Academic literature on the topic 'Nightmare severity'

Parasomnias are undesirable and abnormal movements, behaviors, emotions, perceptions, and dreams that occur during or immediately surrounding sleep. The parasomnias are categorized as nonrapid eye movement (NREM) sleep parasomnias, rapid eye movement (REM) sleep parasomnias, and other parasomnias. This chapter provides an overview to the epidemiology, clinical characteristics, differential diagnoses, diagnostic approach, and treatment of common parasomnias encountered in clinical practice. These common parasomnias include NREM parasomnias, considered to be disorders of arousal from NREM sleep and which include a heterogeneous spectrum of sleep behaviors encountered following arousal from NREM sleep exemplified by the phenotypes of sleep terrors, sleep walking, confusional arousals, sleep-related eating disorder, and sexsomnias; the REM parasomnias, including nightmare disorder, recurrent isolated sleep paralysis, and REM sleep behavior disorder, which is strongly associated with prodromal or overt alpha-synucleinopathy neurodegenerative disorders such as Parkinson disease and dementia with Lewy bodies; and other parasomnias, including a spectrum of “leftovers” that do not map well to NREM or REM sleep specifically such as exploding head syndrome, sleep-related hallucinations, sleep enuresis, and parasomnias ascribed to medical disorders, medication or substance use, or unspecified etiologies. It is important for a psychiatrist to be conversant with the complete range of parasomnias given the importance of effective management of frequent psychiatric and psychological comorbidities, which serve as drivers of the frequency and severity of nocturnal events, and to ensure timely referral for polysomnography or other necessary sleep diagnostics where appropriate.

Depressive disorders are commonly associated with sleep disturbances including insomnia, hypersomnia, and nightmares. Based on shared neurobiological mechanisms, a bidirectional link exists between sleep disturbances and depressive disorders. Presence of sleep disturbance is not only associated with increased depression severity but also portends a poorer prognosis with increased suicide risk in patients with depressive disorders. Polysomnographic findings such as reduced slow-wave sleep, decreased rapid eye movement (REM) sleep latency and increased REM density are associated with major depression. Comorbid primary sleep disorders such as obstructive sleep apnea, restless legs syndrome, and circadian rhythm disorders not only increase the risk but also complicate the treatment of major depression. It is imperative to comprehensively assess and treat sleep disturbances, either due to depression or due to co-existing primary sleep disorders, to optimize remission, prevent relapse, and reduce the risk of suicide in patients with depressive disorders. Medications, chronotherapies, and behavioral approaches alone or in combination may prove to be effective in treating sleep disturbances associated with depressive disorders; however, more research is warranted in this area to determine the optimal management strategies. Cognitive behavioral therapy for insomnia, a promising treatment for management of insomnia comorbid with major depression, needs wider implementation and more research to establish its efficacy in preventing suicide.

When gathering the best papers presented in 2019 during the 8th ATMC conference in Namur for editing this book, we were not expecting 2020 to become the nightmare year that we all experienced in the world. The Covid-19 crisis has significantly disrupted our consumption and travel habits. Heaps of business sectors were severely impacted by the two waves of lockdown of populations and countries, the closure of stores and restaurants and the overall context of anxiety and uncertainty. More than other sectors, the tourism and travel industry was severely affected. The trips and recreative activities of our fellow citizens are henceforth punctuated by ‘barrier gestures’ and by a large number of health measures taken in order to limit the spread of the pandemic. Of course, the objective of this book was not to account for the current crisis, nor to analyze the extent to which our tourism and leisure activities have changed, and whether these changes are likely to last. The aim of the book was first to discuss sustainability and collaborative practices in order to fill tourism development with ethics and responsibility. Following the collegial tradition of Advances in Tourism Marketing conferences, this book is the result of the collaboration of established international scholars with emergent researchers around the globe. The twelve chapters of this book have offered innovative and dovetailing perspectives around four major strategic questions that may support tourism development in these vulnerable times, i.e.: Can technology enhance value co-creation and the tourism experience? How sharing economy practices develop in tourism? To what extent sustainability issues affect culture and the well-being of residents? What is the connection between technology, millennials and overtourism? Of course, those issues were considered in the framework of the digital world that is ever expanding since two decades. Digital technology has been massively integrated into the strategies and operations of tourism operators. Historically dedicated to marketing and communication, digital technology is now revolutionizing the entire tourism value chain. The promotion of a destination can no longer be considered without the mix between official digital channels and levers such as influencers and rating platforms. Any tourist expects to find relevant and up-to-date information on the Internet in order to prepare for his stay, to choose among transportation, accommodation and recreational alternatives, and to book activities. The exchange of tips and advice has become an important element in choosing a destination. In many regions, competition between destinations and operators makes it essential to be attractive via a different offer and digital technology may act as a major differentiator (e.g., Histopad to visit Chambord’s Castle, Monument Tracker). To answer these questions, the book was organized in four parts where interdependence, collaboration, sustainability and responsible behavior are deeply discussed with the aim of contributing to marketing tourism in the digital world that we know today. The book started with a discussion about how to co-create value with or without technologies, detailed how web platforms reboot collaborative economic practices, presented sustainable tourism development under a human perspective and ended with the discussion of key issues in tourism marketing, including overtourism and residents’ propensity to boost tourism development. We now summarize the key takeaways of those four parts, closing each part with a reflection on the lessons learnt from current Covid-19 crisis in order to assess what will be left after the vulnerable times that we live now.