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Nightmares in obstructive sleep apnoea.

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Obstructive Sleep Apnoea (OSA) is linked to more frequent nightmares, potentially due to its effects on emotional regulation and REM sleep. Treatment should be comprehensive, including psychotherapy and lifestyle changes.

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Psychiatry

Background:

  • Obstructive Sleep Apnoea (OSA) involves breathing disruptions during sleep, leading to sleep fragmentation and desaturation.
  • These events are associated with parasomnias, including nightmares, suggesting a potential link between OSA and increased nightmare frequency.

Purpose of the Study:

  • To review the existing literature on the association between Obstructive Sleep Apnoea (OSA) and nightmares.
  • To explore the potential mechanisms linking OSA to nightmares and discuss treatment implications.

Main Methods:

  • A comprehensive literature search was conducted in major databases (PubMed, Cochrane Library, Web of Science, Google Scholar) from January 2000 to November 2020.
  • Keywords included Obstructive Sleep Apnoea (OSA), Nightmares, CPAP, PTSD, Sleep Quality, and Dream.
  • A total of 168 articles were included in the final review after initial screening of 1361 articles.

Main Results:

  • OSA may impair emotional regulation through limbic system activation and REM sleep suppression.
  • A higher prevalence of nightmares was observed in patients with OSA.
  • OSA is significantly associated with psychiatric morbidity, including a strong link between nightmares, OSA, PTSD symptoms, and depression.

Conclusions:

  • Complex therapeutic approaches are necessary for OSA patients, particularly those with psychiatric comorbidities.
  • Psychotherapy should be considered a primary treatment for nightmares in OSA patients, especially those with poor adherence to CPAP.
  • Emphasis on healthy lifestyle and sleep hygiene is crucial for managing OSA and associated nightmares.