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Session Schedule

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0:00:00
Introduction

0:01:34
The spectrum of conscious experiences and sensory disconnection in patients with Non-REM parasomnias
Francesca Siclari (Netherlands)

0:27:18
Nocturnal mentation in insomnia and its consequences for regulation of emotional distress
Rick Wassing (Australia)

0:46:28
The cathartic dream: Using a large language model to study a new type of functional dream in healthy and clinical populations
Lampros Perogamvros (Switzerland)

1:08:32
Dreaming in action: Bridging neurobiology and phenomenology in REM behavior disorder
Andrea Galbiati (Italy)

Summary
In the last decade, the brain activity supporting conscious mental content during sleep has gained increasing attention. However, there remains a discrepancy between what recent scientific literature has revealed and what is reflected in current diagnostic manuals. For instance, in disorders of arousal, the absence of mental content and of responsiveness to the environment is still listed in diagnostic criteria, despite recent evidence showing the presence of mental content during and after nocturnal episodes in affected patients (Castelnovo et al., 2024; Cataldi et al., 2024; Siclari, 2024). This information is critical not only for accurate diagnosis but also for understanding the patient’s subjective experience and identifying potential new treatment targets.
In other contexts, such as REM Sleep Behavior Disorder (RBD), mental content has historically been considered noteworthy for its vivid and often aggressive nature. This remains a key area of investigation (Fasiello et al., 2023; Masset et al., 2023), providing insights into the relationship between altered REM sleep and dream activity. Another notable case is insomnia disorder: while cognitive aspects are recognized as important for diagnosis and treatment, very few studies have explored the mental content and sleep perception during sleep in insomnia patients (Stephan et al., 2021; Stephan & Siclari, 2023; Wassing et al., 2016). It remains unclear whether this specific aspect is relevant in understanding the disorder and could serve as a potential target for treatment (Stephan et al., 2021; Stephan & Siclari, 2023).
Additionally, in psychiatric conditions where sleep disturbances are prominent, such as post-traumatic stress disorder (PTSD) (Pace-Schott et al., 2023), the manipulation of mental content related to nightmares has become a treatment target (Schwartz et al., 2022) with promising findings emerging from advanced "sleep engineering" techniques (Schwartz et al., 2022; van der Heijden et al., 2024).
Finally, neurological disorders such as epilepsy provide a unique model for understanding how transient focal abnormal brain activity shapes sleep structure (Peter-Derex et al., 2020) and sleep-related mental content including dreams and sleep perception (de la Chapelle et al., 2021). In particular, data retrieved from survey conducted in large cohorts of patients (Charpentier--Hélary et al., 2024) or from intra-cranial recordings in patients with drug-resistant epilepsy suggest that epilepsy influences sleep-related cognition the same way as it does during wakefulness.
This symposium aims to explore the critical role of sleep mentation—and the mind’s activity throughout the sleep-wake cycle—in the understanding, diagnosis and management of various sleep-related disorders, including parasomnias, insomnia, PTSD, epilepsy and RBD. Mental content during sleep offers valuable insights into the neurocognitive processes underlying these conditions, and its evaluation may enhance both diagnostic accuracy and treatment approaches.
The symposium will gather leading experts in sleep research, psychology, and neurology to present cutting-edge studies on the content, frequency, and nature of sleep mentation across different disorders. Special emphasis will be placed on:

Disorders of Arousal
Insomnia
PTSD and Nightmare Disorder
RBD
Epilepsy
The symposium will emphasize the importance of assessing sleep mentation for more comprehensive treatment strategies and better patient outcomes.