文章讨论了梦境与疾病的关系，特别是快速眼动睡眠行为障碍（REM Sleep Behavior Disorder，RBD）与神经退行性疾病如帕金森病的关联。文章还提到了RBD患者的梦境行为为研究梦境提供了观察窗口，以及梦境内容可能存在的特定主题和类型。
相较于无法完整回忆梦境细节的大多数人，RBD患者能将梦境实时“演绎”出来，为研究梦境提供了难得的观察机会。
研究发现，RBD可能是帕金森病等神经退行性疾病的有力预警，对老年群体尤其重要。
从说梦话到梦游，从肢体抽动到惊呼尖叫，我们的梦境不仅映射着心理状态，还可能预示着某些疾病的潜在风险。更令人惊奇的是，有些情况下梦境还可以为我们所控制。
法国巴黎皮提耶-萨尔佩特里厄尔医院
（Pitié-Salpêtrière University Hospital）
睡眠障碍诊所负责伊莎贝尔·阿尔努夫
（Isabelle Arnulf）
教授表示，快速眼动睡眠行为障碍
（REM Sleep Behavior Disorder，RBD）
是一种特殊的睡眠异常，患者在睡梦中可能表现出拳打脚踢、大声喊叫等暴力行为，这不仅是最常见的梦境行为类型，也可能对患者自身及家人造成伤害。因此，一旦出现此类症状，应当及时就医。
阿尔努夫教授同时也是法国索邦大学
（Sorbonne University）
的神经学教授，研究领域涵盖梦游、快速眼动
（Rapid Eye Movement，REM）
、睡眠行为障碍、清醒梦
（lucid dream）
等多个方面，对睡眠与帕金森病、嗜睡症
（narcolepsy）
等疾病的关联也进行了探讨。
睡眠行为障碍在年轻人中并不常见，多发于 50~80 岁的中老年群体。近年来的研究发现，对于老年群体，RBD 可能是帕金森病等神经退行性疾病的有力预警。2019 年，阿尔努夫团队在《大脑》
（
Brain
）
上发表的
一项列队研究
证实了这一观点。他们追踪了近 1300 名患者，发现在平均 5 年左右（最长可达 19 年）的随访期内，从特发性快速眼动睡眠行为障碍
（Idiopathic REM sleep behaviour disorder，iRBD）
向显性神经退行性综合征的总体年转化率高达 6.3%，而在 12 年的随访后，73.5% 的受试者出现了转化。
RBD 患者的梦境行为为我们打开了一扇观察窗口。虽然大多数人难以完整回忆梦境细节，但 RBD 患者却将梦境实时"演绎"出来，其行为和言语与清醒时无异，为研究者提供了难得的观察机会。
神经退行性疾病患者的梦境存在一些特定的主题和类型，多为负面情景。其中，“攻击”是最常见的主题：要么是自己遭受人类或动物的攻击，要么是为保护亲人而反击。因此，如果
……
[
查看全文
]
Gary Stix:
For
Science, Quickly
, I'm Gary Stix.
Dreams may say something about the psyche, but they also say something about disease states. Dreams may even be something we can take some control over. To find out about all this, Scientific American got in touch with sleep expert Isabelle Arnulf, who is head of the Sleep Disorders Clinic at Pitié Salpêtrière University Hospital in Paris.
During her career, Arnulf, who is also a professor of neurology at Sorbonne University in France, has researched a broad range of sleep conditions. Sleepwalking, rapid eye movement, sleep behavior disorder, lucid dreaming, sleep and Parkinson's disease and hypersomnia, hypersomnia being excessive daytime sleepiness. Professor Arnulf is with us now to talk about sleep and dreams.
Hello, Professor Arnulf. Welcome to the podcast.
Isabelle Arnulf:
Hello. Thank you.
Stix:
So REM Sleep Behavior Disorder has been a real focus of your research. Can you tell us what that is and how you've found that it interacts with dreams and also how it might help us to better understand dreams?
Arnulf:
So REM sleep behavioral disorders correspond to people having some violent behaviors during sleep, including boxing, kicking, shouting. This is the most common kind of dream behavior we see. And this is a disorder that should be treated because people are injuring themselves or their loved one. Most of them are older than 50 years old and they can go up to 80.
So it's not young people. And it has been discovered in the last 15 years that these behaviors, when they occurred in the elderly, is a strong predictor of Parkinson's disease and related disorders. So we started to do a lot of cohort of patients to follow them over time and looked whether they would develop Parkinson's disease or not.
This is the main research direction presently, but in addition to that was to use these behaviors as a window onto the dream process. Because if you think about it, during this process of waking up and remembering your dream, you lose a lot of information. In contrast, if you look at people during REM sleep behavior disorder, you'll see that dream in action at the time it's happening. People speak exactly like they would speak during wakefulness. They behave like they would during wakefulness. It's a narrow window, but it's a very, very proficient window into dreams.
Stix:
Is there certain content of these dreams? And my understanding is that in some of the neurodegenerative conditions like Parkinson's that you just mentioned, there are certain themes, there's certain types of dreams that they have. Can you talk about them?
Arnulf:
The most recurring themes of these dreams are aggression. They are mostly aggressed by animals, or by other humans. Or it's their loved ones who were aggressed, and they fight back to protect their loved ones, to protect themselves. We see that in 80% of the dreams, but 20% of them are quite normal.
