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Adults Have Dreamlike Thoughts During Sleepwalking and Sleep Terrors Episodes


ScienceDaily (Dec. 1, 2009) — A study in the Dec.1 issue of the journal Sleep shows that short, unpleasant, dreamlike mental activity occurs during sleepwalking and sleep terrors episodes, suggesting that people with these sleep disorders may be acting out dreamlike thoughts.


Results show that 71 percent of participants reported at least one incident of dreamlike mental content associated with an episode of sleepwalking or sleep terrors, and the action in the dreamlike thoughts corresponded with the observed behavior. A total of 106 reports of dreamlike mental activity were collected; the mental content was brief, with 95 percent of the reports involving a single visual scene. These dreamlike thoughts were frequently unpleasant, with 84 percent involving apprehension, fear or terror; 54 percent involving misfortune, in which injury, mishap or adversity occurred through chance or environmental circumstances; and 24 percent involving aggression, with the dreamer always being the victim. Compared with healthy controls, patients with sleepwalking and sleep terrors reported more severe daytime sleepiness and had four times as many arousals from slow-wave sleep.


Principal investigator Isabelle Arnulf, MD, PhD, neurologist and head of the sleep disorders unit at Unité des Pathologies du Sommeil at Hôpital Pitié-Salpêtrière in Paris, France, said that it has been widely believed that dreams do not occur during sleepwalking and sleep terrors events. However, previous studies focused mostly on children rather than adults.


“The results are surprising, as it is commonly reported that sleepwalkers and patients with sleep terrors do not remember dreaming,” said Arnulf. “Adults involved in the study who experienced sleepwalking and sleep terrors were less confused during the episode than children, making it easier to express their dream mentations.”


According to the AASM, sleepwalking and sleep terrors typically occur during arousals from slow-wave sleep and are classified as “parasomnias,” which are undesirable events or experiences that occur during entry into sleep, within sleep or during arousals from sleep. Sleepwalking occurs when a person gets out of bed and walks around with an altered state of consciousness and impaired judgment. An episode of sleep terrors occurs when a person sits up in bed with a look of intense fear, often making a cry or piercing scream.


Forty-three patients with severe, frequent, dangerous or disturbing episodes of sleepwalking or sleep terrors participated in the study and were matched with 25 healthy control subjects. The mean age of patients was 26 years with a range from 11 to 72 years, and 46 percent were male. Five patients suffered exclusively from sleep terrors, eight subjects suffered from sleepwalking only and 30 experienced both sleepwalking and sleep terrors.


Data were gathered retrospectively by interview, so that the dreamlike thoughts that were collected covered a lifetime span for each patient. Thirty-eight patients (88 percent) were able to reliably answer questions about their mental content during the sleepwalking and sleep terrors episodes. Sleep also was monitored during one night in a laboratory.


For a long time rapid eye movement (REM) sleep has been considered to be the neurobiological basis of dreaming, the authors noted. Although complex mental activity has been reported in non-REM sleep during slow-wave sleep, the extent to which the reported dreamlike thoughts may be described as “dreaming” is still debated.


The authors suggested that the brief, dreamlike activity occurring during sleepwalking and sleep terrors could be either the terminal part of a longer dream that is forgotten at the time of arousal, or a short mental creation elicited before or just at the time of arousal.


Source:   http://www.sciencedaily.com/releases/2009/12/091201084053.htm



Sleep Changes Predict Onset of Physical Changes Associated With Puberty


ScienceDaily (Dec. 1, 2009) — A new study in the journal Sleep suggests that changes in children’s sleep patterns that typically occur between the ages of 11 and 12 years are evident before the physical changes associated with the onset of puberty.


Results show that over the two-year course of the study, sleep onset was significantly delayed by an average of 50 minutes, and sleep time was significantly reduced by an average of 37 minutes. Girls had higher sleep efficiency and reported fewer night wakings than boys. Initial levels of sleep predicted an increase in pubertal development over time, whereas there was no similar prediction in the opposite direction. According to the authors, this suggests that the neurobehavioral changes associated with puberty may be seen earlier in measures of sleep organization than in bodily changes.


Lead author Avi Sadeh, D.Sc, professor of psychology at Tel Aviv University in Israel, said that biological factors have a significant influence on sleep during puberty; however, psychosocial issues such as school demands, social activities and technological distractions can lead to the development of bad sleep habits. Therefore, parents and educators can play an important role in helping children understand how to prioritize sleep as they grow and mature.


“It is very important for parents to be aware of the importance of sleep to their developing teenager and to maintain their supervision throughout the adolescent years,” said Sadeh. “School health education should also provide children with compelling information on how insufficient sleep compromises their well-being, psychological functioning and school achievements.”


According to the authors, sleep-wake organization undergoes significant reorganization during the transition to adolescence. The main changes include a delayed sleep phase, which involves a tendency for later bedtimes and rise times; shorter sleep, which is associated with increased levels of daytime sleepiness; and irregular sleep patterns, which involve sleeping very little on weekdays and sleeping longer during weekends to partially compensate for this sleep loss. During maturation adolescents also develop greater tolerance to sleep deprivation or extended wakefulness.


Data from 94 children (41 boys and 53 girls) were collected from a larger study on sleep and neurobehavioral functioning during the transition to puberty. Children were recruited from regular classes of five different elementary schools in the Tel Aviv area. At first assessment the age range was about 10 years to 11 years. Each child completed a number of questionnaires, including the Sexual Maturation Scale (SMS) and the Puberty Development Scale (PDS) for pubertal development assessment. All children were healthy with no chronic medical or psychological problems.


Sleep-wake patterns were observed subjectively with a sleep diary and objectively using an actigraph, which the children wore on their wrist. The same assessment was repeated, at a similar time of year, for two successive years. Eighty-two children completed the second assessment, and 72 completed the third assessment.


The authors noted that Israel has a six-day school week, with Friday being the only day that is not followed by school. As expected, significant differences were found between sleep on Friday nights and sleep on school nights. On Fridays, sleep onset was delayed, sleep time was extended and sleep quality was poorer in comparison with school nights. These differences were not associated with puberty status or gender, suggesting that the tendency for weekend compensatory sleep is relatively steady over the period of early adolescence.


According to the authors, a deeper understanding of the interrelationships between sleep and pubertal maturation may provide new insights into the emergence of vulnerabilities for behavioral and emotional health problems in early adolescence, which could improve prevention and early intervention efforts.


Source:   http://www.sciencedaily.com/releases/2009/12/091201084051.htm



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