Dream tyranny: Hyperonirism diagnostic criteria

Area of Science:

• Sleep Medicine
• Psychiatry
• Clinical Neuroscience

Background:

• Hyperonirism, or "epic dreaming," is an emerging clinical phenomenon.
• It is characterized by excessive, vivid, and continuous dream activity.
• This condition is poorly defined and not recognized by current nosological systems.

Purpose of the Study:

• To describe the clinical characteristics of hyperonirism.
• To propose preliminary diagnostic criteria for hyperonirism disorder.
• To support the characterization of hyperonirism as a distinct clinical entity.

Main Methods:

• Case series of four patients assessed in expert sleep and psychiatry centers.
• Comprehensive clinical, psychiatric, and sleep evaluations were performed.
• Evaluations included polysomnography and actigraphy.

Main Results:

• Patients reported excessive, vivid, intrusive, and continuous dream activity.
• This "dream overflow" was linked to non-restorative sleep and daytime fatigue.
• Objective sleep investigations were largely normal, highlighting a gap between subjective experience and conventional measures.

Conclusions:

• This case series supports hyperonirism disorder as a distinct clinical entity.
• Preliminary diagnostic criteria are proposed, addressing nocturnal and diurnal aspects.
• Recognition may improve assessment and guide research into mechanisms and treatments.