Objective: The aim of this observational study is to perform an analysis of dream characteristics in a large sample of Parkinson’s Disease (PD) patients and their relation with clinical and demographic variables.

Background: In the prodromal and early stage of the disease, PD is frequently associated with sleep disorders such as vivid dreams, nightmares and REM sleep behavior disorder (RBD). Several factors can influence dream experience, such as RBD, anxious and depressive symptoms and relative treatments, dosage and quality of dopaminergic drugs and other psychotropic medications.

Methods: A consecutive series of idiopathic PD Italian mother-tongue patients who attended the Parkinson’s Disease and Movement Disorders Center at Humanitas San Pio X Clinic of Milan were prospectively observed from May 2016 until October 2016. Patients with a Mini-Mental State Examination score of 24 or below and younger than 50 years old were excluded from the study.

Patients were assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) part III (in ON), type and daily dosage of medications, demographic informations. Dream content was assessed with the ‘Typical Dreams Questionnaire’ (55-TDQ) and an interview about the presence/absence of RBD, dreamlike narrative and the most recent drem recalled.

Results: 85 PD patients fulfilled inclusion criteria (33 women, mean age 70 ± 10.5, mean duration disease 8.5 ± 5.5 years) and recalled, on average, 6 dreams and 2,53 nightmares per month. Most common dream contents, as resulted by the 55-TDQ, consisted in: “a person now alive as dead”, “falling” and “being on the verge of falling”. Patients with RBD episodes with violent arm and leg movements referred a higher prevalence of dreaming of “being smothered, unable to breathe”(Χ², p<0.01), “lunatics or insane people” (Χ², p<0.05) and “being chased or pursued”(Χ², p<0.001). The presence or absence of specific items of the 55-TDQ were significantly correlated with different dosages of levodopa and dopamine-agonists.

Conclusions: RBD patients had a higher percentage of violent dreams compared to non-RBD patients. Dopaminergic and non-dopaminergic drugs play a role in PD dream content.

References: Zadra, A. L., & Nielsen, T.A. (1999). The 55 typical dreams questionnaire: consistencies across student samples. Sleep, 22 (Suppl 1), S175.

Valli K, Frauscher B, Peltomaa T, Gschliesser V, Revonsuo A, Högl B. Dreaming furiously? A sleep laboratory study on the dream content of people with Parkinson’s disease and with or without rapid eye movement sleep behavior disorder. Sleep Med. 2015 Mar;16(3):419-27. 

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dream-content-in-parkinsons-disease/