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Various isolated neurotic sleep rituals observed during analysis have been reported. Abraham (1916) in a paper on oral organization included a patient who required oral gratification or masturbation as a condition for falling asleep. Eisler (1922), commenting upon the infant's chain reaction of feeding and sleeping, reported several instances of disturbed sleep in which oral inhibitions were active. Isakower (1938), observing patients who experienced peculiar physical sensations while half asleep, related these to archaic revivals of infantile experiences at the breast which represented a restoration of the early sleep-inducing mother-child relationship. Windholz (1942) and Olden (1942) described several patients with sleep rituals involving masturbation, intercourse, and sleeping powders. Fenichel (1942) defined sleep rituals as '… compulsive measures [which] serve the purpose of putting out of action a definite danger which is unconsciously connected with the idea of being asleep …'. None of these authors developed the theme, and they have related the rituals only to special neurotic maneuvers for falling asleep.
This study emphasizes the common nature of presleep mechanisms, describes their role within the total personality, and their function in sleep and dreaming.
Sleep is generally accepted as a state of narcissistic regression which provides a renewal of energy for the next day's activities. It is normally anticipated as a pleasant, desired, refreshing experience. Anything which interferes with this pleasure arouses tensions and thus not only requires the expenditure of energy but also prevents the accumulation of energy that accrues during sleep. The sleeper, therefore, seeks those conditions,