Original ArticleNightmare sufferers show atypical emotional semantic associations and prolonged REM sleep-dependent emotional priming

•Nightmare (NM) sufferers have uncommon emotional semantic associations.•Rapid eye movement (REM) naps lead to restricted breadth of associations for primed negative cue words.•REM naps lead to increased breadth of associations for primed positive cue words.•After 1 week, the healthy control (CTL) group no longer showed altered semantic access for primed words.•NM sufferers retain their priming effect at the 1-week retest.

Study ObjectivesThe objective of this study was to investigate whether nightmare (NM) sufferers exhibit an abnormal network of emotional semantic associations as measured by a recently developed, rapid eye movement (REM) sleep-sensitive, associational breadth (AB) task.DesignNM sufferers were compared to healthy controls (CTL) for their performance on an emotional AB task containing positive and negative cue words both before and after a nap with REM sleep. AB was assessed in both a priming condition, where cue words were explicitly memorized before sleep, and a non-priming condition, where cue words were not memorized. Performance was assessed again 1 week later.SettingThe study was conducted in a sleep laboratory with polysomnographic recording at the Hôpital du Sacré-Coeur de MontréalParticipantsTwenty-eight participants between the ages of 18 and 35 years (Mage = 23.3 ± 3.4) were included in the study.Measurements and ResultsThe NM group scored higher than the CTL group on both positive and negative AB, with group differences persisting at the 1-week retest. However, the two groups did not differ as expected in the AB priming effect following REM sleep. Both groups showed decreased REM sleep-related AB priming for negative cue words and increased AB priming for positive cue words. However, the NM group maintained these effects 1 week later, whereas the CTL group did not.ConclusionsNM sufferers may access broader than normal emotional semantic networks in the wake state, a difference that may lead to this group being perceived as more creative. The fact that the AB priming effect is maintained at the 1-week retest for NM sufferers suggests that the presence of frequent NMs may alter REM sleep-dependent emotional processes over time.