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Previous research has aimed at linking these impairments with altered sleep architecture, but results were inconclusive. One plausible explanation is that only a few studies recorded markers of autonomic nervous system activity. For the first time, this study collected such markers under ecologically valid conditions with ambulatory assessment. In 19 individuals with frequent nightmares (\u22651 nightmare\/week) and 19 healthy control participants (&lt;1 nightmare\/month), measures indicating autonomic activation (heart rate, heart rate variability, respiration cycle length, electrodermal fluctuations, EEG arousals, saliva cortisol, REM density) were collected while applying ambulatory polysomnographic assessment during 3 consecutive nights. When nightmare participants reported a nightmare, we analyzed the last 5\u00a0min of REM sleep before awakening and compared these data to their non\u2010nightmares as well as to the dream episodes of control participants. Overall, there were no general differences in autonomic activation of nightmare sufferers compared to control participants. However, when nightmare participants experienced nightmares, autonomic activation was markedly increased compared to their own non\u2010nightmares and, to some extent, to control participant\u2019s dreams. Significant intraindividual differences were found for all autonomic measures except in participant\u2019s EEG arousals and cortisol levels. Group differences were found in EEG arousals and heart rate. In conclusion, ambulatory polysomnography demonstrates that nightmares are accompanied by increased autonomic activation. Results support the notion of impaired self\u2010reported sleep quality caused by one\u2019s autonomic response rather than altered sleep pattern.<\/jats:p>","DOI":"10.1111\/psyp.13366","type":"journal-article","created":{"date-parts":[[2019,3,30]],"date-time":"2019-03-30T10:44:34Z","timestamp":1553942674000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Nightmares do result in psychophysiological arousal: A multimeasure ambulatory assessment study"],"prefix":"10.1111","volume":"56","author":[{"given":"Franc","family":"Paul","sequence":"first","affiliation":[{"name":"Central Institute of Mental Health Medical Faculty Mannheim\/Heidelberg University Mannheim Germany"},{"name":"Department of Psychology, Clinical and Biological Psychology and Psychotherapy, School of Social Sciences University of Mannheim Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg W.","family":"Alpers","sequence":"additional","affiliation":[{"name":"Department of Psychology, Clinical and Biological Psychology and Psychotherapy, School of Social Sciences University of Mannheim Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Reinhard","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health Medical Faculty Mannheim\/Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schredl","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health Medical Faculty Mannheim\/Heidelberg University Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0017489"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2007.11.009"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.114.1.126"},{"key":"e_1_2_6_5_1","volume-title":"International classification of sleep disorders","author":"American Academy of Sleep Medicine","year":"2014"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. 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