among sleep-disordered patients. Dreaming March 1, 2011
- Challenging the myth of REM sleep behavior disorder: no evidence of heightened aggressiveness in dreams. Sleep Medicine April 13, 2012
- Changes in cardiac variability after REM sleep deprivation in recurrent nightmares. Sleep 2010
- Alexithymia and dream recall upon spontaneous morning awakening. Psychosomatic Medicine March 1, 2003
- Alexithymia and impoverished dream content: evidence from rapid eye movement sleep awakenings. Psychosomatic Medicine July 1, 2000
and 3 more in the library