Nightmare Disorder and Isolated Sleep Paralysis

Summary & key facts

Nightmare disorder and isolated sleep paralysis are REM-related sleep problems that can cause real distress. Nightmare disorder means repeated, very upsetting, well-remembered dreams that wake a person and hurt their mood, sleep, or daily life. Isolated sleep paralysis is a state where the body stays in REM sleep muscle paralysis while the person is awake and can come with vivid hallucinations. Both are linked to things like psychiatric disorders, sleep loss, and irregular sleep schedules. Treatments that have shown benefit include imagery rehearsal therapy for nightmares and avoiding sleep loss or irregular schedules for sleep paralysis.

Key facts:

• Nightmare disorder is defined by repeated, very distressing, well-remembered dreams that usually involve threats and that cause significant problems in mood, sleep, or daily functioning (ICSD-3 criteria).
• The DSM-5 requires nightmares to occur at least once a week to meet a frequency-based diagnosis of nightmare disorder.
• Sporadic nightmares are common: one study reported 22% of adults in Austria, and Finnish data reported 36.2% of men and 45.1% of women reporting nightmares at all.
• Frequent nightmares (several nights per week) were found in 2.9% of men and 4.4% of women in pooled Finnish surveys from 1972–2007.
• In people with psychiatric disorders, the average prevalence of nightmare disorder was 38.9% across 22 studies; prevalence by condition was 66.7% in PTSD, 37.3% in mood disorders, 31.1% in personality disorders, and 15.6% in anxiety disorde
• Up to 40% of the general population experience isolated sleep paralysis at least once, though repeated episodes are less common.
• Sleep paralysis is a dissociated REM state in which REM muscle atonia persists into wakefulness and can be accompanied by very intense and vivid hallucinations.
• Research links nightmare generation to hyperarousal and impaired fear extinction, and brain imaging studies have found altered activity in emotion-regulation areas such as the cingulate cortex and frontal regions.
• Non-medication treatment, especially imagery rehearsal therapy, has been found to be especially effective for nightmares.
• Predisposing factors for isolated sleep paralysis that the review names include sleep deprivation, irregular sleep–wake schedules, and jetlag, and the review states that avoiding these factors is the most effective therapy for sleep paralys

Topics

Memory and Neural Mechanisms Sleep and related disorders Sleep and Wakefulness Research

Categories

Cognitive Neuroscience Life Sciences Neuroscience

Tags

Cognition Computer science Electroencephalography Environmental health Excessive daytime sleepiness Insomnia Medicine Nightmare Non-rapid eye movement sleep Operating system Paralysis Population Psychiatry Psychology Sleep (system call) Sleep deprivation Sleep disorder Sleep paralysis Wakefulness