Perception of dreams and subjective sleep quality in patients with myasthenia gravis.
Svenja Happe, Gerhard Klösch, Josef Zeitlhofer
Neuropsychobiology 2004 DOI: 10.1159/000077937 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational case-control study Peer reviewed |
|---|---|
| Sample size | 31 |
| Population | 17 consecutive patients with myasthenia gravis (mean age 49.5 +/- 13.6 years) and 14 healthy controls (mean age 50.5 +/- 16.0 years) |
| Duration | 2 weeks |
| Measures | Self-Rating Depression Scale, Self-Rating Anxiety Scale, Quality of Life Index, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, self-rating questionnaire for sleep and awakening quality and dreaming |
| Key findings | Patients with myasthenia gravis reported worse subjective sleep and awakening quality, lower sleep efficiency, more nocturnal awakenings, and more frequent dream recall than controls, with dreams more often body-related and tactile and less often visual. The authors argue the absence of the usual awakening-dream recall relationship in patients favors the continuity hypothesis of dreaming over the arousal-retrieval model. |
Abstract
Recent reports have led to the hypothesis of a central nervous system involvement in myasthenia gravis (MG). As the central cholinergic system also plays an important role in sleep/wake rhythms and in the regulation of REM sleep, sleep perception and dreaming may be altered in MG patients. Seventeen consecutive patients with MG (mean age 49.5 +/- 13.6 years) and 14 healthy controls (mean age 50.5 +/- 16.0 years) were investigated by means of the Self-Rating Depression Scale, Self-Rating Anxiety Scale, Quality of Life Index, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale as well as a self-rating questionnaire for sleep and awakening quality and dreaming for 2 weeks. Subjective sleep and awakening quality and sleep efficiency were reduced (p < 0.05), and the number of nocturnal awakenings (p = 0.02) as well as dream recall frequency (p = 0.02) were increased in patients with MG. Patients reported more often body-related and tactile sensations during dreaming (p = 0.001) and dreamed less often visually (p = 0.04). Dream content, emotions, and dream sources did not differ between both groups. Whereas the number of awakenings was related to dream recall frequency in healthy controls, no such a relationship was found in the patient group. There is no clear evidence for the arousal-retrieval model of dream recall in patients with MG, but more for the continuity hypothesis of dreaming. Other factors such as the functional state of the brain, possibly related to a central cholinergic involvement in MG or its anticholinesterase treatment, may be important in explaining dream recall in this patient group.