Oneirism (sleep Delirium): Symptoms, Causes And Treatment

Oneirism or dream delirium is an alteration of consciousness which usually occurs due to the abuse of psychoactive substances or organic brain disorders such as epilepsy and parasomnias. Its main characteristic is the appearance of hallucinations similar to those that occur when we dream, but in this case they occur in a waking state.

In this article we will describe the characteristics, symptoms and main causes of dreaming To do this, it is necessary that we focus on other concepts and disorders associated with sleep delusions, such as “productive disorder of consciousness”, “parasomnia” or the term “hallucination” itself.

What is oneirism or dream delirium?

Oneirism, also known as dream delirium, is a psychological state characterized by the presence of hallucinations similar to those that occur during dreams but that occur during wakefulness. The two nomenclatures refer to this fact, since the Greek word “oneiros” can be translated as “dream” or “reverie.”

This phenomenon is associated with the abusive consumption of certain substances, such as toxic products or alcohol and other drugs, as well as pathophysiological alterations of the brain. However, on other occasions, dreaming does not have a pathological component, but can also be the result of normal biological factors, such as sleep deprivation.

Sleep delirium is part of the group of disorders that we know as “productive disorders of consciousness”, which also includes delirium (very common in hospitalized elderly people and in alcoholics with withdrawal syndrome), depersonalization, derealization or phantom limb syndrome.

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The common aspect that unites this group of disorders is that in all of them hallucinations appear due to alterations that affect consciousness. We speak of hallucination when a person perceives something through any sensory channel (auditory, visual, etc.) without there being a stimulus to justify it, especially if he believes that such perception is real.

Symptoms and main manifestations

In the case of dreaming, and as tends to happen when organic alterations of the brain are present or when substances with psychoactive effects are consumed, hallucinations are mainly visual in nature However, sometimes tactile hallucinations and to a lesser extent auditory, olfactory and gustatory hallucinations are also identified.

Hallucinations do not always occur in a single sensory modality, but can be multimodal; For example, hearing a threatening voice and feeling someone’s breath on your ear would be a multimodal hallucination. Some authors use the concept “dream delirium” only when the hallucinations are of this type, while “oneirism” would be a broader term.

Like most productive disorders of consciousness, dreaming is frequently associated with loss of contact with reality, either completely or partially Sometimes the person can lose consciousness of himself or perceive the environment in which he is in a hallucinatory way.

The most common thing is that sleep delusions are temporary in nature, closely related to specific biological factors, and do not have a significant impact on the psychological state of those who suffer from them in the long term. Another characteristic of dreaming is that it usually starts suddenly, in a matter of hours or at most days.

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Causes of sleep delusions

The dreaming arises as a consequence of different organic factors that affect the brain The most common is intoxication due to the abuse of certain substances, but any transient or chronic brain alteration has the potential to cause these symptoms, especially those that affect the processes related to wakefulness and sleep.

1. Abuse of psychoactive substances

The most common cause of sleep delusions is excessive consumption of alcohol, antidepressant and sedative-hypnotic drugs (especially barbiturates) and drugs with hallucinogenic effects, among which are hallucinogenic mushrooms or psilocybin, mescaline, found in peyote, and lysergic acid or LSD.

Intoxication by certain types of poison and other substances that are toxic to the human body is also associated with the appearance of dreamlike episodes.

2. Parasomnias

Parasomnias are a group of sleep disorders that are characterized by the appearance of abnormal behaviors, perceptions or emotions in the transition periods between sleep and wakefulness. Dreaming is especially common in REM sleep disorders during which dreams are very vivid and muscle tone is elevated.

3. Organic alterations

Epilepsy, in which episodes of abnormal brain activity occur that frequently cause seizures, is one of the chronic organic disorders most closely related to sleep delirium. Other relevant organic processes include febrile states, infections, gastrointestinal bleeding and degenerative brain diseases

4. Non-pathological factors

People without relevant organic disorders and who are not under the influence of one of the substances we have mentioned can also have low-intensity dream delusions. Among the non-pathological factors that predispose to dreaming, it is worth highlighting severe fatigue, sleep deprivation, indigestion and states of marked anxiety.

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