Unusual sleep experiences, dissociation, and schizotypy: Evidence for a common domain

Abstract

This paper reviews studies that have examined associations between unusual sleep experiences (including nightmares, vivid dreaming, narcolepsy symptoms, and complex nighttime behaviors) and dissociation and schizotypy. Using correlational studies and structural analyses, evidence is provided that unusual sleep experiences, dissociation, and schizotypy belong to a common domain. It is demonstrated that unusual sleep experiences show specificity to dissociation and schizotypy compared to other daytime symptoms (e.g., anxiety, depression, substance use) and other sleep disturbances (e.g., insomnia, lassitude/fatigue). The paper also outlines the methodological limitations of the existing evidence and makes suggestions for future research. Finally, three models for the overlap of daytime and nighttime symptoms are reviewed, including biological abnormalities, trauma, and personality traits. Although further research is needed, it is suggested that daytime and nighttime symptoms result from problems with sleep-wake state boundaries, which may be precipitated by stress or trauma. In addition, association between daytime and nighttime symptoms can be attributed to the higher order personality trait of Oddity. Keywords dissociation; schizotypy; sleepPeople have long noted the phenotypic similarities between select nighttime experiences and daytime psychological symptoms, such nightmares and hallucinations. It is possible that phenotypically similar daytime and nighttime experiences are related, although this remains an empirical question. Specifically, it has been suggested that dissociation, schizotypy, and certain sleep experiences (i.e., nightmares, narcolepsy symptoms) belong to a domain that involves unusual cognitions and perceptions (Watson, 2001). Moreover, these daytime and nighttime experiences may share common processes under different contexts (e.g., walking around during the day versus lying in bed) (Butler, 2006;Watson, 2001), although the exact nature of these processes and whether they are due to biological or environmental factors is still uncertain.The purpose of this paper is to review evidence that certain sleep experiences, dissociation, and schizotypy represent a common domain with shared etiology. We begin by defining dissociation and schizotypy and outline the disorders and symptom dimensions that will be Correspondence should be sent to Erin Koffel,

Further validation of the Iowa Sleep Disturbances Inventory.

“…Previous research has suggested the existence of an additional higher order sleep factor, consisting of narcolepsy symptoms, nightmares, and dreaming (Watson, 2001). This factor, which is referred to as Unusual Sleep Experiences in the current study, shows evidence of specificity with PTSD symptoms within the mood and anxiety disorders, and more broadly, to measures of dissociation and schizotypy (Koffel & Watson, 2009b).One of the primary goals of this study was to expand the current ISDI to include more measures of the Unusual Sleep Experiences factor in order to continue mapping the overlap between this factor and pathological symptoms. Since the standard ISDI scales do not contain measures of narcolepsy symptoms, the current study details the addition of two narcolepsy scales: Sleep Hallucinations and Sleep Paralysis.…”

“…In this time, a significant body of research has shown that insomnia (including difficulties falling asleep, awakenings during the night, and poor sleep quality) and lassitude (including oversleeping and feelings of fatigue and sleepiness) are associated with depression and anxiety disorders (Benca, 2005;Mellman, 2006;Papadimitriou & Linkowski, 2005;Peterson & Benca, 2006;Stein & Mellman, 2005). More unusual sleep experiences (including narcolepsy symptoms and nightmares) have been linked to dissociation, schizotypy, and posttraumatic stress disorder (PTSD) (Koffel & Watson, 2009b). Watson (2001) refers to these unusual nighttime experiences as sleep-related experiences and suggests that "measures of dissociation, schizotypy and sleep-related experiences define a common domain that is characterized by unusual cognitions and perceptions" (p. 531).…”

The Mediating Role of Pathological Worry in Associations Between Dissociative Experiences and Sleep Quality Among Health Staff

“…We highlighted and extended the robust link between dissociative symptoms and sleep that has been documented on a number of studies Koffel & Watson, 2009;Selvi et al, 2017;Soffer-Dudek & Shahar, 2011;SofferDudek et al, 2017;Van Der Kloet et al, 2013;Van der Kloet et al, 2011;van Heugten-van der Kloet et al, 2015;van Heugten-van der Kloet et al, 2014;Watson, 2001). Second we demonstrated that interaction between dissociation and worry play role in sleep disturbance that the direct relations between dissociative symptomatology and sleep quality fell short of significance when the relation was moderated by pathological worry.…”

“…Scholars have argued that a labile sleep wake cycle is connected with dissociative symptomatology. It was contended that dream-like states arising from a labilesleep-wake cycle intrudes into waking consciousness, produces memory failures, and triggers dissociative experiences (Giesbrecht, Lynn, Lilienfeld, & Merckelbach, 2008;Koffel & Watson, 2009;Watson, 2001). Levin and Nielsen (2007) proposed the concept of 'cross-state continuity' that assumes the brain areas and cognitive processes implicated in nightmare production are responsible in the pathophysiology of emotion dysregulation during the waking states.…”

Stress-induced dissociation in the trajectory of schizotypal personality disorder (on the model of nosogenias in oncologic patients)

“…), а преморбид больных, склонных к таким видам расстройств самосознания [18][19][20][21], определяется в рамках расстройств личности (РЛ) драматического кластера, то применительно к сепариру-ющей диссоциации вопросы клинической структуры, «почвы» для формирования расстройств самосознания, а также их нозологической квалификации остаются акту-альными для дальнейших исследований [22][23][24][25] 2 . Клинический анализ провоцированных стрессом стойких диссоциативных расстройств, а также конститу-циональных аномалий, представляющих собой «почву» для их формирования, является основной задачей настоя-щего исследования.…”