Study of the Determinants of Dream Recall and Content in Patients With Epilepsy

Dreaming is a sleep-associated cognitive process whose neural substrates and functions remain poorly understood. In healthy subjects, the frequency of dream recall is influenced by several factors such as age, gender, interest in dreams and sleep quality. The content of dreams mainly depends on waking life experiences, especially when they are recent and have a strong emotional content. The function of dreams remains debated but it is widely accepted that dreams play a role in emotional regulation.

Modifications in dreams are observed in several neurological diseases and sleep disorders, due to the modifications of sleep related to these diseases, as well as to associated disturbances in cognitive functioning and to the impact on such diseases on waking life. Epilepsy is a neurological condition characterized by a predisposition to seizures resulting from excessive and synchronized abnormal brain activity; it is associated with numerous co-morbidities including sleep and cognitive disorders, which are present in nearly one in two patients. However, the influence of epilepsy on sleep-related cognitive processes is poorly understood. It is suspected that nocturnal epileptic activity disturbs sleep-related memory consolidation processes, but the consequences of epilepsy on dreams have been little investigated.

The study of the determinants (epilepsy syndrome, location of the epileptic focus, presence of sleep-related seizures, certain anti-epileptic treatments, alteration of the quality of sleep) of dream characteristics in this context could lead to a better understanding of the dreams physiology, the interactions between epilepsy and sleep, as well as the cognitive and emotional functioning related to sleep in epilepsy. It could also determine whether dream characteristics can provide information on the epilepsy syndrome and on the presence of nocturnal seizures, and thus constitute a diagnostic tool.

In this cross-sectional observational study, we aim to identify determinants of dream recall in relation to epilepsy by administering a simple and brief questionnaire on sleep and dreams, to all consecutive patients seen in epileptology consultation during 12 months. Our objectives are

1. To determine whether the presence of sleep-related seizures influences the frequency of dream recall in patients with epilepsy
2. To describe the characteristics of dreams in epilepsy, the influence of epilepsy on dreams and to characterize the determinants of dream recall frequency in patients with epilepsy We hypothesize that the presence of seizures during sleep will be associated with poorer sleep quality, increased frequency of dream recall, and that we will observe the inclusion of epilepsy symptoms in dream content, particularly in subjects who are aware of their nocturnal seizures and are awakened by them.