Abstract
In the 19th century, several authors held the view that nightmares are caused by oxygen shortage. The present study was designed to study nightmare frequency in patients with obstructive sleep apnea syndrome and its relationship to respiratory parameters. A brief questionnaire was administered to 323 patients with sleep apnea syndrome before their first laboratory night. The reduction in nightmare frequency in the sleep apnea group was explained by the reduced dream recall frequency. Despite some illustrative examples of a correlation between oxygen desaturation and dream content, the respiratory parameters as measures of sleep apnea syndrome severity did not correlate substantially with nightmare frequency. Psychiatric comorbidity and an intake of psychotropic medication were associated with heightened nightmare frequency in this sample. It must be concluded that the oxygen hypothesis did not play a major role in explaining the occurrence of nightmares. As this might be partly explained by adaptation to the nightly desaturation periods, it will be fruitful to apply experimental procedures that interrupt airflow during (rapid eye movement) REM sleep for short periods in a systematic way without the knowledge of the sleeper and to then study their effects on dream content. Some patients reported a correlation between daytime stressors and nightmares, which is in line with modern etiological models of nightmares.
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References
Hartmann E (1984) The nightmare: the psychology and biology of terrifying dreams. Basic Books, New York
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (DSM IV). American Psychiatric Association, Washington, DC
Siebenthal W (1953) Die Wissenschaft vom Traum: ergebnisse und probleme. Springer, Berlin Heidelberg New York
Schredl M (2003) Effects of state and trait factors on nightmare frequency. Eur Arch Psychiatry Clin Neurosci 253:241–247
Waller J (1824) Abhandlung über das Alpdrücken, den gestörten Schlaf, erschreckende Träume und nächtliche Erscheinungen. Philipp Heinrich Guilhauman, Frankfurt
Strahl M (1833) Der Alp, sein Wesen und seine Heilung. Theod Chr Fr Enslin, Berlin
Boerner J (1855) Das alpdrücken: seine begründung und verhütung. Carl Joseph Becker, Würzburg
Cubasch W (1877) Der Alp Habel, Berlin
Klink M, Quan SF (1987) Prevalence of reported sleep disturbances in a general adult population and their relationship to obstructive airway diseases. Chest 91:540–546
Janson C, Gislason T, Boman G, Hetta J, Roos BE (1990) Sleep disturbances in patients with asthma. Respir Med 84:37–42
Wood JM, Bootzin RR, Quan SF, Klink ME (1993) Prevalence of nightmares among patients with asthma and chronic obstructive airways disease. Dreaming 3:231–241
Shapiro CM, Catterall JR, Montgomery I, Raab GM, Douglas NJ (1986) Do asthmatics suffer bronchoconstriction during rapid eye movement sleep. BMJ 292:1161–1164
de Groen JHM, Op den Velde W, Hovens JE, Falger PR, Schouten EGW, van Duijn H (1993) Snoring and anxiety dreams. Sleep 16:35–36
Youakam JM, Doghraniji K, Schutte SL (1998) Posttraumatic stress disorder and obstructive sleep apnea syndrome. Psychosomatics 39:168–179
Krakow B, Lowry C, Germain A, Gaddy L, Hollifield M, Koss M, Tandberg D, Johnston L, Melendrez D (2000) A retrospective study on improvements in nightmares and post-traumatic stress disorder following treatment for co-morbid sleep-disordered breathing. J Psychosom Res 49:291–298
Hicks RA, Bautista J (1993) Snoring and nightmares. Percept Mot Skills 77:433–434
Schredl M (1991) Traumerinnerungshäufigkeit und trauminhalt bei schlafgestörten, psychiatrischen patienten und gesunden. Unveröffentlichte diplomarbeit, Universität Mannheim
Gross M, Lavie P (1994) Dreams in sleep apnea patients. Dreaming 4:195–204
Schredl M (1998) Träume und Schlafstörungen: empirische studie zur traumerinnerungshäufigkeit und zum trauminhalt schlafgestörter patientinnen. Marburg, Tectum
Schredl M, Kraft-Schneider B, Kröger H, Heuser I (1999) Dream content of patients with sleep apnea. Somnologie 3:319–323
Sahota PK, Singh HW, Karim A (2001) Changes in dreaming in patients using continuous positive airway pressure (CPAP) for documented obstructive sleep apnea (OSA). Sleep Suppl 24:A294–A295
Schredl M, Kraft B, Morlock M, Bozzer A (1998) Trauminhalte von schlafgestörten patienten und patientinnen. Psychother Psychosom Med Psychol 48:39–45
Schredl M (2002) Messung der traumerinnerung: skala und daten gesunder personen. Somnologie 6:34–38
Schredl M, Wittmann L, Ciric P, Götz S (2003) Factors of home dream recall: a structural equation model. J Sleep Res 12:133–141
Schramm E, Riemann D (1995) Internationale Klassifikation der Schlafstörungen (ICSD). Beltz, Weinheim
Dement WC, Wolpert EA (1958) The relation of eye movements, body motility and external stimuli to dream content. J Exp Psychol 44:543–553
Nielsen TA (1993) Changes in the kinesthetic content of dreams following somatosensory stimulation of leg muscles during REM sleep. Dreaming 3:99–113
Zadra A, Donderi DC (2000) Nightmares and bad dreams: their prevalence and relationship to well-being. J Abnorm Psychology 109:273–281
Levin R, Fireman G (2002) Nightmare prevalence, nightmare distress, and self-reported psychological disturbance. Sleep 25:205–212
Schredl M (2003) Continuity between waking and dreaming: a proposal for a mathematical model. Sleep Hypnosis 5:38–52
Pagel JF, Helfter P (2003) Drug induced nightmares—an etiology based review. Hum Psychopharmacol 18:59–67
Schredl M, Montasser A (1996-97) Dream recall: state or trait variable? Imagin Cogn Pers 16:181–210, 239–261
Schredl M (Eur J Neurol) Dream recall frequency of patients with restless legs syndrome. Eur J Neurol 8:185–189
Aldrich M, Eiser A, Lee M, Shipley JE (1989) Effects of continuous positive airway pressure on phasic events of REM sleep in patients with obstructive sleep apnea. Sleep 12:413–419
Fietze I, Warmuth R, Witt C, Baumann GG (1995) Sleep-related breathing disorder and pavor nocturnus. Sleep Res 24A:301
Pressman MR, Meyer TJ, Kendrick-Mohamed J, Figueroa WJ, Greenspan LW, Petersen DD (1995) Night terrors in an adult precipitated by sleep apnea. Sleep 18:773–775
Nielsen TA, Zadra AL, Simard V, Saucier S, Stenstrom P, Smith C, Kuiken D (2003) The typical dreams of Canadian university students. Dreaming 13:211–235
Schredl M (1996) Höre auf deine Träume. Midena-Verlag, Küttingen
Gastaut H, Broughton R (1964) A clinical and polygraphic study of episodic phenomena during sleep. Recent Adv Biol Psychiatry 7:197–221
Beyme F (1993) Revalidierung des “Dream hostility counts” nach Saul und Sheppard mittels einer Zeitreihe aus 24 Träumen, von denen sieben in einer Aufwachmigräne ausmünden. Schweiz Arch Neurol Psychiatr 144:561–573
Heather-Greener GQ, Comstock D, Joyce R (1996) An investigation of the manifest content associated with migraine headaches: a study of dreams that precede nocturnal migraines. Psychother Psychosom 65:216–221
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The authors are members of the AG Traum of the German Sleep Society (DGSM).
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Schredl, M., Schmitt, J., Hein, G. et al. Nightmares and oxygen desaturations: is sleep apnea related to heightened nightmare frequency?. Sleep Breath 10, 203–209 (2006). https://doi.org/10.1007/s11325-006-0076-8
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DOI: https://doi.org/10.1007/s11325-006-0076-8