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

BaHammam, Ahmed S.; Almeneessier, Aljohara S.

doi:10.3389/fneur.2019.01127

Cited by 22 publications

(9 citation statements)

References 67 publications

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“… 82 One explanation could be that it depends on the OSA being REM-stage specific or not. 83 OSA is relevant during the pandemic as people at high risk for OSA were more likely to contract COVID-19, to be hospitalized or receive intensive unit care treatment. 73 …”

Section: Discussionmentioning

confidence: 99%

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey

Holzinger¹,

Nierwetberg²,

Chung³

et al. 2022

NSS

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Purpose The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored. Patients and Methods For this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: ≥1–2 nights/week; low: <1–2 nights/week). A total of 9100 participants were excluded if answers on variables of interest were missing or receiving rewards for participation. Chi-square tests identified changes of nightmare frequency. Predictors of high nightmare frequency were assessed using logistic regression and presented as Odds Ratios. Post-hoc mediation models were used to investigate the role of post-traumatic stress symptoms (PTSS). Results The mean age was 41.63 (SD=16.55) with 64.05% females. High nightmare frequency increased significantly from 13.24% to 22.35% during the pandemic. Factors associated with it included self-reported PTSS (OR=2.11), other mental disorders and various sleep disorders or problems. Financial burden due to the pandemic, confinement, having had COVID-19, and work situation during the pandemic were associated with nightmare frequency, those relations were partly mediated through PTSS. Conclusion Our results display the pandemic influence on nightmare frequency, which in turn connects to multiple mental health and sleep factors. These relations were partly mediated through PTSS. The COVID-19 pandemic appears to have caused traumatization of a substantial proportion of society. Health care workers should consider nightmares in their screening routines, as it might indicate PTSS and/or other mental and sleep disorders.

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Section: Discussionmentioning

confidence: 99%

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey

Holzinger¹,

Nierwetberg²,

Chung³

et al. 2022

NSS

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“…Parasomnias are dissociated sleep states which are partial arousals during transitions between wakefulness, NREM sleep, REM sleep, and their combinations ( Howell, 2012 ). Multiple studies have shown that OSAHS is associated with parasomnias, including nightmares ( BaHammam and Almeneessier, 2019 ), RBD, sleepwalking, and sleep terrors ( Guilleminault et al, 2003 ; Haupt et al, 2013 ). A study of 84 children with recurrent or long-term sleepwalking showed that 58% had OSAHS.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with OSAHS often present at sleep centers because of nightmares ( BaHammam and Almeneessier, 2019 ) and other parasomnias. Some symptoms of parasomnias are secondary to OSAHS ( Goyal et al, 2018 ), and when OSAHS is effectively treated, the symptoms of parasomnia are also relieved ( Carrasco et al, 2006 ).…”

Section: Discussionmentioning

confidence: 99%

“…Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, when sleeping, between sleep stages, or during arousal from sleep ( Howell, 2012 ). Obstructive events induce recurrent sleep fragmentation and intermittent desaturations in patients with OSAHS ( Mendonca et al, 2019 ), which may trigger various parasomnias, including nightmares ( BaHammam and Almeneessier, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Parasomnia Overlap Disorder Induced by Obstructive Sleep Hypopnea Apnea Syndrome: A Case Report and Literature Review

Sun

Zhang

et al. 2020

Front. Neurosci.

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Obstructive sleep apnea hypopnea syndrome (OSAHS) and parasomnia overlap disorder (POD) are types of sleep disorders. When the symptoms of both conditions coexist, the POD symptoms are most likely caused by OSAHS. In these cases, the symptoms of POD will be relieved when OSAHS is effectively treated. We refer to these cases as symptomatic POD (related to OSAHS), which differs in pathophysiology, complications, and treatment from idiopathic POD. It is important to note that the treatment for idiopathic POD may aggravate the symptoms of OSAHS. In this case, we used video polysomnography (v-PSG) on a POD patient with suspected OSAHS to distinguish idiopathic POD from symptomatic POD, to inform the appropriate treatment course. The video results and clinical features lead us to diagnose symptomatic POD, and we treated the patient with auto-set continuous positive airway pressure to address their OSAHS. This course of treatment resolved all POD-related symptoms. Here, we discuss this case and review the relevant literature. This report highlights the importance of the use of v-PSG in the clinical diagnosis, differential diagnosis, and subsequent treatment of POD.

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“…Additionally, awakenings from obstructive events often occur with sympathetic nervous system activation, with associated symptoms of racing heart, shortness of breath, and anxiety, all of which could worsen the experience of a nightmare [47]. OSA has been associated with nightmares even in individuals without PTSD, often with content related to suffocation, choking, drowning, strangulation, burial, and death [48][49][50][51]. A study of patients with OSA who slept in a laboratory before and after starting continuous positive airway pressure (CPAP) were awakened after the beginning of every REM period for dream reports.…”

Section: The Osa and Ptsd Overlapmentioning

confidence: 99%

A Narrative Review of the Association between Post-Traumatic Stress Disorder and Obstructive Sleep Apnea

McCall

Watson

2022

JCM

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Obstructive sleep apnea (OSA) and post-traumatic stress disorder (PTSD) are often co-morbid with implications for disease severity and treatment outcomes. OSA prevalence is higher in PTSD sufferers than in the general population, with a likely bidirectional effect of the two illnesses. There is substantial evidence to support the role that disturbed sleep may play in the pathophysiology of PTSD. Sleep disturbance associated with OSA may interfere with normal rapid eye movement (REM) functioning and thus worsen nightmares and sleep-related movements. Conversely, hyperarousal and hypervigilance symptoms of PTSD may lower the arousal threshold and thus increase the frequency of sleep fragmentation related to obstructive events. Treating OSA not only improves OSA symptoms, but also nightmares and daytime symptoms of PTSD. Evidence suggests that positive airway pressure (PAP) therapy reduces PTSD symptoms in a dose-dependent fashion, but also presents challenges to tolerance in the PTSD population. Alternative OSA treatments may be better tolerated and effective for improving both OSA and PTSD. Further research avenues will be introduced as we seek a better understanding of this complex relationship.

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

Cited by 22 publications

References 67 publications

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey

Case Report: Parasomnia Overlap Disorder Induced by Obstructive Sleep Hypopnea Apnea Syndrome: A Case Report and Literature Review

A Narrative Review of the Association between Post-Traumatic Stress Disorder and Obstructive Sleep Apnea

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