Hallucinations, sleep fragmentation, and altered dream phenomena in Parkinson's disease

• Published in: Movement disorders Vol. 14; no. 1; pp. 117 - 121
• Main Authors: Pappert, Eric J., Goetz, Christopher G., Niederman, Francie G., Raman, Rema, Leurgans, Sue
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.01.1999; Wiley
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Delusions - diagnosis; Dream phenomenon; Dreams; Female; Hallucinations; Hallucinations - diagnosis; Humans; Illusions; Male; Medical sciences; Middle Aged; Neurology; Parkinson Disease - diagnosis; Parkinson's disease; Sleep fragmentation; Sleep Wake Disorders - diagnosis; Human; Nervous system diseases; Hallucination; Interaction; Idiopathic; Parkinson disease; Sleep disorder; Exploration; Illusion; Cerebral disorder; Fragmentation; Dream; Central nervous system disease; Adult; Degenerative disease; Nightmare; Neurological disorder; Extrapyramidal syndrome
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/1531-8257(199901)14:1<117::AID-MDS1019>3.0.CO;2-0

In a series of consecutively randomized outpatients who had Parkinson's disease (PD), we examined the association of three behaviors: sleep fragmentation, altered dream phenomena, and hallucinations/illusions. Using a log‐linear model methodology, we tested the independence of each behavior. Sixty‐two percent of the subjects had sleep fragmentation, 48% had altered dream phenomena, and 26% had hallucinations/illusions. Eighty‐two percent of the patients with hallucinations/illusions experienced some form of sleep disorder. The three phenomena were not independent. The interaction between sleep fragmentation and altered dream phenomena was strongly statistically significant. Likewise, a significant interaction existed between altered dream phenomena and hallucinations/illusions. No interaction occurred between sleep fragmentation and hallucinations/illusions. Sleep fragmentation, altered dream phenomena, and hallucinations/illusions in PD should be considered distinct but often overlapping behaviors. The close association between altered dream phenomena and hallucinations suggests that therapeutic interventions aimed at diminishing dream‐related activities may have a specific positive impact on hallucinatory behavior.