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BMC Psychiatry Apr 2023As nightmares may be a risk factor for, or symptom of, multiple psychological disorders, some researchers suggest that nightmares should be screened, diagnosed, and...
BACKGROUND
As nightmares may be a risk factor for, or symptom of, multiple psychological disorders, some researchers suggest that nightmares should be screened, diagnosed, and treated. Treatments for nightmares include trauma-focused Cognitive Behavioural Therapy and Image Rehearsal Therapy, and pharmacological interventions such as prazosin and nitrazepam. As recent research has put into question our current understanding of treatment efficacy, there is a need to systematically review findings related to the effectiveness of nightmare treatments to inform best practice. The current review assessed the efficacy of psychosocial treatments of nightmare in all cohorts.
METHODS
A systematic search of four databases for peer reviewed journal articles from 2000 onwards produced 69 (35 RCTs, 34 non-RCTs) eligible articles that underwent narrative synthesis.
RESULTS
The results provide strong evidence for exposure and image rehearsal treatments for the reduction of nightmare frequency, severity, and distress, in civilian, military, idiopathic, and posttraumatic stress disorder (PTSD) cohorts. There is emerging evidence that self-guided and brief treatment modalities offer efficient and effective treatment options. There is an urgent need for clinical trials of treatment effectiveness in children.
CONCLUSIONS
The results suggest that treatments for nightmares are most effective when they facilitate a sense of control or mastery by directly targeting the nightmare content and/or the client's emotional responses to the nightmare content.
TRIAL REGISTRATION
A review protocol was registered with PROSPERO (CRD42020204861).
Topics: Humans; Adult; Child; Dreams; Prazosin; Stress Disorders, Post-Traumatic; Cognitive Behavioral Therapy; Treatment Outcome
PubMed: 37085821
DOI: 10.1186/s12888-023-04703-1 -
Neuroscience and Biobehavioral Reviews Jun 2024Changes in sleep and dreams are often observed during pregnancy. Dreaming may represent privileged access to the inner world of individuals, providing relevant... (Review)
Review
Changes in sleep and dreams are often observed during pregnancy. Dreaming may represent privileged access to the inner world of individuals, providing relevant information about their well-being. For this reason, a growing but heterogeneous literature has investigated dream experiences of pregnant women. The present paper aimed to systematically review the available evidence on the relationship between pregnancy and oneric activity, focusing on dream and nightmare frequency, dream contents, and emotional features. Moreover, dream changes between pre-partum and post-partum periods and the impact of previous pregnancy-related adverse events on dreaming have been summarized. Overall, 17 studies have been examined. The reviewed evidence suggests that women tend to have an abundant production of dreams and nightmares during pregnancy, and some results support the view that a high rate of dream recall is associated with poor sleep quality. Most studies have shown a high presence of pregnancy-related dream content, likely reflecting waking experiences and concerns. Additionally, dreaming may promote psychological preparation and activation of functional coping strategies to face life changes after childbirth.
PubMed: 38852848
DOI: 10.1016/j.neubiorev.2024.105763 -
Croatian Medical Journal Dec 2022To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the... (Review)
Review
AIM
To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the current understanding of this topic.
METHODS
A scoping review of available evidence on dreams and dreamlike mentation in NREM parasomnias was conducted in accordance with the PRISMA-ScR guidelines. We searched peer-reviewed literature using Google Scholar, PubMed, Ovid (Embase), Ovid Medline®, Global Health, and APA Psych Info. The Mixed Method Appraisal Tool (MMAT) was used to appraise the quality of selected articles.
RESULTS
The final analysis included 16 studies. All of the studies were from high-income countries. The studies reported on dreams and dreamlike mentation in NREM parasomnias, but there was scarcity of literature for sexsomnia, sleep-related eating disorder, and confusional arousal. All of the studies had the highest quality as shown by the MMAT (76%-100%). Emotions such as apprehension and misfortune were associated with sleepwalking and sleep terrors.
CONCLUSION
Sleep studies involving collection of dream content immediately following NREM parasomnia could significantly minimize reporting bias and improve dream data quality.
Topics: Humans; Parasomnias; Polysomnography; Emotions
PubMed: 36597564
DOI: 10.3325/cmj.2022.63.525 -
The Australian and New Zealand Journal... Oct 2022Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more... (Review)
Review
BACKGROUND
Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma exposure, emotional dysregulation and worse treatment outcomes in Posttraumatic Stress Disorder and Dissociative Disorders, with implications for BPD.
OBJECTIVE
A systematic scoping review was conducted to assess the extent of current literature regarding the impact of dissociation on BPD and to identify knowledge gaps.
METHODS
Four electronic databases (MEDLINE, APA PsycINFO, EMBASE, CINAHL Plus) were searched, and English peer-reviewed studies with adults with BPD were included, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension for scoping reviews (PRISMA-ScR) 2018 guidelines.
RESULTS
Most of the 70 included studies were observational (98%) with first authors from Germany (59%). Overall, dissociation was associated with increased BPD symptom severity, self-harm and reduced psychotherapy treatment response; findings regarding suicide risk were mixed. Dissociation was associated with working memory and cognitive deficits, decreased pain perception, altered body ownership, no substance abuse or the abuse of sedative substances, increased fantasy proneness, personality fragmentation, fearful attachment, dream anxiety, perceived stress and altered stress responses, increased cumulative body mass index, decreased water consumption, several neurological correlates and changes in gene expression.
CONCLUSION
BPD with significant dissociative symptoms may constitute a more severe and at-risk subgroup of BPD patients. However, there are significant research gaps and methodological issues in the area, including the possibility of unrecognized Dissociative Disorders in BPD study populations confounding results. Further studies are needed to better understand the impact of dissociation on BPD course and treatment, and to clarify the most appropriate assessment tools for clinical practice. In addition, interventional studies are needed to develop dissociation-specific BPD treatments to determine whether targeting dissociation in BPD can improve treatment outcomes.
Topics: Adult; Borderline Personality Disorder; Dissociative Disorders; Humans; Hypnotics and Sedatives; Psychotherapy; Self-Injurious Behavior
PubMed: 35152771
DOI: 10.1177/00048674221077029 -
Clinical Psychology Review Mar 2023Nightmares occur across a wide range of psychiatric disorders, but outside of PTSD presentations are infrequently considered a treatment priority. We aimed to assess... (Review)
Review
Nightmares occur across a wide range of psychiatric disorders, but outside of PTSD presentations are infrequently considered a treatment priority. We aimed to assess evidence for a contributory causal role of nightmares to the occurrence of psychiatric disorders, and vice versa. A systematic review was conducted of longitudinal, experimental, and clinical trial studies. Twenty-four longitudinal, sixteen trials, and no experimental studies were identified. Methodological shortcomings were common, especially the use of single-item nightmare assessment. Thirty-five studies assessed the path from nightmares to psychiatric symptoms. Depression (n = 10 studies), PTSD (n = 10) and anxiety (n = 5) were the most commonly assessed outcomes in trials. Most were not designed to assess the effect of nightmare treatment on psychiatric symptoms. Treating nightmares led to moderate reductions in PTSD and depression, small to moderate reductions in anxiety, and potentially moderate reductions in paranoia. Nightmares increased the risk of later suicide outcomes (n = 10), but two small pilot trials indicated that treating nightmares might potentially prevent recovery of suicidal ideation. PTSD treatment led to large reductions in trauma-related nightmares (n = 3). The limited literature suggests that treating nightmares may be one route to lessening threat-based disorders in particular, suggestive of a causal relationship. Overall, however, nightmares in most disorders are greatly understudied.
Topics: Humans; Stress Disorders, Post-Traumatic; Dreams; Anxiety; Anxiety Disorders; Suicidal Ideation
PubMed: 36566699
DOI: 10.1016/j.cpr.2022.102241 -
International Journal of Environmental... Sep 2021Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective... (Review)
Review
Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63-72.5%) and nightmares (ranging between 33.3-46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires.
Topics: Dreams; Humans; Natural Disasters; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Wildfires
PubMed: 34639453
DOI: 10.3390/ijerph181910152 -
Frontiers in Integrative Neuroscience 2023The presence of visual imagery in dreams of congenitally blind people has long been a matter of substantial controversy. We set to systematically review body of... (Review)
Review
BACKGROUND
The presence of visual imagery in dreams of congenitally blind people has long been a matter of substantial controversy. We set to systematically review body of published work on the presence and nature of oneiric visuo-spatial impressions in congenitally and early blind subjects across different areas of research, from experimental psychology, functional neuroimaging, sensory substitution, and sleep research.
METHODS
Relevant studies were identified using the following databases: EMBASE, MEDLINE and PsychINFO.
RESULTS
Studies using diverse imaging techniques and sensory substitution devices broadly suggest that the "blind" occipital cortex may be able to integrate non-visual sensory inputs, and thus possibly also generate visuo-spatial impressions. Visual impressions have also been reported by blind subjects who had near-death or out-of-body experiences.
CONCLUSION
Deciphering the mechanistic nature of these visual impression could open new possibility in utilization of neuroplasticity and its potential role for treatment of neurodisability.
PubMed: 37457556
DOI: 10.3389/fnint.2023.1204129 -
Sleep Medicine Reviews Apr 2024Sleep is typically considered a state of disconnection from the environment, yet instances of external sensory stimuli influencing dreams have been reported for... (Review)
Review
Sleep is typically considered a state of disconnection from the environment, yet instances of external sensory stimuli influencing dreams have been reported for centuries. Explaining this phenomenon could provide valuable insight into dreams' generative and functional mechanisms, the factors that promote sleep continuity, and the processes that underlie conscious awareness. Moreover, harnessing sensory stimuli for dream engineering could benefit individuals suffering from dream-related alterations. This PRISMA-compliant systematic review assessed the current evidence concerning the influence of sensory stimulation on sleep mentation. We included 51 publications, of which 21 focused on auditory stimulation, ten on somatosensory stimulation, eight on olfactory stimulation, four on visual stimulation, two on vestibular stimulation, and one on multimodal stimulation. Furthermore, nine references explored conditioned associative stimulation: six focused on targeted memory reactivation protocols and three on targeted lucid reactivation protocols. The reported frequency of stimulus-dependent dream changes across studies ranged from 0 to ∼80%, likely reflecting a considerable heterogeneity of definitions and methodological approaches. Our findings highlight a lack of comprehensive understanding of the mechanisms, functions, and neurophysiological correlates of stimulus-dependent dream changes. We suggest that a paradigm shift is required for meaningful progress in this field.
Topics: Humans; Dreams; Sleep; Cognition; Consciousness
PubMed: 38417380
DOI: 10.1016/j.smrv.2024.101908 -
Journal of the American Heart... May 2022Background Clinical prediction models have been developed for hospitalization for heart failure in type 2 diabetes. However, a systematic evaluation of these models'... (Meta-Analysis)
Meta-Analysis Review
Background Clinical prediction models have been developed for hospitalization for heart failure in type 2 diabetes. However, a systematic evaluation of these models' performance, applicability, and clinical impact is absent. Methods and Results We searched Embase, MEDLINE, Web of Science, Google Scholar, and Tufts' clinical prediction registry through February 2021. Studies needed to report the development, validation, clinical impact, or update of a prediction model for hospitalization for heart failure in type 2 diabetes with measures of model performance and sufficient information for clinical use. Model assessment was done with the Prediction Model Risk of Bias Assessment Tool, and meta-analyses of model discrimination were performed. We included 15 model development and 3 external validation studies with data from 999 167 people with type 2 diabetes. Of the 15 models, 6 had undergone external validation and only 1 had low concern for risk of bias and applicability (Risk Equations for Complications of Type 2 Diabetes). Seven models were presented in a clinically useful manner (eg, risk score, online calculator) and 2 models were classified as the most suitable for clinical use based on study design, external validity, and point-of-care usability. These were Risk Equations for Complications of Type 2 Diabetes (meta-analyzed c-statistic, 0.76) and the Thrombolysis in Myocardial Infarction Risk Score for Heart Failure in Diabetes (meta-analyzed c-statistic, 0.78), which was the simplest model with only 5 variables. No studies reported clinical impact. Conclusions Most prediction models for hospitalization for heart failure in patients with type 2 diabetes have potential concerns with risk of bias or applicability, and uncertain external validity and clinical impact. Future research is needed to address these knowledge gaps.
Topics: Diabetes Mellitus, Type 2; Heart Failure; Hospitalization; Humans; Models, Statistical; Prognosis
PubMed: 35574959
DOI: 10.1161/JAHA.121.024833 -
Sleep Medicine Reviews Jun 2024Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and...
Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and nightmares in individuals without a concomitant psychopathology. The relationships between insomnia and dreams are also addressed. PsycINFO and Medline were searched for papers published in English or French from 1970 to March 2023. Sixty-seven articles were included for review. Most results support positive relationships between insomnia variables and nightmare variables in individuals with insomnia, individuals with nightmares, the general population, students, children and older adults, and military personnel and veterans. These positive relationships were also apparent in the context of the COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective in alleviating both nightmares and insomnia symptoms. Regarding the relationships between insomnia and dreams, compared with controls, the dreams of individuals with insomnia are characterized by more negative contents and affects. The results show that insomnia and nightmares are connected and may be mutually aggravating. A model is proposed to explain how insomnia might increase the likelihood of experiencing nightmares, and how nightmares can in turn lead to sleep loss and nonrestorative sleep.
Topics: Humans; COVID-19; Dreams; Sleep Initiation and Maintenance Disorders
PubMed: 38733767
DOI: 10.1016/j.smrv.2024.101931