The nature and time course of sleep onset (hypnagogic) mentation was studied in the home environment using the Nightcap, a reliable, cost-effective, and relatively noninvasive sleep monitor. The Nightcap, linked to a personal computer, reliably identified sleep onset according to changes in perceived sleepiness and the appearance of hypnagogic dream features. Awakenings were performed by the computer after 15 s to 5 min of sleep as defined by eyelid quiescence. Awakenings from longer periods of sleep were associated with (1) an (...) increase in reported sleepiness, (2) a decrease in the length of mentation reports, (3) a decrease in the frequency of reports of normal, wake-like thoughts, (4) an increase in the frequency of ''unusual thoughts,'' and (5) increased frequencies of formal dream features, including visual hallucination, self-representation, fictive movement, narrative plot, and bizarreness. While sleep-onset reports can include all features of rapid eye movement (REM) dream reports, the number of such features is markedly reduced at sleep onset, suggesting that this mentation is a greatly diminished version of REM dreaming. (shrink)

Consciousness can be studied only if subjective experience is documented and quantified, yet first-person accounts of the effects of brain injury on conscious experience are as rare as they are potentially useful. This report documents the alterations in waking, sleeping, and dreaming caused by a lateral medullary infarct. Total insomnia and the initial suppression of dreaming was followed by the gradual recovery of both functions. A visual hallucinosis during waking that was associated with the initial period of sleep and dream (...) suppression is described in detail. Since the changes in sleep and their recovery are comparable to results of animal experiments, it can be concluded that damage to the medullary brain stem causes extreme but short-lived alterations in conscious state and that substantial recovery occurs even though the damage to the brain stem endures. (shrink)