Bernd Feige, PhD: Insomnia and the REM Sleep State

“We see a modified type of REM sleep which is experienced by the insomnia patients as being awake, and it has these dreams which are experienced as wake-like and we think it’s like having a kind of nightmare, a very stressful dream that’s about being awake.”

At the 24^th Congress of European Sleep Research Society in Basel, Switzerland, NeurologyLive sat with Bernd Feige, PhD, Department of Clinical Psychology and Psychophysiology, Medical Center, University of Freiburg, in an exclusive interview to discuss the results of a study examining awakening thresholds and REM sleep perception in insomnia patients and good sleeper controls.

In previous studies, researchers hypothesized that REM sleep may be vulnerable to be perceived as wake, and Feige and colleagues sought to assess this more directly, determining auditory waking thresholds and sleep perception in those with insomnia disorder and healthy control subjects in N2 and REM sleep.

The study presents direct evidence that the subjective experience of insomnia may be specifically connected to the REM sleep state. Assuming that chronic hyperarousal is a relevant pathway for insomnia, this may become especially evidence during REM sleep, which in insomnia, reflects a hybrid sleep state coupled with altered sleep perception.

Feige and colleagues now have a key to help create better therapies for patients and hope to integrate elements from nightmare therapy into treatment of insomnia, Other options Feige mentioned include strengthening REM sleep by medications, which is still in the project phase.