new therapies to better control them

This is the story of a journey that will end very badly. A young man gets on a plane, but it has no windows or cockpit. He sits in the back, but fails to fasten his seat belt. The plane, in which there are also members of his family and his girlfriend, takes off in the middle of town, nearly crashing into a building. A desert is flown over, then a Paris Saint-Germain training camp. The young man panics, slips into the void, clings to the cabin, but drags the plane and the passengers down with him. The plane crashes. The dreamer wakes up. Are there any deaths? Adrien de Stabenrath, who told us about this dream, knows nothing about it. This dream is one of many nightmares that have populated his nights for eleven years.

While we imagine, once in the arms of Morpheus, to have beautiful dreams, it is not so. “Two thirds of our dreams are unpleasant and we all have them”, establishes Isabelle Arnulf, professor of neurology, head of the sleep pathologies department at the Pitié-Salpêtrière hospital (AP-HP). Also called “dysphoric dreams”, they can leave us with an unpleasant feeling in the morning. But these bad dreams may have a therapeutic function: they would allow us to simulate threats to better face them during the day, to take up daily events, to rework them and to digest our negative emotional memories.

When this bad dream wakes us up, it’s a nightmare. About 35% of us do it occasionally. They appear during the phases of REM sleep, a period during which brain activity is close to the waking phase. However, it is impossible to detect them during a polysomnography, a medical examination which studies the architecture of sleep in physiological terms.

Nocturnal and diurnal repercussions

Devoid of a biological signature, the nightmare has fascinated for centuries, it has been scrutinized by psychoanalysis and is now by neuroscience. According to the model of Nielsen and Levin (2007), two Canadian neuroscientists, nightmares are produced by a dysfunction of executive and emotional processing (median prefrontal cortex) during REM sleep. “In the event of traumatic experiences, adversity in childhood… the emotions are not integrated and awaken the sleeper: there is then a nightmare and therefore failure of the process of emotional regulation and desensitization of dysphoric emotions”explains Charlotte Chaumereuil, neuropsychologist at Pitié-Salpêtrière. “The prefrontal cortex, seat of reason, and the anterior cingulate cortex, sensor of bodily reactions to stress, tension and anxiety, regulate the activity of the amygdalaexplains Benjamin Putois, researcher in cognitive sciences, in his book Nightmare Healing Manual (The Arenas, 2020). Nightmares appear when these affective loads are too high and the prefrontal cortex does not do this regulatory work. »

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