Dream Content Alalysis at the Initiation of CPAP for Obstructive Sleep Apnea

Abstract

Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is a condition characterized by repeated episodes of airway obstruction during sleep, causing intermittent asphyxia and sleep fragmentation. The goal of this study was to assess dream content analysis before and during the first night of treatment for OSAHS using Continuous Positive Pressure (CPAP). We included 38 patients diagnosed using complete overnight polysomnography (PSG), who received CPAP therapy during a second night under PSG. Dream content (word count, thematic units, and emotional content) and the percent of REM sleep were analyzed after both nights. There was an increase in the percent of REM under CPAP (from 16,7% to 26,8%). There was an increase in the number of thematic units (1,36 without CPAP versus 1,82 under CPAP) and in the word count (30,52 without CPAP versus 45,22 under CPAP) and a change in the dream content (unpleasant content in 50% without CPAP versus 37,5% under CPAP). Under CPAP, more patients recalled their dreams than without CPAP (94,2% versus 57,9%). In conclusion, at the initiation of CPAP for OSAHS, there is a rebound of REM sleep associated with a quantitative increase in dream recall and a change in dream content.

Nightmare types and suicide.

“…However, we believe this term and the topic (examination of differences between trauma-related nightmares that exist with and without the presence of SDB) will prove to produce many novel insights into the complicated phenomenon that is the trauma-related nightmare. Furthermore, previous research does exist that documents and supports the complicated relationship between nightmares and SDB (such as poor dream recall associated with SDB; Lovin et al, 2013; Pagel & Kwiatkowski, 2010), thus warranting the term and future endeavors. Regardless, more research is needed to both validate this definition and provide further clarification into the relationship between nightmares and SDB.…”

Dreams and Nightmares in Patients With Obstructive Sleep Apnea: A Review

“…Positively toned dreams, especially after long-term CPAP therapy, may be explained by the continuity hypothesis (whereby dreams express waking concerns and emotional preoccupations) because CPAP treatment is often seen as very beneficial in patients with OSA (76). However, another study of 38 patients OSA who underwent a diagnostic study followed by a second night on CPAP therapy reported a rebound of REM sleep accompanied by a quantitative increase in dream recall and a change in dream content (26). CPAP therapy resulted in a change in the dream content with a reduction in unpleasant content (50% without CPAP vs. 37.5% under CPAP) (26).…”

“…However, another study of 38 patients OSA who underwent a diagnostic study followed by a second night on CPAP therapy reported a rebound of REM sleep accompanied by a quantitative increase in dream recall and a change in dream content (26). CPAP therapy resulted in a change in the dream content with a reduction in unpleasant content (50% without CPAP vs. 37.5% under CPAP) (26). A third study demonstrated that OSA patients with nightmares experienced an increase in sleep interruptions and had more obstructive events in REM sleep than those without nightmares.…”