Sleep and hallucination; Endophenotypic similarities

Ali Bozorgmehr

Neurocognitive Lab, Iran Psychiatric Hospital, Iran University of Medical Sciences, Tehran

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Sleep

A normal, reversible, recurrent state of reduced responsiveness to external stimulation that is accompanied by complex and predictable changes in physiology.

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Sleep waves

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Non-lucid Dreaming

A dream is a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during the rapid-eye movement (REM) stage of sleep. Dreaming is a non-conscious electrophysiological state, or at least in part, a mental experience that can be described during waking consciousness.

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Hallucination

A hallucination is a perception in the absence of external stimulus that has qualities of real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space.

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Endophenotype

The idea that dreaming can indeed serve as a model for psychosis has a long and honorable tradition

➢Kant (1724-1804) likened the madman to a waking dreamer.

➢Schopenhauer considered the dream a brief madness and madness a long dream.

➢Bleuler (1857-1939), Kraepelin (1856-1926), Freud (1856-1939) stressed the similarities between dreaming and psychosis.

➢English neurologist, John Hughlings Jackson (1835-1911): strong “sensory discharges” were likely a common mechanism of dreams and hallucinations.

➢Dement (1928-2020) has referred to dreaming as "the prototypical hallucinatory experience" and has alluded to the possibility that "the same process (may underlie) both normal dreaming and abnormal hallucinations

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Decreased NE release during REM and SCZ

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Tonic release of Ach during REM and wakefulness and phasic release during hallucination

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Decreased Serotonin release during REM and SCZ

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Higher metabolism in the limbic system during REM and hallucination

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Lower metabolism in the PFC REM and hallucination

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Higher visual and motor areas metabolic activityduring REM and visuomotorhallucinations

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Grey matter volume reductions in frontal and parietal regions causes the decreased probability of lucid dreaming and the increased probability of

psychosis (disrupted self-referential network)

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Functional-anatomical similarities

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Ranking of psychoactive substances in terms of the similarity of their subjective reports to those of low lucidity

dreams.

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Word clouds for the top 40 most frequent terms in the reports of four substances with high similarity to dream reports

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Sleep quality as a predictor for psychosis

➢Increased sleep fragmentation and reduced subjective and objective sleep efficiency predict greater next-day auditory hallucinations in SCZ patients.

➢Poor sleep was linked to negative daytime mood that partially mediated the associations between sleep quality and next days’ psychotic‐like experiences in young adults with schizotypal traits.

➢Insomnia and excessive daytime somnolence are found to predict psychotic‐like experiences in adolescents.

➢There is also evidence that reducing sleep elicits psychotic experiences in non-clinical individuals, and that improving sleep in individuals with psychosis may lessen psychotic experiences.

➢Sleep disturbance can be a potential target to improve symptoms and quality of life in those living with psychosis.

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Sleep intrusion theory?

Thanks for your attention!

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• Chaudhury, S. (2020). "Hallucinations: Clinical aspects and management." Industrial psychiatry journal 19: 5.

• Dresler, M., R. Wehrle, V. I. Spoormaker, A. Steiger, F. Holsboer, M. Czisch and J. A. Hobson (2015). "Neural correlates of insight in dreaming and psychosis." Sleep Medicine Reviews 20: 92-99.

• Jacobs, B. L. (1978). "Dreams and hallucinations: A common neurochemical mechanism mediating their phenomenological similarities." Neuroscience & Biobehavioral Reviews 2(1): 59-69.

• Kass, W., G. Preiser and A. H. Jenkins (1970). "Inter-relationship of hallucinations and dreams in spontaneously hallucinating patients." Psychiatr Q 44(3): 488-499.

• Sanz, C., F. Zamberlan, E. Erowid, F. Erowid and E. Tagliazucchi (2018). "Corrigendum: The Experience Elicited by Hallucinogens Presents the Highest Similarity to Dreaming within a Large Database of Psychoactive Substance Reports." Frontiers in Neuroscience 12.

• Waters, F., J. D. Blom, T. T. Dang-Vu, A. J. Cheyne, B. Alderson-Day, P. Woodruff and D. Collerton (2016). "What Is the Link Between Hallucinations, Dreams, and Hypnagogic-Hypnopompic Experiences?" Schizophr Bull 42(5): 1098-1109.

• Zielinski, M. R., J. T. McKenna and R. W. McCarley (2016). "Functions and Mechanisms of Sleep." AIMS neuroscience 3(1): 67-104.

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References