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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01127

Dreams and nightmares in patients with obstructive sleep apnea: A review

  • 1Department of Medicine, King Saud University, Saudi Arabia
  • 2Department of Internal Medicine, College of Medicine, King Saud University, Saudi Arabia
  • 3Department of Family and Community Medicine, College of Medicine, King Saud University, Saudi Arabia

Obstructive sleep apnea (OSA) can present with or provoke various psychological symptoms. In this article, we critically review studies that have examined dreams, dream recall, and dream contents in patients with OSA. Obstructive events induce recurrent sleep fragmentation and intermittent desaturations in patients with OSA, which may trigger different parasomnias, including nightmares. Contradictory results have been reported concerning dreams in patients with OSA; while some investigators have reported less dreams in OSA patients, others have described that patients with OSA have increased dreams with emotional content, mainly violent and hostile content. Although there are reports of respiratory-related dream contents in patients with OSA, most studies that have assessed the dream contents of patients with OSA revealed that respiratory-related dream contents were unusual. A clear association between post-traumatic stress disorders, comorbid OSA, and nightmares has been reported in several studies. Further, an improvement in nightmare frequency with continuous positive airway pressure (CPAP) treatment has been shown. An inverse relationship between the severity of OSA reflected by the apnea-hypopnea index and dream recall has been demonstrated in several studies. Future studies should differentiate between patients with non-stage specific OSA and patients with rapid eye movement (REM) predominant OSA.

Keywords: Sleep-disordered breathing (SDB), CPAP (continuous positive airway pressure), REM sleep, Post-Traumatic Stress Disorder (PTSD), Hypopnea, emotion

Received: 24 Jul 2019; Accepted: 09 Oct 2019.

Copyright: © 2019 BaHammam and Almeneessier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Ahmed S. BaHammam, King Saud University, Department of Medicine, Riyadh, 11324, Saudi Arabia,