A study investigated this sleep disorder with the aim of understanding the neural systems involved and paving the way towards more specific pharmacological interventions, which help alleviate the burden of those who suffer from it
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| Genetic predispositions and lifestyle elements, including stress and lack of sleep, may elevate the likelihood of experiencing parasomnias. (Illustrative Image: Infobae) |
Parasomnias encompass a spectrum of sleep disorders characterized by abnormal movements, behaviors, emotions, perceptions, and dreams occurring during sleep, sleep phases, or sleep deprivation. These behaviors, ranging in characteristics, severity, and frequency, include phenomena such as sleepwalking, sleep paralysis, and night terrors, as outlined by the US Sleep Association.
Seeking to delve deeper into this realm, researchers at the Dutch Institute of Neuroscience embarked on a study to unravel the intricacies of what unfolds within the brain of individuals caught between the realms of sleep and wakefulness. Published in the journal Nature Communications, their findings shed light on this complex phenomenon. Contrary to the stereotypical image of a sleepwalker with eyes shut and arms outstretched, these individuals often navigate with their eyes open and engage in multifaceted interactions with their surroundings.
Experts categorize this aberrant sleep conduct as "parasomnia," encompassing simple actions like sitting up in bed with a bewildered expression, as well as more intricate behaviors such as rising, moving, or screaming with a frightened countenance. While these parasomnias are more prevalent among children, around 2% to 3% of adults still encounter them regularly, causing distress for both the affected individual and their bed partner.
Francesca Siclari, director of the dream laboratory, elaborated, stating, "Affected individuals may inadvertently harm themselves or others during these episodes and subsequently experience feelings of shame."
Researchers posit that a combination of genetic predispositions and lifestyle elements heighten the likelihood of developing parasomnias.
"We're aware of certain genes associated specifically with sleepwalking," stated Jennifer Mundt, assistant professor of sleep medicine, psychiatry, and behavioral sciences at Northwestern University Feinberg School of Medicine in Chicago. Mundt further explained that this genetic predisposition can be triggered by factors such as stress, sleep deprivation, alcohol, medications, or other events. "Even a noise can trigger it," she added in a recent statement to Infobae.
The Study Methodology:
Siclari and her team undertook this study to gain deeper insights into the brain's activities during parasomnias. "There was a prevailing belief that dreams only occur in one stage: REM sleep. However, we now understand that they can manifest in other phases," Siclari explained. "Individuals experiencing parasomnias during non-REM sleep sometimes report dream-like encounters while others appear entirely unconscious, operating on autopilot."
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In order to decipher the reasons behind these discrepancies, Siclari and her team delved into the experiences and brain activity patterns of individuals experiencing parasomnia during non-REM sleep. However, capturing a person's brain activity during a parasomnia episode posed a challenge. "The patient must fall asleep, undergo an episode, and record their brain activity while in motion," Siclari noted.
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| While parasomnias are more common in children, between 2% and 3% of adults experience these disorders regularly, which can cause distress for both the affected person and their bed partner (Getty) |
"There are currently very few studies that have managed to overcome this challenge. However, with the numerous electrodes we utilize in the laboratory and specific analysis techniques, we can now obtain a remarkably clear signal even when patients are in motion," Siclari explained.
Siclari's equipment has the capability to induce a parasomnia episode in the lab, albeit requiring two consecutive recordings. Initially, the patient undergoes a typical night of sleep. Subsequently, they are kept awake the following night until the morning when they are permitted to sleep again.
During this recording, the patient is subjected to a loud sound as they enter the deep sleep stage. In certain instances, this auditory stimulus triggers a parasomnia episode. Following the episode, the patient is queried about their mental state during the event.
Insights into the Brain During a Parasomnia Episode:
In 56% of the episodes, patients reported experiencing dreams. "Often, these dreams involved mishaps or impending danger. Some mentioned feeling as though the roof was about to collapse," Siclari elucidated. "One patient believed they had misplaced their baby and was frantically searching through the sheets," she added.
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| In 56% of the episodes, patients reported having dreamed, frequently about imminent dangers, while 19% did not experience anything (Illustrative Image Infobae |
In 19% of cases, the patients were not experiencing anything and simply woke up and found themselves doing things, almost as if in a trance,” said the expert. Another small portion reported that they had experienced something but could not remember what it was.
Based on these three categories, Siclari's group compared the measured brain activities and found clear parallels . “Compared to patients who experienced nothing, those who dreamed during the episode showed brain activations similar to those previously found for dreaming, both immediately before the episode and also during it,” Siclari added.
“What determines whether the patient will be completely unconscious or dreaming seems to depend on the state they are in at the time. If we activate the brain while he is probably already dreaming, he appears to be able to 'do something', whereas when his brain is largely 'inactivated', simple behaviors appear to occur without experience.
“Interestingly, patients almost never mention the sound that started the parasomnia episode, but rather some other type of imminent danger. “The louder the sound, the more likely we are to trigger an episode
As this is only the first step, there is much room for follow-up studies. “The ideal would be to create a system for more people to record their sleep at home , where they could also have much more complex and more frequent episodes. We would also like to repeat the same type of studies in people who experience parasomnias in REM sleep . By measuring brain activity as in this study, we hope to better understand which neural systems are involved in different types of parasomnias,” says Siclari.
While there is still much research to be done, Siclari is confident that his work can provide valuable information. “These experiences are very real for patients and most have already felt relieved to share them with us. As in previous studies, our research clarifies what they are experiencing, which is educationally valuable.
“In addition, our work could contribute to more specific pharmacological interventions in the future. Parasomnias are often treated with nonspecific sleeping pills , which are not always effective and can have negative side effects . If we can deduce which neuronal system functions abnormally, we may eventually try to develop more specific treatments,” said the expert.
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