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A consideration of ketamine dreams.

This study was designed to see whether covering of the eyes during and after ketamine anaesthesia would reduce the incidence of dreams. One hundred and fifty patients, randomly divided into three groups, underwent therapeutic abortion with ketamine as the sole anaesthesia. One hundred patients had their eyes completely covered, 50 in the operating room only and 50 in the operating room and in the recovery room. The third 50 were controls, with their eyes uncovered. All patients were questioned post-operatively about dreams, nausea and vomiting, headache, dizziness and experiences, and also how frequently they dreamed at home. Although covering the eyes in the recovery room only reduced the incidence of dreams marginally, it became obvious that the patients who dreamed after ketamine (in all 3 groups) were those who normally dreamed at home. There were 82 patients who were recorded as not being home-dreamers, and only two of these dreamed after ketamine. In contrast, of the 68 home-dreamers, 50 dreamed after ketamine, and 17 of these had unpleasant dreams. In the home-dreamers, covering the eyes reduced the incidence of dreams from 86 per cent in Group 1 to 72 per cent in Group 2 and 64 per cent in Group 3. It is suggested that goggles may be advantageous when dealing with home-dreamers, and a question about the patient's tendency to dream should be included in the preoperative questioning. Alterations in premedication and the use of a quiet dark room during recovery may even further reduce unpleasant dreams in this group.

Anesthesia, Intravenous↗

Dreams and reality monitoring.

Experiment 1 tested the counterintuitive prediction that memories for one's own dreams should not be particularly easy to discriminate from memories for someone else's dreams. Pairs of people reported dreams to each other that they had either dreamed, read, or made up the night before. On a test requiring subjects to discriminate events they had reported from those reported by their partner, subjects had more difficulty with real dreams than with dreams they read or made up. Experiment 2 provided evidence that real dreams do not simply produce overall weaker memories; the deficit for dreams was eliminated with more time to respond and with more detailed cues. In addition, subjects' ratings of various characteristics of their memories (e.g., vividness, personal relevance) indicated that dreams were not generally weaker or impoverished. The results are interpreted within the framework for reality monitoring described by Johnson and Raye (1981): Memories for real dreams are proposed to be deficient in conscious cognitive operations that help identify the origin of information generated in a waking state. At the same time, real dreams are embedded in a network of supporting memories that can be drawn on for reality monitoring decisions under appropriate circumstances. Finally, a comparison of recognition and recall indicated that dreams may leave persisting memories that are difficult to access via free recall.

Adult↗

Incorporation of pain in dreams of hospitalized burn victims.

It has been shown that realistic, localized painful sensations can be experienced in dreams either through direct incorporation or from past memories of pain. Nevertheless, the frequency of pain dreams in healthy subjects is low. This prospective study was designed to evaluate the occurrence and frequency of pain in the dreams of patients suffering from burn pain. Twenty-eight nonventilated burn victims were interviewed for 5 consecutive mornings during the first week of hospitalization. A structured-interview protocol was used to collect information on dream content, quality of sleep, and pain intensity and location. Patients were also administered the Impact of Event Scale to assess posttraumatic symptoms. Thirty-nine percent of patients reported 19 pain dreams on a total of 63 dreams (30%). Patients with pain dreams showed evidence of worse sleep, more nightmares, higher intake of anxiolytic medication, and higher scores on the Impact of Event Scale than did patents reporting dreams with no pain content. Moreover, patients with pain dreams also had a tendency to report more intense pain during therapeutic procedures. Although more than half of our sample did not report pain dreams, these results suggest that pain dreams do occur at a greater frequency in suffering populations than in normal volunteers. More importantly, dreaming about pain may be an added stress for burn patents and may contribute to both poor sleep and higher pain intensity, which could evolve into a cycle of pain-anxiety-sleeplessness.

Adolescent↗

Dreaming during anesthesia and anesthetic depth in elective surgery patients: a prospective cohort study.

BACKGROUND: Dreaming reported after anesthesia remains a poorly understood phenomenon. Dreaming may be related to light anesthesia and represent near-miss awareness. However, few studies have assessed the relation between dreaming and depth of anesthesia, and their results were inconclusive. Therefore, the authors tested the hypothesis that dreaming during anesthesia is associated with light anesthesia, as evidenced by higher Bispectral Index values during maintenance of anesthesia. METHODS: With approval, 300 consenting healthy patients, aged 18-50 yr, presenting for elective surgery requiring relaxant general anesthesia with a broad range of agents were studied. Patients were interviewed on emergence and 2-4 h postoperatively. The Bispectral Index was recorded from induction until the first interview. Dream content and form were also assessed. RESULTS: Dreaming was reported by 22% of patients on emergence. There was no difference between dreamers and nondreamers in median Bispectral Index values during maintenance (37 [23-55] vs. 38 [20-59]; P=0.68) or the time at Bispectral Index values greater than 60 (0 [0-7] vs. 0 [0-31] min; P=0.38). Dreamers tended to be younger and male, to have high home dream recall, to receive propofol maintenance or regional anesthesia, and to open their eyes sooner after surgery. Most dreams were similar to dreams of sleep and were pleasant, and the content was unrelated to surgery. CONCLUSIONS: Dreaming during anesthesia is unrelated to the depth of anesthesia in almost all cases. Similarities with dreams of sleep suggest that anesthetic dreaming occurs during recovery, when patients are sedated or in a physiologic sleep state.

Adolescent↗

Aggressive dream content without daytime aggressiveness in REM sleep behavior disorder.

BACKGROUND: REM sleep behavior disorder (RBD) is characterized by vigorous sleep motor activity associated with dream mentation. Patients with RBD frequently report action-filled and violent dreams. OBJECTIVE: To systematically assess dream characteristics and daytime aggressiveness in patients with RBD and controls. METHODS: Forty-nine patients with polysomnographic-confirmed RBD diagnosis and 71 age- and sex-matched controls were asked to recall the most recent dreams and to complete the Aggression Questionnaire (AQ). Forty-one patients with RBD (81.6%; 36 men, 5 women; mean age: 67.5 +/- 7.5 years) and 35 controls (49.3%; 30 men, 5 women; mean age: 69.1 +/- 5.9 years) were able to remember their dreams and a total of 98 (RBD) and 69 (controls) dreams were collected in the two groups. Verbatim dream descriptions were scored and analyzed according to the Hall and Van De Castle method. RESULTS: Patients with RBD showed a higher percentage of dream with at least one aggressive episode (DWA) than controls (66% vs 15%; p < 0.00001), a higher aggression/friendliness interaction ratio (86% vs 44%; p < 0.0001), and a greater frequency of animal characters (19% vs 4%; p = 0.0001). In contrast to controls, no patient with RBD had dreams with elements of sexuality (0% vs 9%; p < 0.0001). The two groups did not differ in total AQ scores, except for a lower score on the physical aggressiveness subscale in patients with RBD compared to control subjects (16.5 +/- 6.4 vs 20.4 +/- 8.3; p = 0.034). No correlation was observed between dream aggressiveness and age, duration, or frequency of RBD symptoms. CONCLUSIONS: Dreams in patients with REM sleep behavior disorder were characterized by an elevated proportion of aggressive contents, despite normal levels of daytime aggressiveness. Dreams with aggressiveness and the known excessive phasic muscle activity during REM sleep may be related to the hyperactivity of a common neuronal generator.

Aged↗

Dream-recall frequency and waking imagery.

The purpose was to investigate the relationship between dream-recall frequency and waking imagery, so 323 undergraduates completed four imagery tests: (1) Sheehan's modified version of Betts' Questionnaire on Mental Imagery, (2) Marks' Vividness of Visual Imagery Questionnaire, (3) the Gordon Test of Visual Imagery Control, (4) Richardson's Verbalizer Visualizer Questionnaire, and a dream-recall questionnaire which contained a question about dream-recall frequency. When scores on the four imagery tests and the seven sensory subscales of the Questionnaire on Mental Imagery were compared for the n = 82 frequent and n = 80 infrequent dream recallers, higher recall was associated with more vivid voluntary images and more frequent use of visual imagery; however, control visual imagery as measured by the Test of Visual Imagery Control was not associated with dream-recall frequency. Scores for frequent use of visual imagery on dream-recall frequency might have been due to the two items of the Verbalizer-Visualizer Questionnaire which asked about dream experiences. The results for the seven sensory subscales of the Betts' questionnaire indicated that the frequency of dream recall was significantly related to scores on visual, cutaneous, and organic but not on auditory, gustatory, kinaesthetic, and olfactory subscales. No significant differences were found between males and females. Present findings indicated that forming vivid mental images in the waking state is related to frequency of dream recall and support Cohen's salience theory of dream recall, i.e., that evoking vivid waking mental images voluntarily may play an important role in retrieving dream images or saving them during wakefulness. All sensory modalities should be considered in study of dream recall.

Adult↗

Treatment with weak electromagnetic fields restores dream recall in a parkinsonian patient.

Absent or markedly reduced REM sleep with cessation of dream recall has been documented in numerous neurological disorders associated with subcortical dementia including Parkinson's disease, progressive supranuclear palsy and Huntington's chorea. This report concerns a 69 year old Parkinsonian patient who experienced complete cessation of dreaming since the onset of motor disability 13 years ago. Long term treatment with levodopa and dopamine (DA) receptor agonists (bromocriptine and pergolide mesylate) did not affect dream recall. However, dreaming was restored after the patient received three treatment sessions with AC pulsed picotesla range electromagnetic fields (EMFs) applied extracranially over three successive days. Six months later, during which time the patient received 3 additional treatment sessions with EMFs, he reported dreaming vividly with intense colored visual imagery almost every night with some of the dreams having sexual content. In addition, he began to experience hypnagogic imagery prior to the onset of sleep. Cessation of dream recall has been associated with right hemispheric dysfunction and its restoration by treatment with EMFs points to right hemispheric activation, which is supported by improvement in this patient's visual memory known to be subserved by the right temporal lobe. Moreover, since DA neurons activate REM sleep mechanisms and facilitate dream recall, it appears that application of EMFs enhanced DA activity in the mesolimbic system which has been implicated in dream recall. Also, since administration of pineal melatonin has been reported to induce vivid dreams with intense colored visual imagery in normal subjects and narcoleptic patients, it is suggested that enhanced nocturnal melatonin secretion was associated with restoration of dream recall in this patient. These findings demonstrate that unlike chronic levodopa therapy, intermittent pulsed applications of AC picotesla EMFs may induce in Parkinsonism reactivation of reticular-limbic-pineal systems involved in the generation of dreaming.

Aged↗

[Dreams and interhemispheric asymmetry].

The dreams of 103 children and adolescents, aged 10-17 years, have been studied. The test group included 78 patients with neurotic disorders; control one consisted of 25 healthy subjects. Dream features, which were common for those with preferentially left asymmetry profile both in patients as well as in healthy subjects, were: less expressed novelty factor and frequent appearance of rare phenomena, such as "déjà vu in wakefulness", reality, "mixed" (overlapped) dreams, prolonged dreams in repeat sleep, frequent changes of personages and scenes of action. Left-hander dream peculiarities, being detected only in neurotic patients but not in healthy subjects, emerged as lucid phenomena deficit, "dream in dreams" and "dream reminiscence in dream" syndrome, which have been found only in left-handers. Right and left hemispheres seem to contribute in different ways to a dream formation. In authors believe that the left hemisphere seems to provide dream origin while the right hemisphere provides dream vividness, figurativeness and affective activation level.

Adolescent↗

Dream features in psychiatric patients on multiple psychoactive drugs.

An investigation into dreams was conducted in 100 subjects involving 50 psychiatric in-patients and fifty normal volunteers with the help of a questionnaire. The dream patterns of the two groups were compared. Results revealed that dreams of the patients were different from normal individuals even before the onset of psychiatric illness. The dreams in normal subjects were mostly related to present life situations whereas, the dreams of the patients were less frequent in this respect. On the other hand, frightening dreams, repetitive dreams and vision of snakes in the dreams were more frequent in patients. These differences became more conspicuous with the onset of illness. The dreams were suppressed in 78% patients after the institution of drug therapy. Most of the patients were getting three to four psychoactive drugs which alter the sleep pattern and may therefore affect the dreaming process. Thus, the qualitative changes in dreams of a person may serve as an early warning for an impending future illness. The suppressant effect of psychoactive drugs on dreams demands further investigations.

Journal Article↗

Cloning and mRNA expression of the Ca2+-binding DREAM protein in the pituitary.

It is well recognized that the level of intracellular calcium governs several cellular processes such as gene expression and secretion in the pituitary. Recently, a novel gene has been identified in neuroendocrine cells that encodes DREAM, a calcium-binding protein that acts as a transcriptional repressor by binding specific downstream regulatory elements (DRE) on DNA. To explore the possibility that DREAM may be expressed in the rat pituitary and may function in endocrine activity, we analyzed its mRNA expression by RT-PCR. Using oligonucleotide primers derived from the mouse DREAM cDNA, we amplified, cloned, and characterized a 852-bp RT-PCR product from rat pituitary tissue. Two splice variants of the rat DREAM gene differing by four nucleotides (tetramer ACAG) were identified. The ACAG(+) variant (ORF1) consisted of 768bp encoding a protein of 256 residues with an estimated molecular weight of 29.5kDa. Amino acid sequence analysis of ORF1 indicated 92.6% and 98.1% identity to the DREAM gene product from human and mouse, respectively. The second variant, ACAG(-) (ORF2), was 567-bp long and was predicted to encode a peptide of 189 residues with a molecular mass of about 20.8kDa. To determine which endocrine pituitary cells were expressing DREAM, we evaluated several different clonal populations containing cells that expressed specific pituitary hormones. We found that both DREAM splice variants were expressed in each pituitary cell types examined, which included the mammotropes (MMQ cells), somatotropes (GC cells), mammosomatotropes (GH(3) cells), gonadotropes (LbetaT2 cells), thyrotropes (TalphaT1 cells), and corticotropes (AtT-20 cells). Interestingly, the levels of the two variants differed between the cell types tested with the ACAG(+) variant comprising about two-thirds of the DREAM expression for the mammotropes, somatotropes, mammosomatotropes, and corticotropes as compared to less than one-half for the thyrotropes and the gonadotropes. Our initial attempts to identify pituitary-specific genes regulated by DREAM revealed that prolactin gene expression was not influenced by DREAM suggesting that an action of DREAM may involve other pituitary hormones or be mediated by other cell processes. When taken together, our findings of DREAM expression in the pituitary in a manner specific to pituitary endocrine cell type raises the possibility that this protein may play a role in determining specific pituitary cell function.

Amino Acid Sequence↗

A preliminary study of dream-telling among mentally healthy elderly: no adverse effects on life or sleep quality.

While there have been several studies about dreams and dreaming among the elderly, there does not seem to have been any study of the effects of regular dream-telling (without interpretation). Listening to dreams could become a regular part of caring for the elderly and infirm. The effects of regular dream-telling in mentally healthy elderly clinical research volunteers were measured on several variables using standardized testing and self-report: life satisfaction, intrapsychic boundaries, sleep quality, sleep duration, dream recall, dream tone, and dream epoch, and were compared with two control groups. The six variables showed no significant differences among the three groups, indicating that dream-telling produced no adverse effects. The present findings seem to imply that dream-telling is not dangerous for mentally healthy individuals and may thus serve as a baseline for future studies involving geriatric patients with mental disorders or elderly undergoing significant life-events, e.g., bereavement or retirement, using the method of regular dream-telling.

Aged↗

Phenomenology of dreams in Parkinson's disease.

Rapid eye movement sleep behavior disorder (RBD) occurs in approximately one third of patients with Parkinson's disease (PD) and is associated with a loss of muscle atonia during REM sleep and aggressive dream content. We examined the dream characteristics of PD patients to determine whether dream content differed between patients with RBD and without RBD, men and women with RBD, and men and women with PD. One hundred-twenty patients with a diagnosis of idiopathic PD were consecutively recruited from a movement disorders clinic and were assessed for RBD using clinical diagnostic criteria of the International Classification of Sleep Disorders Revised (2001). Verbatim dream content was obtained from each patient and categorized into dream themes that were coded into nominal categories. Fisher's exact tests determined whether particular dreams were correlated with RBD versus non-RBD, men and women with RBD, and men and women with PD. RBD patients had a higher percentage of violent dreams compared to non-RBD patients. There were no significant sex differences in the dream content of RBD patients. Men with PD had more aggressive dreams compared to females with PD. Aggressive dream content was characteristic of RBD patients and sex differences exist in the dream content of the PD population.

Aged↗

Prevailing mood, mood changes and dreams in bipolar disorder.

In this preliminary and exploratory study, we collected the dream reports and mood ratings of 6 outpatients with bipolar disorder over a 6-month period to compare the relationship between dream themes and mood states. We found that neutral mood states were associated with mundane, routine or uneventful dreams while manic states featured bizarre and improbable dream themes. Neither depressed nor mixed states showed a consistent trend in dream themes. By categorizing the dreams that preceded mood shifts, we were able to identify a particular type of dream that seemed to precede a mood shift, particularly in the direction of mania. Shifts to mania were heralded by dreams of death and bodily injury. Forthcoming depression was more clearly associated with a decrease in overall number of dreams reported. The significance of dreaming in relation to mood is discussed in terms of these preliminary findings and our bipolar dream scale is offered for the convenience of subsequent investigators.

Adult↗

Chronobiological features of dream production.

A review of the scientific literature clarifies several chronobiological features of dreaming. The literature supports the conclusions that dreaming 'intensity' and, to a lesser extent dream-like quality, is modulated by (1) a sinusoidal, 90-min ultradian oscillation, (2) a 'switch-like' circadian oscillation, (3) a 12-h circasemidian rhythm, and (4) a 28-day circatrigintan rhythm (for women). Further, access to dream memory sources appears to be modulated by (5) a 7-day circaseptan rhythm. Further study of these rhythmic influences on dreaming may help to explain diverse and often contradictory findings in the dream research literature, to clarify relationships between dreaming and waking cognitive processes, to explain relationships between disturbed phase relationships and dream disturbances and to shed new light on the problems of dreaming's functions and biological markers. Further chronobiological studies of dreaming will likely enable the development of theoretical models that explain how interactions between and within major levels of oscillation determine the variable characteristics of dreaming.

Adult↗

Continuity between waking activities and dream activities.

Empirical studies largely support the continuity hypothesis of dreaming. Despite of previous research efforts, the exact formulation of the continuity hypothesis remains vague. The present paper focuses on two aspects: (1) the differential incorporation rate of different waking-life activities and (2) the magnitude of which interindividual differences in waking-life activities are reflected in corresponding differences in dream content. Using a correlational design, a positive, non-zero correlation coefficient will support the continuity hypothesis. Although many researchers stress the importance of emotional involvement on the incorporation rate of waking-life experiences into dreams, formulated the hypothesis that highly focused cognitive processes such as reading, writing, etc. are rarely found in dreams due to the cholinergic activation of the brain during dreaming. The present findings based on dream diaries and the exact measurement of waking activities replicated two recent questionnaire studies. These findings indicate that it will be necessary to specify the continuity hypothesis more fully and include factors (e.g., type of waking-life experience, emotional involvement) which modulate the incorporation rate of waking-life experiences into dreams. Whether the cholinergic state of the brain during REM sleep or other alterations of brain physiology (e.g., down-regulation of the dorsolateral prefrontal cortex) are the underlying factors of the rare occurrence of highly focused cognitive processes in dreaming remains an open question. Although continuity between waking life and dreaming has been demonstrated, i.e., interindividual differences in the amount of time spent with specific waking-life activities are reflected in dream content, methodological issues (averaging over a two-week period, small number of dreams) have limited the capacity for detecting substantial relationships in all areas. Nevertheless, it might be concluded that the continuity hypothesis in its present general form is not valid and should be elaborated and tested in a more specific way.

Adult↗

Dreaming and REM sleep are controlled by different brain mechanisms.

The paradigmatic assumption that REM sleep is the physiological equivalent of dreaming is in need of fundamental revision. A mounting body of evidence suggests that dreaming and REM sleep are dissociable states, and that dreaming is controlled by forebrain mechanisms. Recent neuropsychological, radiological, and pharmacological findings suggest that the cholinergic brain stem mechanisms that control the REM state can only generate the psychological phenomena of dreaming through the mediation of a second, probably dopaminergic, forebrain mechanism. The latter mechanism (and thus dreaming itself) can also be activated by a variety of nonREM triggers. Dreaming can be manipulated by dopamine agonists and antagonists with no concomitant change in REM frequency, duration, and density. Dreaming can also be induced by focal forebrain stimulation and by complex partial (forebrain) seizures during nonREM sleep, when the involvement of brainstem REM mechanisms is precluded. Likewise, dreaming is obliterated by focal lesions along a specific (probably dopaminergic) forebrain pathway, and these lesions do not have any appreciable effects on REM frequency, duration, and density. These findings suggest that the forebrain mechanism in question is the final common path to dreaming and that the brainstem oscillator that controls the REM state is just one of the many arousal triggers that can activate this forebrain mechanism. The "REM-on" mechanism (like its various NREM equivalents) therefore stands outside the dream process itself, which is mediated by an independent, forebrain "dream-on" mechanism.

Acetylcholine↗

Intrinsic dreams are not produced without REM sleep mechanisms: evidence through elicitation of sleep onset REM periods.

The hypothesis that there is a strict relationship between dreams and a specific rapid eye movement (REM) sleep mechanism is controversial. Many researchers have recently denied this relationship, yet none of their studies have simultaneously controlled both sleep length and depth prior to non-REM (NREM) and REM sleep awakenings, due to the natural rigid order of the NREM--REM sleep cycle. The failure to control sleep length and depth prior to arousal has confounded interpretations of the REM-dreams relationship. We have hypothesised that different physiological mechanisms underlie dreaming during REM and NREM sleep, based on recent findings concerning the specificity of REM sleep for cognitive function. Using the Sleep Interruption Technique, we elicited sleep onset REM periods (SOREMP) from 13 normal subjects to collect SOREMP and sleep onset NREM (NREMP) dreams without the confounds described above. Regression analyses showed that SOREMP dream occurrences were significantly related to the amount of REM sleep, while NREMP dream occurrences were related to arousals from NREM sleep. Dream properties evaluated using the Dream Property Scale showed qualitative differences between SOREMP and NREMP dream reports. These results support our hypothesis and we have concluded that although 'dreaming' may occur during both REM and NREM periods as previous researchers have suggested, the dreams obtained from these distinct periods differ significantly in their quantitative and qualitative aspects and are likely to be produced by different mechanisms.

Adolescent↗

Adult recollections of earliest childhood dreams: a cross-cultural study.

In two studies, Caucasian and Asian college students recalled their earliest memory of a dream, and they provided information about behaviours and beliefs associated with dreaming. Consistent with previous research on childhood amnesia, participants rarely recounted dreams that occurred before age 3. In Study 1, the mean age of the earliest dream memory was 14 months earlier for Caucasians than for Asians. In Study 2, more Asians than Caucasians were unable to remember a childhood dream. Dream-related behaviours and beliefs also differed markedly across cultures. Compared to Asians, Caucasians reported talking more frequently with parents about their dreams in childhood, receiving stronger parental encouragement to share dreams, and feeling more comfortable doing so. Caucasians also reported sharing their dreams with others more frequently in adulthood and they assigned greater value to their dreams. Most Caucasians but few Asians consented to the researchers' request to send parents a questionnaire concerning the participant's childhood dreams. The results support the social interaction explanation for autobiographical memory development, in which parent-child conversations about the personal past contribute to memory accessibility.

Adolescent↗