Polysomnographic and clinical correlates of epic dream complaints: A retrospective study of 28 Taiwanese adults

Objective: To describe polysomnographic and clinical findings in a group of patients with epic dreaming, viz. relentless dreaming perceived to occur throughout sleep during most nights with subsequent daytime fatigue. Patients and Methods: This is a retrospective study of a consecutive series of 28 adult patients(17 men, 11 women; mean age is 39 yrs, range 25-63) who were self-referred with epic dream complaints over a 1.5 year period. The setting was a general hospital sleep clinic in Taiwan. Clinical interviews and physical/neurologic exams were conducted by one physician, followed by hospital-based, overnight polysomnography(PSG). Dreams were not systematically analyzed (either at home or in the sleep laboratory), psychiatric interviews were not conducted, and psychometric testing was not administered. Results: Two groups of epic dreamers were identified on the basis of dream content: 'story' epic dreamers (n=5) and 'non-story' epic dreamers (n=23). PSG findings were unremarkable in 22 patients, whereas sleep fragmentation disorders were found in 6 patients (n=5, obstructive sleep apnea; n=1, periodic limb movement disorder). For both groups, there was a major shift towards light sleep, with increased percentages of stages 1 + 2, and decreased percentages os stages 3+4 and REM, which may or may not have been a 'first night effect'. All patients reported typical epic dreaming during their PSG studies. Conclusions: This study suggests epic dreaming should be divided into three groups. The dream content of the first group was like a 'soap opera' but PSG results were normal. we call this as story epic dreaming. The second group's dream didn't involve a story with a plot. Reported dreams were random, with disconnected content, and without emotionality, and they never formed a discernible story. We called this non-story epic dreaming. According to PSG results, the non-story epic dreaming group could be subdivided into two groups, one with normal PSG results, and the other with abnormal PSG results. Epic dreaming has now been reported in two ethnic groups (Asian and Caucasian) residing in Taiwan and North America, with similarities and differences being identified.