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April 8, 1969. A PSYCHOPHYSIOLOGICAL STUDY OF NIGHTMARES. (Freud Anniversary Lecture.) Charles Fisher, M.D.
Fisher presented a psychophysiological study of nightmares. Thirty-seven subjects were studied for one hundred fifty nights, using continuous recordings of EEG, eye movements, cardiac and respiratory rates. The most basic findings was that spontaneous arousals with anxiety can occur in all four EEG stages of sleep; the most severe are the Stage 4 nightmares which include the pavor nocturnus of children and adults, and the traumatic neuroses of adult onset. REM anxiety dreams occur with all degrees of intensity, but Stage 2 arousals can occur with much less anxiety.
In the Stage 4 arousal-reaction nightmare, the subject goes into an arousal reaction in which he is confused, dissociated, unresponsive to the environment, and hallucinates. There are physical flight reactions, intense autonomic discharge, and heart rate may more than double while respiration becomes rapid, irregular, and of increased amplitude. Also there seems to be a relationship between intensity of nightmare and depth of sleep. Stage 1 REM anxiety dreams occur with varying degrees of intensity but the anxiety never matches that of the Stage 4 nightmare. There can be slight to moderate increase in the cardiac and respiratory rates but in most instances they are not greater than normal