中華心理衛生協會

Purpose: Epic dreaming is defined as the recall of relentless, neutral-content dreaming throughout the night, with feelings of exhaustion upon awakening and fatigue during the day. Previous researchers who studied the polysomnographic (PSG) features of these patients found that 21.4 to 25.0% of them had sleep-related breathing disorders (SRBD) and/or periodic limb movement disorder (PLMD). However, the rest had unremarkable PSG findings. The present study further assessed the PSG, personality, and psychopathologic features of these patients in order to understand possible pathologies of this phenomenon. Methods: Twenty three patients (8 men, 15 women; mean age = 34 yrs) who complained of epic dreaming were recruited from a neurologic clinic to participate in the study along with 10 healthy control subjects (3 men, 7 women; mean age = 30 yrs). Clinical interviews concerning sleep and psychopathology were conducted and self-rating questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), the Chinese Health Questionnaire (CHQ-12), and the NEO five-factor inventory (NEO-FFI), were administered. One night of PSG recording was also conducted. Results: In terms of the sleep and mental diagnoses, 7 patients had specific sleep disorders, 6 patients had mental disorders, and 5 patients had both specific sleep disorders and mental disorders. The remaining 5 patients did not have any specific sleep or mental disorders. Several PSG sleep features differed between the patient and control groups. First of all, the patients with epic dreaming had longer sleep onset latency, a higher percentage of stage 1 sleep and waking during sleep, and lower sleep efficiency, and a lower percentage of stage 3 and 4 sleep than controls. Secondly, the patients with epic dreaming had more arousals including spontaneous and respiratory event-related arousal than controls. Thirdly, the patients with epic dreaming had lower electroencephalographic delta power in slow wave sleep and higher alpha and beta power in stage 1 sleep than controls. In terms of personality features, the result of the NEO-FFI showed that the patients with epic dreaming had higher trait scores in neuroticism and openness than controls. Conclusions: The results indicated that patients who complain of epic dreaming have some shared polysomnographic and personality features as a group. These sleep and psychological features may result from different pathologies in different patients. These findings indicate that the pathology of epic dreaming is heterogeneous and complicated. Some issues that require further research to clarify are discussed.