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  • Print publication year: 2011
  • Online publication date: September 2011

41 - REM sleep and dreams: relationship to anxiety, psychosomatic, and behavioral disorders

from Section VI - Disturbance in the REM sleep-generating mechanism

Summary

Summary

Sleep disturbances are frequently associated with, and can comprise core features of, anxiety disorders. Studies using objective sleep recordings have demonstrated impaired sleep initiation and maintenance in persons with generalized anxiety disorder or panic disorder, but a normal latency to REM sleep. Increased phasic motor activity and eye movement density during REM sleep have been reported in combat veterans with post-traumatic stress disorder: moreover, nightmares and other symptomatic awakenings disproportionately arise from REM sleep.

One of the most consistent behavioral manifestations of sleep loss is the worsening of mood state. With prolonged sleep deprivation it is possible to observe an increase in self-reported feelings of depressed mood, anger, frustration, and anxiety. Interestingly, there is little evidence that waking stress leads to increased REM, although there have been reports of small elevations in REM following severe emotional upset. REM sleep might have some sort of calming effect.

The relationship between somatic distress and dream disturbance has been recently investigated: individuals who reported more incidents of both bad dreams and nightmares did report higher levels of somatic distress. However, REM sleep behavior disorder (RBD), a parasomnia characterized by complex and often violent motor behaviors that emerge from REM sleep and that are associated with violent and unpleasant dreams, represents a particular condition. A discrepancy between the aggressiveness displayed in dreams and the placid and mild-mannered temperament has been observed in patients with RBD.

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American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th Ed (text revision, DSM-IV-R). Washington, DC:American Psychiatric Association Press.
American Sleep Disorders Association (2005) ICSD-II, International Classification of Sleep Disorders: Diagnostic and Coding Manual. Chicago, IL:American Academy of Sleep Medicine.
Barrett, D. (1996) Trauma and Dreams. Cambridge, MA:Harvard University Press.
Beyer, J. L. & Krishnan, K. R. (2002) Volumetric brain imaging findings in mood disorders. Bipolar Disord 4: –104.
Blagrove, M., Farmer, L. & Williams, E. (2004) The relationship of nightmare frequency and nightmare distress to well-being. J Sleep Res 13: –36.
Boeve, B. F., Silber, M. H., Saper, C. B. . (2007) Pathophysiology of REM sleep behavior disorder and relevance to neurodegenerative disease. Brain 130: –88.
Breslau, N., Roth, T. & Rosenthal, L. . (1996) Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 39: –18.
Breslau, N., Roth, T., Burduvali, E. . (2004) Sleep in lifetime posttraumatic stress disorder: a community-based polysomnographic study. Arch Gen Psychiatry 61: –16.
Caldwell, J., Caldwell, J., Brown. D, L, . (2004) The effects of 37 h of continuous wakefulness on the physiological arousal, cognitive performance, self-reported mood, and simulator flight performance of F-117A pilots. Military Psychology 16: –81.
Cartwright, R. D., Monroe, L. & Palmer, C. (1967) Individual differences in response to REM sleep deprivation. Arch Gen Psychiatr 16: –303.
Choi, J, Kang, D., Kim, J. . (2005) Decreased caudal anterior cingulate gyrus volume and positive symptoms in schizophrenia. Psychiat Res: Neuroim 139: –47.
Dinges, D. F., Pack, F., Williams, K. . (1997) Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4–5 h per night. Sleep 20: –77.
Domhoff, G. W. (2001) A new neurocognitive theory of dreams. Dreaming 11: –33.
Fantini, M. L., Ferini-Strambi, L. & Montplaisir, J. (2005a) Idiopathic REM sleep behavior disorder: toward a better nosological definition. Neurology 64: –6.
Fantini, M. L., Corona, A., Clerici, S. . (2005b) Aggressive dream content without daytime aggressiveness in REM sleep behaviour disorder. Neurology 65: –
Fantini, M. L., Postuma, R. B., Montplaisir, J. . (2006) Olfactory deficit in idiopathic REM sleep behavior disorder. Brain Res Bull 70: –90.
Fantini, M. L. & Ferini-Strambi, L. (2007) REM-related dreams. In REM Sleep Behavior Disorder: the New Science of Dreaming, eds. McNamara, P. & Barrett, D.. Westport, CT: Greenwood Publishers, pp. 185–200.
Ferini-Strambi, L., Di Gioia, M. S., Castronovo, V. . (2004) Neuropsychological assessment in idiopathic REM sleep behavior disorder (RBD). Does the idiopathic form of RBD really exist?Neurology 62: –5.
Ferini-Strambi, L., Fantini, M. L., Zucconi, M. . (2005) REM sleep behavior disorder. Neurol 26 (Suppl 3): –92.
Foulkes, D. (1967) Dreams of the male child: four case studies. J Child Psychol Psychiatry 8: –98.
Gagnon, J. F., Bédard, M. A., Fantini, M. L. . (2002) REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease. Neurology 59: –9.
Gillin, J. C., Buchsbaum, M., Wu, J. . (2001) Sleep deprivation as a model experimental antidepressant treatment: findings from functional brain imaging. Depress Anxiety 2: –49.
Habukawa, M., Uchimura, N., Maeda, M. . (2007) Sleep findings in young adult patients with posttraumatic stress disorder. Biol Psychiatry 62: –82.
Hobson, J. A. & McCarley, R. W. (1977) The brain as a dream state generator: an activation-synthesis hypothesis of the dream process. Am J Psychiatry 134:–48.
Hohagan, F., Lis, S., Krieger, S. . (1994) Sleep EEG of patients with obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 243: –8.
Insel, T., Gillin, J., Moore, A. . (1982) The sleep of patients with obsessive-compulsive disorder. Arch Gen Psychiatry 39: –7.
Iranzo, A., Graus, F., Clover, L. . (2006) Rapid eye movement sleep behavior disorder and potassium channel antibody-associated limbic encephalitis. Ann Neurol 59: –81.
Jung, C. (1974) Dreams. Princeton, NJ: Princeton University Press.
Kahn-Greene, E. T., Killgore, D. B. & Kamimori, G. (2007) The effects of sleep deprivation on symptoms of psychopathology in healthy adults. Sleep Med 8: –21.
Kupfer, D. J. & Bowers, M. B. (1972) REM sleep and central monoamine oxidase inhibition. Psychopharmacology 27: –90.
Landolt, H. P., de Boer, L. P., Raimo, E. B. . (1999) Almost complete absence of REM sleep in a depressed patient during six months on Phenelzine. Sleep Res Online 2 (Suppl) 1: .
Levin, R. & Fireman, G. (2002) Nightmares prevalence, nightmares distress, and self-reported psychological disturbance. Sleep 25: –12.
Levin, R., Lantz, E., Fireman, G. . (2009) The relationship between disturbed dreaming and somatic distress. J Nerv Ment Dis 197: –12.
Liguori, R., Vincent, A., Clover, L. . (2001) Morvan’s syndrome: peripheral and central nervous system and cardiac involvement with antibodies to voltage-gated potassium channels. Brain 124: –26.
Maquet, P., Peters, J. M., Aerts, J. . (1996) Functional neuroanatomy of human repid eye movement sleep and dreaming. Nature 383: –6.
McKeith, I. G. for the DLB Consortium (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65: –72.
Mellman, T. (2008) Sleep and anxiety disorders. Sleep Med Clin 3: –8.
Mellman, T. & Uhde, T. (1989) Electroencephalographic sleep in panic disorder: a focus on sleep-related panic attacks. Arch Gen Psychiatry 46: –84.
Meyer-Lindenberg, A. S., Olsen, R. K., Kohn, P. D. . (2005) Regionally specific disturbance of dorsolateral prefrontal-hippocampal functional connectivity in schizophrenia. Arch Gen Psychiatry 62: –86.
Morris, J. S., Ohman, A. & Dolan, R. (1998) Conscious and unconscious emotional learning in the human amygdala. Nature 393: –70.
Nielsen, T. & Levin, R. (2007) Nightmares: a new neurocognitive model. Sleep Med Rev 11: –310.
Nofzinger, E. A., Mintun, M., Wiseman, M. B. . (1997) Forebrain activation in REM sleep: an FDG PET study. Brain Res 770: –201.
Nolen-Hoeksema, S. (1990) Sex Differences in Depression. Stanford, CA:Stanford University Press.
Noyes, R. Jr, Watson, D. B., Letuchy, E. M. . (2005) Relationship between hypochondriacal concerns and personality dimensions and traits in a military population. J Nerv Ment Dis 193: –18.
Ohayon, M., Morselli, P. L. & Guilleminault, C. (1997) Prevalence of nightmares and their relationship to psychopathology and daytime functioning in insomnia subjects. Sleep 20: –8.
Pesant, N. & Zadra, A. (2006) Dream content and psychological well-being: a longitudinal study of the continuity hypothesis. J Clin Psychol 62:–21.
Postuma, R. B., Lang, A., Massicotte-Marquez, J. . (2006) Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder. Neurology 66: –51.
Postuma, R. B., Gagnon, J. F., Vendette, M. . (2009) Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology 72: –300.
Rief, W., Hiller, W. & Margraf, J. (1998) Cognitive aspects of hypochondriasis and the somatization syndrome. J Abnorm Psychol 107: –95.
Robinson, D., Walsleben, J., Pollack, S. . (1998) Nocturnal polysomnography in obsessive-compulsive disorder. Psychiatry Res 80: –63.
Saletu-Zyhlarz, G., Saletu, B., Anderer, P. . (1997) Nonorganic insomnia in generalized anxiety disorder: controlled studies on sleep, awakening and daytime vigilance utilizing polysomnography and EEG mapping. Neuropsychobiology 36: –29.
Scott, J. P., McNaughton, L. & Polman, R. C. (2006) Effects of sleep deprivation and exercise on cognitive, motor performance and mood. Physiol Behav 87: –408.
Schenck, C. H. & Mahowald, M. W. (2002) REM sleep behavior disorder: clinical, developmental, and neuroscience perspectives 16 years after its formal identification in Sleep. Sleep 25:–38.
Schenck, C. H., Bundlie, S. R. & Mahowald, M. W. (2003) REM behavior disorder (RBD): delayed emergence of parkinsonism and/or dementia in 65% of older men initially diagnosed with idiopathic RBD, and analysis of the minimum and maximum tonic and/or phasic electromyographic abnormalities found during REM sleep. Sleep 26: Abstract Supplement: .
Simard, V., Nielsen, T., Tremblay, R. E. . (2008) Longitudinal study of bad dreams in preschool children: prevalence, demographic correlates, risk and protective factors. Sleep 31: –70.
Smith, C. & Lapp, L. (1991) Increases in number of REMS and REM density in humans following an intensive learning period. Sleep 14: –30.
Staner, L., Kerkhofs, M., Detroux, D. . (1995) Acute, subchronic and withdrawal sleep EEG changes during treatment with paroxetine and amitryptyline: a double blind randomised trial in major depression. Sleep 18: –7.
Stirling, J., Hellewell, J., Blakey, A. . (2006) Thought disorder in schizophrenia is associated with both executive dysfunction and circumscribed impairments in semantic function. Psychol Med 20: –10.
Thomas, M., Sing, H., Belenky, G. . (2000) Neural basis of alertness and cognitive performance impairments during sleepiness. I. Effects of 24 h of sleep deprivation on waking human regional activity. J Sleep Res 9: –52.
Videbech, P. (2000) PET measurements of brain glucose metabolism and blood flow in major depressive disorder: a critical review. Acta Psychiatr Scand 101: –20.
Watt, M. C. & Stewart, S. H. (2000) Anxiety sensitivity mediates the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood. J Psychosom Res 49: –18.
Wyatt, R. J., Fram, D. H., Kupferm, D. J. . (1971a) Total, prolonged drug induced REM sleep suppresssion in anxious depressed patients. Arch Gen Psychiat 24: –55.
Wyatt, R. J., Fram, D. H. & Buchbinder, R. (1971b) Treatment of intractable narcolepsy with a monoamine oxidase inhibitor. New Eng J Med 285: –91.
Zadra, A. & Donden, D. C. (1993) Variety and intensity of emotions in bad dreams and nightmares. Can Psychol 34: .
Zohar, D., Tzischinsky, O., Epstein, R. . (2005) The effects of sleep loss on medical residents’ emotional reactions to work events: a cognitive-energy model. Sleep 28: –54.