Hypnogogic and Hypnopompic Phemonema
From Wikipedia (quit smirking – this is a good overview)
Hypnogogic
Sometimes the word hypnagogia is used in a restricted sense to refer to the onset of sleep, and contrasted with hypnopompia, Frederic Myers’s term for waking up.[1] However, hypnagogia is also regularly employed in a more general sense that covers both falling asleep and waking up, and Havelock Ellis questioned the need for separate terms.[2] Indeed, it is not always possible in practice to assign a particular episode of any given phenomenon to one or the other, given that the same kinds of experience occur in both, and that people may drift in and out of sleep. In this article hypnagogia will be used in the broader sense, unless otherwise stated or implied.
Other terms for hypnagogia, in one or both senses, that have been proposed include “presomnal” or “anthypnic sensations”, “visions of half-sleep”, “oneirogogic images” and “phantasmata”,[2] “the borderland of sleep”, “praedormitium”,[3] “borderland state”, “half-dream state”, “pre-dream condition”,[4] “sleep onset dreams”,[5] “dreamlets”,[6] and “wakefulness-sleep transition” (WST).[7]
Threshold consciousness (commonly called “half-asleep” or “half-awake”, or “mind awake body asleep”) describes the same mental state of someone who is moving towards sleep or wakefulness, but has not yet completed the transition. Such transitions are usually brief, but can be extended by sleep disturbance or deliberate induction, for example during meditation.]
Hypnopompic
A hypnopompic state (or hypnopomp) is the state of consciousness leading out of sleep, a term coined by the psychical researcher Frederic Myers. Its mirror is the hypnagogic state at sleep onset; though often conflated, the two states are not identical. The hypnagogic state is rational waking cognition trying to make sense of non-linear images and associations; the hypnopompic state is emotional and credulous dreaming cognition trying to make sense of real world stolidity. They have a different phenomenological character. Depressed frontal lobe function in the first few minutes after waking – known as “sleep inertia” – causes slowed reaction time and impaired short-term memory. Sleepers often wake confused, or speak without making sense, a phenomenon the psychologist Peter McKeller calls “hypnopompic speech”.[1] When the awakening occurs out of rapid eye movement (REM) sleep, in which most dreams occur, the hypnopompic state is sometimes accompanied by lingering vivid imagery. Some of the creative insights attributed to dreams actually happen in this moment of awakening from REM. In Deirdre Barrett’s The Committee of Sleep, Margie Profet’s McArthur-award winning biology experiment is shown to be one of these.
Research on Hypnogogic and Hypnopompic Phenomena
Sleep paralysis, ‘the ghostly bedroom intruder’ and out-of-body experiences: The role of mirror neurons.
Jalal, Baland., Ramachandran, Vilayanur S.
Frontiers in Human Neuroscience, Vol 11, Feb 28, 2017. ArtID: 92
Abstract:
This article discusses role of mirror neurons in sleep paralysis, out-of-body experiences. Sleep paralysis (SP) is triggered by the pons and ventromedial medulla that suppress skeletal muscle tone during Rapid eye movement (REM) sleep—via inhibition of motor neurons in the spinal cord; through neurotransmitters Gamma Aminobutyric Acid (GABA) and glycine. Perceptual activation occurs while under the ‘spell’ of REM paralysis. The result is a curious condition called sleep paralysis, where the person is left ‘trapped’—unable to move or speak upon falling asleep or upon awakening. During SP, the vivid—and sometimes terrifying—dreams of REM sleep can spill over into emerging wakefulness. Hypnogogic or hypnopompic hallucinations occur in all sensory modalities, and include out-of-body experiences (OBE), and sensing and seeing the presence of menacing intruders in one’s bedroom. The authors further evoke the mirror neuron system (MNS) as crucial in giving rise to this ‘intruder’ hallucination. The MNS allows one to temporarily detach from once body and ‘see’ the world from another person’s vantage point. The authors suggest that OBEs during SP, likewise result from the massive deafferentation that occurs during REM sleep paralysis.
What is the link between hallucinations, dreams, and hypnagogic – hypnopompic experiences?
Waters, Flavie. Health, Perth, Blom, Jan Dirk., Dang-Vu, Thien Thanh., Cheyne, Allan J.. Alderson-Day, Ben., Woodruff, Peter., Collerton, Daniel.
Schizophrenia Bulletin, Vol 42(5), Sep, 2016. pp. 1098-1109.
Abstract:
By definition, hallucinations occur only in the full waking state. Yet similarities to sleep-related experiences such as hypnagogic and hypnopompic hallucinations, dreams and parasomnias, have been noted since antiquity. These observations have prompted researchers to suggest a common aetiology for these phenomena based on the neurobiology of rapid eye movement (REM) sleep. With our recent understanding of hallucinations in different population groups and at the neurobiological, cognitive and interpersonal levels, it is now possible to draw comparisons between the 2 sets of experiences as never before. In the current article, we make detailed comparisons between sleep-related experiences and hallucinations in Parkinson’s disease, schizophrenia and eye disease, at the levels of phenomenology (content, sensory modalities involved, perceptual attributes) and of brain function (brain activations, resting-state networks, neurotransmitter action). Findings show that sleep-related experiences share considerable overlap with hallucinations at the level of subjective descriptions and underlying brain mechanisms. Key differences remain however: (1) Sleep-related perceptions are immersive and largely cut off from reality, whereas hallucinations are discrete and overlaid on veridical perceptions; and (2) Sleep-related perceptions involve only a subset of neural networks implicated in hallucinations, reflecting perceptual signals processed in a functionally and cognitively closed-loop circuit. In summary, both phenomena are non-veridical perceptions that share some phenomenological and neural similarities, but insufficient evidence exists to fully support the notion that the majority of hallucinations depend on REM processes or REM intrusions into waking consciousness.
How to make the ghosts in my bedroom disappear? Focused-attention meditation combined with muscle relaxation (MR therapy)—A direct treatment intervention for sleep paralysis.
Jalal, Baland.
Frontiers in Psychology, Vol 7, Jan 29, 2016. ArtID: 28
Abstract:
[Correction Notice: An Erratum for this article was reported in Vol 7[1194] of Frontiers in Psychology (see record 2016-41711-001). Due to a typesetting error, the references of Sharpless and Barber (2011) and Sharpless and Doghramji (2015) were inadvertently interchanged in the original article. Corrections are provided in the erratum.] Sleep paralysis (SP) is a common state of involuntary immobility occurring at sleep onset or offset. It can include terrifying hypnogogic or hypnopompic hallucinations of menacing bedroom intruders. Unsurprisingly, the experience is associated with great fear and horror worldwide. To date, there exist no direct treatment intervention for SP. In this article, I propose for the first time a type of focused inward-attention meditation combined with muscle relaxation as a direct intervention to be applied during the attack, to ameliorate and possibly eliminate it (what could be called, meditation-relaxation or MR therapy for SP). The intervention includes four steps: (1) reappraisal of the meaning of the attack; (2) psychological and emotional distancing; (3) inward focused-attention meditation; (4) muscle relaxation. The intervention promotes attentional shift away from unpleasant external and internal stimuli (i.e., terrifying hallucinations and bodily paralysis sensations) unto an emotionally pleasant internal object (e.g., a positive memory). It may facilitate a relaxed meditative state characterized by a shift from sympathetic to parasympathetic dominance, associated with greater levels of alpha activity (which may lead to drowsiness and potentially sleep). The procedure may also reduce the initial panic and arousal that occur when realizing one is paralyzed. In addition, I present a novel Panic-Hallucination (PH) Model of Sleep Paralysis; describing how through escalating cycles of fear and panic-like autonomic arousal, a positive feedback loop is created that worsens the attack (e.g., leading to longer and more fearful episodes), drives content of hallucinations, and causes future episodes of SP. Case examples are presented to illustrate the feasibility of MR therapy for SP.
A web survey of the content, sensory modalities, and interpretation of hypnagogic and hypnopomic experiences.
Sherwood, Simon J.
Journal of Parapsychology, Vol 76(1), Spr 2012. pp. 27-55.
Abstract:
Various anomalous experiences have been reported just as people are falling asleep (hypnagogic state) or awakening from sleep (hypnopompic state). These states might be conducive to the operation of paranormal processes but might also facilitate the misinterpretation of normal experiences. It is therefore important to investigate the range of experiences reported in these states and how they are interpreted. Research into hypnagogic/hypnopompic imagery has focused on hypnagogic (HG) imagery and the visual and auditory modalities in particular. Comparatively little is known about hypnopompic (HP) imagery and other sensory modalities. A web survey, with 492 respondents, investigated the relative frequency of sensory modalities for HG and HP imagery, their content, and how they have been interpreted. The results suggest that HG is more common than HP imagery; visual, falling and sense of presence sensations are the most common forms,followed by auditory, tactile, bodily, and movement sensations. Olfactory and gustatory imagery is rare. A qualitative analysis revealed a wide range of themes that apply to both HG/ HP experiences, although some only occur in one particular state. Respondents’ interpretations of the imagery included normal aspects of mind/body functioning, possible physical or mental health problems, and paranormal, spiritual, mystical, or supernatural processes.
When words and pictures come alive: Relating the modality of intrusive thoughts to modalities of hypnagogic/hypnopompic hallucinations.
McCarthy-Jones, Simon., Barnes, Laura J., Hill, Georgina E., Marwood, Lindsey., Moseley, Peter, Fernyhough, Charles., McCarthy-Jones, Simon.
Personality and Individual Differences, Vol 51(6), Oct, 2011. pp. 787-790.
Abstract:
Hypnagogic and hypnopompic (H&H) hallucinations are those experienced on the borders of sleep and waking. Intrusive thoughts have been proposed to relate to the occurrence of such experiences. In a sample of students (N =299), the present study investigated the relation between auditory and felt-presence H&H experiences, and specific modalities of intrusive thought (auditory and visual) whilst controlling for age, gender, depression, anxiety and thought suppression. The psychometric properties of the Durham Hypnagogic and Hypnopompic Hallucinations Questionnaire (DHQ) were also examined. Exploratory (N =299) and, in a second sample, confirmatory (N =502) factor analyses showed good internal and test–retest reliability for the auditory and felt-presence subscales of the DHQ, but not for the visual subscale. Regression analyses indicated that the sole predictor of auditory H&H hallucinations was intrusive auditory imagery, and the sole predictor of felt-presence H&H experiences was intrusive visual imagery. Explanations for these findings are considered and implications for future research are discussed.
Sleep paralysis in adolescents: The ‘a dead body climbed on top of me’ phenomenon in Mexico.
Jiménez-Genchi, Alejandro., Ávila-Rodríguez, Víctor M., Sánchez-Rojas, Frida, Nenclares-Portocarrero, Alejandro.
Psychiatry and Clinical Neurosciences, Vol 63(4), Aug, 2009. pp. 546-549.
Abstract:
Aims: The aim of the present study was to evaluate the prevalence and characteristics of sleep paralysis in adolescents using a folk expression. Methods: Three hundred and twenty-two adolescents (mean age, 15.9 ± 0.88 years; 66.8% female) from three high schools in Mexico City completed both a self-reported questionnaire, including a colloquial definition of sleep paralysis and the Epworth Sleepiness Scale. Results: A high proportion of the adolescents (92.5%) had heard about the ‘a dead body climbed on top of me’ expression and 27.6% of them had experienced the phenomenon. Sleep paralysis was present in 25.5% while the prevalence rate for hypnagogic/hypnopompic hallucinations was 22%; 61% had experienced ≥2 episodes in their lifetime. The mean age of onset was 12.5 ± 3 years. Sleepiness scores for the subjects who had experienced at least one event were not significantly different from subjects who had not experienced any. In 72% of cases, the episodes were composed of both sleep paralysis and hallucinations while 20.2% consisted of only sleep paralysis and 7.8% of only hallucinations. The number and characteristics of events were not significantly different between adolescents with only one episode and those with two or more episodes. Conclusions: The characteristics of the ‘a dead body climbed on top of me’ phenomenon suggest that is identical to sleep paralysis and a frequent experience among Mexican adolescents. During adolescence, sleep paralysis seems to be a recurrent phenomenon frequently accompanied by hallucinatory experiences.
‘The devil lay upon her and held her down’: Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand Van Diemerbroeck (1609-1674) in 1664 .
Kompanje, E. J. O.
Journal of Sleep Research, Vol 17(4), Dec, 2008. pp. 464-467.
Abstract:
Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664, the Dutch physician Isbrand Van Diemerbroeck (1609–1674) published a collection of case histories. One history with the title ‘Of the Night-Mare’ describes the nightly experiences of the 50-year-old woman. This case report is subject of this article. The experiences in this case could without doubt be diagnosed as sleep paralysis accompanied by hypnagogic hallucinations. This case from 1664 should be cited as the earliest detailed account of sleep paralysis associated with hypnagogic illusions and as the first observation that sleep paralysis and hypnagogic experiences occur more often in supine position of the body.
Sleep Paralysis, Sexual Abuse, and Space Alien Abduction.
McNally, Richard J., Clancy, Susan A.
Transcultural Psychiatry, Vol 42(1), Mar, 2005. pp. 113-122.
Abstract:
Sleep paralysis accompanied by hypnopompic (‘upon awakening’) hallucinations is an often-frightening manifestation of discordance between the cognitive/perceptual and motor aspects of rapid eye movement (REM) sleep. Awakening sleepers become aware of an inability to move, and sometimes experience intrusion of dream mentation into waking consciousness (e.g. seeing intruders in the bedroom). In this article, we summarize two studies. In the first study, we assessed 10 individuals who reported abduction by space aliens and whose claims were linked to apparent episodes of sleep paralysis during which hypnopompic hallucinations were interpreted as alien beings. In the second study, adults reporting repressed, recovered, or continuous memories of childhood sexual abuse more often reported sleep paralysis than did a control group. Among the 31 reporting sleep paralysis, only one person linked it to abuse memories. This person was among the six recovered memory participants who reported sleep paralysis (i.e. 17% rate of interpreting it as abuse-related). People rely on personally plausible cultural narratives to interpret these otherwise baffling sleep paralysis episodes.
Relationship between the hypnagogic/hypnopompic states and reports of anomalous experiences.
Sherwood, Simon J.
Journal of Parapsychology, Vol 66(2), Jun, 2002. pp. 127-150.
Abstract:
A range of anomalous experiences has been reported during the borderline hypnagogic or hypnopompic states that surround periods of sleep. The question is whether these states are conducive to anomalous processes or agencies, whether normal features are being misinterpreted, or both. This article outlines the main physiological and psychological features of these hypnagogic/hypnopompic states and considers some of the evidence to address this question. It is concluded that hypnagogic/hypnopompic features may be both conducive to anomalous experiences and misinterpreted as involving anomalous processes or agencies. The interpretation may depend on the specific hypnagogic/hypnopompic features experienced, on individual knowledge and beliefs, and on the context in which the phenomena occur. What is being proposed then is that, although hypnagogic/hypnopompic imagery and sleep paralysis are relatively normal experiences, occasionally they may be influenced by anomalous processes or may facilitate anomalous experiences. More attention to the stages, features, contents, and physiology of the hypnagogic/hypnopompic states may enable us to identify, perhaps with a greater degree of accuracy, if and when anomalous processes are operating.
The ominous numinous: Sensed presence and ‘other’ hallucinations.
Cheyne, J. Allan.
Journal of Consciousness Studies, Vol 8(5-7), May-Jul, 2001. Special Issue: Between ourselves. pp. 133-150.
Abstract:
A ‘sensed presence’ often accompanies hypnagogic and hypnopompic hallucinations associated with sleep paralysis. Qualitative descriptions of the sensed presence during sleep paralysis are consistent with the experience of a monitoring, stalking predator. It is argued that the sensed presence during sleep paralysis arises because of REM-related endogenous activation of a hypervigilant and biased attentive state, the normal function of which is to resolve ambiguities inherent in biologically relevant threat cues. Given the lack of disambiguating environmental cues, however, the feeling of presence persists as a protracted experience that is both numinous and ominous. This experience, in turn, shapes the elaboration and integration of the concurrent hallucinations that often take on supernatural and daemonic qualities. The sense of presence considered here is an ‘other’ that is radically different from, and hence more than a mere projection of, the self. Such a numinous sense of otherness may constitute a primordial core consciousness of the animate and sentient in the world around us.
The place of confusional arousals in sleep and mental disorders: Findings in a general population sample of 13,057 subjects.
Ohayon, Maurice M., Priest, Robert G., Zulley, Jürgen Smirne, Salvatore
Journal of Nervous and Mental Disease, Vol 188(6), Jun, 2000. pp. 340-348.
Abstract:
Confusional arousals, or sleep drunkenness, occur upon awakening and remain unstudied in the general population. A representative sample of 13,057 Ss aged 15+ yrs from the UK, Germany, and Italy were interviewed. Confusional arousals were reported by 2.9% of the sample: 1% of the sample also presented with memory deficits, disorientation in time and/or space, or slow mentation and speech, and confusional arousals without associated features. Ss younger than 35 yrs and shift or night workers were at higher risk of reporting confusional arousals. These arousals were strongly associated with the presence of a mental disorder. Bipolar and anxiety disorders were the most frequently associated mental disorders. Furthermore, subjects with Obstructive Sleep Apnea Syndrome (OSAS), hypnagogic or hypnopompic hallucinations, violent or injurious behaviors, insomnia, and hypersomnia, are more likely to suffer from confusional arousals. Confusional arousals appear to occur quite frequently in the general population, affecting mostly younger Ss regardless of their gender. Physicians should be aware of the frequent associations between confusional arousals, mental disorders, and OSAS.
Prevalence and pathologic associations of sleep paralysis in the general population.
Ohayon, Maurice M., Zulley, Jürgen Guilleminault, Christian Smirne, Salvatore.
Neurology, Vol 52(6), Apr, 1999. pp. 1194-1200.
Abstract:
Estimated the prevalence of sleep paralysis (SP) in the general population and identified the factors associated with this phenomenon. 8,085 Ss (aged ≥ 15 yrs) were surveyed by telephone using the Sleep-EVAL questionnaire and the Sleep Questionnaire of Alertness and Wakefulness (A. B. Douglass et al, 1994). 494 Ss had experienced at least one SP episode in their lifetime. At the time of the interview, severe SP (at least 1 episode per wk) occurred in 0.8% of the sample, moderate SP (at least 1 episode per mo) in 1.4%, and mild SP (less than 1 episode per mo) in 4.0%. Significant predictive variables of SP were anxiolytic medication, automatic behavior, bipolar disorders, physical disease, hypnopompic hallucinations, nonrestorative sleep, and nocturnal leg cramps. This study indicates that the disorder is often associated with a mental disorder. Users of anxiolytic medication were nearly 5 times as likely to report SP, even after the authors controlled for possible effects of mental and sleep disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Hypnogogic/pompic Hallucinations and Children
Parasomnias in children.
Mahowald, Mark W., and Rosen, Gerald M.
Pediatrician, Vol 17(1), 1990. pp. 21-31.
Abstract:
Describes a clinical classification system for parasomnia and presents guidelines for evaluation and treatment. REM disorders include dream anxiety attacks, sleep paralysis, hypnagogic or hypnopompic hallucinations, and REM sleep behavior disorder. Sleep starts, partial arousals, and sleep drunkenness characterize nonrapid eye movement (NREM) disorders. Non-sleep stage parasomnias include bruxism, enuresis, rhythmic movement disorder, posttraumatic stress disorder (PTSD), periodic movements of sleep, and somniloquy. Secondary sleep parasomnias include central nervous system (CNS) cardiopulmonary, and gastrointestinal disorders. The importance of a thorough diagnostic work-up prior to treatment is stressed.
Hypnagogic and hypnopompic hallucinations: Pathological phenomena?
Ohayon, Maurice M., et al.
The British Journal of Psychiatry, Vol 169(4), Oct, 1996. pp. 459-467.
Abstract:
Explored the prevalence of hypnagogic and hypnopompic hallucinations in the general population. A representative community sample of 4,972 people (aged 15–100 yrs) in the UK interviewed by telephone. 37% of the sample reported experiencing hypnagogic hallucinations, and 12.5% reported experiencing hypnopompichallucinations. Both types of hallucinations were significantly more common among Ss with symptoms of insomnia, excessive daytime sleepiness, or mental disorders. According to this study, the prevalence of narcolepsy in the UK is 0.04%.
The place of confusional arousals in sleep and mental disorders: Findings in a general population sample of 13,057 subjects.
Ohayon, Maurice M., et al
Journal of Nervous and Mental Disease, Vol 188(6), Jun, 2000. pp. 340-348.
Abstract:
Confusional arousals, or sleep drunkenness, occur upon awakening and remain unstudied in the general population. A representative sample of 13,057 Ss aged 15+ yrs from the UK, Germany, and Italy were interviewed. Confusional arousals were reported by 2.9% of the sample: 1% of the sample also presented with memory deficits, disorientation in time and/or space, or slow mentation and speech, and confusional arousals without associated features. Ss younger than 35 yrs and shift or night workers were at higher risk of reporting confusional arousals. These arousals were strongly associated with the presence of a mental disorder. Bipolar and anxiety disorders were the most frequently associated mental disorders. Furthermore, subjects with Obstructive Sleep Apnea Syndrome (OSAS), hypnagogic or hypnopompic hallucinations, violent or injurious behaviors, insomnia, and hypersomnia, are more likely to suffer from confusional arousals. Confusional arousals appear to occur quite frequently in the general population, affecting mostly younger Ss regardless of their gender. Physicians should be aware of the frequent associations between confusional arousals, mental disorders, and OSAS.
The ominous numinous: Sensed presence and ‘other’ hallucinations.
Cheyne, J. Allan.
Between ourselves: Second-person issues in the study of consciousness. Thompson, Evan, (Ed); pp. 133-150; Charlottesville, VA: Imprint Academic; 2001. vi, 314 pp.
Abstract:
A ‘sensed presence’ often accompanies hypnagogic and hypnopompic hallucinations associated with sleep paralysis. Qualitative descriptions of the sensed presence during sleep analysis are consistent with the experience of a monitoring, stalking predator. It is argued that the sensed presence during sleep paralysis arises because of REM-related endogenous activation of a hypervigilant and biased attentive state, the normal function of which is to resolve ambiguities inherent in biologically relevant threat cues. Given the lack of disambiguating environmental cues, however, the feeling of presence persists as a protracted experience that is both numinous and ominous. This experience, in turn, shapes the elaboration and integration of the concurrent hallucinations that often take on supernatural and daemonic qualities. The sense of presence considered here is an ‘other’ that is radically different from, and hence more than a mere projection of, the self. Such a numinous sense of otherness may constitute a primordial core consciousness of the animate and sentient in the world.
Sleep Paralysis, Sexual Abuse, and Space Alien Abduction.
McNally, Richard J., and Clancy, Susan A.
Transcultural Psychiatry, Vol 42(1), Mar, 2005. pp. 113-122.
Abstract:
Sleep paralysis accompanied by hypnopompic (‘upon awakening’) hallucinations is an often-frightening manifestation of discordance between the cognitive/perceptual and motor aspects of rapid eye movement (REM) sleep. Awakening sleepers become aware of an inability to move, and sometimes experience intrusion of dream mentation into waking consciousness (e.g. seeing intruders in the bedroom). In this article, we summarize two studies. In the first study, we assessed 10 individuals who reported abduction by space aliens and whose claims were linked to apparent episodes of sleep paralysis during which hypnopompic hallucinations were interpreted as alien beings. In the second study, adults reporting repressed, recovered, or continuous memories of childhood sexual abuse more often reported sleep paralysis than did a control group. Among the 31 reporting sleep paralysis, only one person linked it to abuse memories. This person was among the six recovered memory participants who reported sleep paralysis (i.e. 17% rate of interpreting it as abuse-related). People rely on personally plausible cultural narratives to interpret these otherwise baffling sleep paralysis episodes.
In a dark time: Development, validation, and correlates of the Durham Hypnagogic and Hypnopompic Hallucinations Questionnaire.
Jones, Simon R., et al
Personality and Individual Differences, Vol 46(1), Jan, 2009. pp. 30-34.
Abstract:
One factor limiting research involving hypnagogic and hypnopompic (H&H) hallucinations is the lack of a brief, valid and reliable self-report measure of such experiences. The present paper reports on the development of the Durham Hypnagogic and Hypnopompic Hallucinations Questionnaire (DHQ), which consists of three unidimensional subscales assessing the presence of auditory, visual, and felt-presence experiences in the H&H state. In a sample of 18-29 year olds (N = 365) this scale was found to have satisfactory psychometric properties. A subsample (n = 293) completed self-report measures of intrusive thoughts, thought suppression and transliminality. Intrusive thoughts and the conscious desire to undertake thought suppression both correlated with levels of auditory, but not visual or felt-presence H&H hallucinations. Transliminality correlated with all DHQ subscales, but significantly more strongly with felt presence than visual H&H experiences. Implications of these findings are considered, and recommendations for future research made.
Confusional arousals, sleep terrors, and sleepwalking.
Meltzer, Lisa J., and McLaughlin Crabtree, Valerie.
Pediatric sleep problems: A clinician’s guide to behavioral interventions. Meltzer, Lisa J.; McLaughlin Crabtree, Valerie; pp. 175-182; Washington, DC, US: American Psychological Association; 2015. xv, 282 pp.
Abstract:
Confusional arousals, sleep terrors, and sleepwalking are all disorders of arousal, also known as partial arousal parasomnias or nonrapid eye movement (NREM) parasomnias. These events occur during the transition out of slow-wave sleep to lighter sleep, rapid eye movement (REM) sleep, or a brief arousal. Because most slow-wave sleep occurs in the first part of the night, NREM parasomnias typically occur during the first few hours after sleep onset. In addition, because slow-wave sleep decreases with age, events become less common in older school-age children and adolescents. Although less common, NREM parasomnias can also occur during daytime naps for younger children (thus the term sleep terrors rather than night terrors). There are also REM parasomnias that can occur, including REM-sleep behavior disorder, hypnagogic/hypnopompic hallucinations, and nightmares. The treatment of nightmares is covered in Chapter 8, and the other two disorders are rare in children and adolescents, and thus are not covered in this chapter. Each type of NREM parasomnia has a different presentation. Confusional arousals can be seen in infants as young as 6 months and are characterized by confusion, disorientation, grogginess, and possible agitation. Sleep terrors are most common in preschool and early school age children and present with a child waking suddenly and appearing frightened and/or significantly distressed (i.e., screaming, crying). Many children (up to 40%) will have at least one episode of sleepwalking in their life. These children will appear dazed and confused, with their eyes open, and may mumble or talk nonsensically. In addition, some sleepwalkers will engage in unusual behaviors (e.g., walking down the hall and urinating in a closet, making a sandwich and then not eating it or cleaning up, wandering out of the house). Despite the different presentations, there are a number of common features for these events. Most are brief in duration (i.e., 5–10 minutes) and end spontaneously, although some children may experience more severe NREM parasomnias that last up to an hour. Children will often not respond to, not interact with, or not be comforted by parents during an event, and if they do, the child will often appear confused or noncoherent. Attempting to wake a child who is having an NREM parasomnia event will likely make the event last longer. Finally, children will have retrograde amnesia and thus will not recall the event in the morning.