Erin Wamsley1, Claire E H M Donjacour2, Thomas E Scammell3, Gert Jan Lammers4, Robert Stickgold5. 1. Department of Psychiatry, Harvard Medical School, Boston, MA ; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA ; Department of Psychology, Furman University, Greenville, SC. 2. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Neurology, Harvard Medical School, Boston, MA ; Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA. 4. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands ; Sleep Wake Center SEIN, Heemstede, The Netherlands. 5. Department of Psychiatry, Harvard Medical School, Boston, MA ; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA.
Abstract
STUDY OBJECTIVES: We investigated a generally unappreciated feature of the sleep disorder narcolepsy, in which patients mistake the memory of a dream for a real experience and form sustained delusions about significant events. DESIGN: We interviewed patients with narcolepsy and healthy controls to establish the prevalence of this complaint and identify its predictors. SETTING: Academic medical centers in Boston, Massachusetts and Leiden, The Netherlands. PARTICIPANTS: Patients (n = 46) with a diagnosis of narcolepsy with cataplexy, and age-matched healthy healthy controls (n = 41). INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: "Dream delusions" were surprisingly common in narcolepsy and were often striking in their severity. As opposed to fleeting hypnagogic and hypnopompic hallucinations of the sleep/wake transition, dream delusions were false memories induced by the experience of a vivid dream, which led to false beliefs that could persist for days or weeks. CONCLUSIONS: The delusional confusion of dreamed events with reality is a prominent feature of narcolepsy, and suggests the possibility of source memory deficits in this disorder that have not yet been fully characterized.
STUDY OBJECTIVES: We investigated a generally unappreciated feature of the sleep disorder narcolepsy, in which patients mistake the memory of a dream for a real experience and form sustained delusions about significant events. DESIGN: We interviewed patients with narcolepsy and healthy controls to establish the prevalence of this complaint and identify its predictors. SETTING: Academic medical centers in Boston, Massachusetts and Leiden, The Netherlands. PARTICIPANTS: Patients (n = 46) with a diagnosis of narcolepsy with cataplexy, and age-matched healthy healthy controls (n = 41). INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: "Dream delusions" were surprisingly common in narcolepsy and were often striking in their severity. As opposed to fleeting hypnagogic and hypnopompic hallucinations of the sleep/wake transition, dream delusions were false memories induced by the experience of a vivid dream, which led to false beliefs that could persist for days or weeks. CONCLUSIONS: The delusional confusion of dreamed events with reality is a prominent feature of narcolepsy, and suggests the possibility of source memory deficits in this disorder that have not yet been fully characterized.