title: Fight or flight? Dream content during sleepwalking/sleep terrors vs. rapid eye movement sleep behavior disorder.
abstract: OBJECTIVE
  Dreams enacted during sleepwalking or sleep terrors (SW/ST) may differ from those enacted during rapid eye movement sleep behavior disorder (RBD).
  
  
  METHODS
  Subjects completed aggression, depression, and anxiety questionnaires. The mentations associated with SW/ST and RBD behaviors were collected over their lifetime and on the morning after video polysomnography (PSG). The reports were analyzed for complexity, length, content, setting, bizarreness, and threat.
  
  
  RESULTS
  Ninety-one percent of 32 subjects with SW/ST and 87.5% of 24 subjects with RBD remembered an enacted dream (121 dreams in a lifetime and 41 dreams recalled on the morning). These dreams were more complex and less bizarre, with a higher level of aggression in the RBD than in SW/ST subjects. In contrast, we found low aggression, anxiety, and depression scores during the daytime in both groups. As many as 70% of enacted dreams in SW/ST and 60% in RBD involved a threat, but there were more misfortunes and disasters in the SW/ST dreams and more human and animal aggressions in the RBD dreams. The response to these threats differed, as the sleepwalkers mostly fled from a disaster (and 25% fought back when attacked), while 75% of RBD subjects counterattacked when assaulted. The dreams setting included their bedrooms in 42% SW/ST dreams, though this finding was exceptional in the RBD dreams.
  
  
  CONCLUSIONS
  Different threat simulations and modes of defense seem to play a role during dream-enacted behaviors (e.g., fleeing a disaster during SW/ST, counterattacking a human or animal assault during RBD), paralleling and exacerbating the differences observed between normal dreaming in nonrapid eye movement (NREM) vs rapid eye movement (REM) sleep.
authors.affiliation: Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, APHP, Paris, France; Pierre and Marie Curie University, Paris, France.
authors.forename: Ginevra
authors.initials: G
authors.lastname: Uguccioni
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Golmard
authors.forename: Alix Noël
authors.initials: AN
authors.lastname: de Fontréaux
authors.forename: Smaranda
authors.initials: S
authors.lastname: Leu-Semenescu
authors.forename: Agnès
authors.initials: A
authors.lastname: Brion
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression / Q000502:physiology / Q000523:psychology; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D004325:Dreams / Q000502:physiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020184:Night Terrors / Q000503:physiopathology* / Q000523:psychology; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000503:physiopathology* / Q000523:psychology; D012895:Sleep, REM / Q000502:physiology*; D013009:Somnambulism / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires