Oneiroid Syndrome

Oneiroid syndrome is a dream-like confusional state with clouded consciousness. The sensory illusions, which are perceived as very lifelike, are often associated with intense emotional experiences, which usually have strong negative connotations. Affected people cannot separate what they seem to have experienced from reality and, because of the supposed authenticity of it, are difficult to convince of the unreality of the events.

Oneiroid Syndrome

What is Oneiroid Syndrome?

Oneiroid syndrome is closely related to the concepts of delirium and delusions. The term was introduced into German psychiatry by Wilhelm Mayer-Gross, a psychopathologist from Heidelberg, in 1924. These are extremely complex dreams in which the person experiencing them seems to be awake to their own well-being. See acronymmonster for Definition of Ventricular Fibrillation (or Ventricular Flutter) in English.

The name of the syndrome comes from the Greek word “oneiros” (“dream”) and means something like “dream-like”. The experienced dream event usually triggers strong fear or anxiety in those affected. Even in hindsight it is not possible for him to differentiate between dream and reality. To them, the oneiroid was as real as being awake.

Triggers are situations in which the brain is intact and awake, but the person still faces a loss of the world or self. Experiences are interpreted in a delusional way, and depersonalization occurs. For the occurrence of the oneiroid syndrome, however, the affected person must have had a fantastic tendency before the triggering psychosis. When making the diagnosis, it is important for the treating physician to differentiate the syndrome from schizophrenia and other delusional disorders.


Oneiroid syndrome can have many causes. It typically occurs when the brain is intact but the sufferer is unresponsive for a long time. People with a paralyzed body who have little or no opportunity to make independent contact with the outside world are particularly affected . These include Guillain-Barré syndrome, among others.

With this progressive paralysis, those affected will eventually have to be artificially ventilated. You dream more. In combination with the involvement of the cranial nerves and the withdrawal from the outside world, oneiroidal conditions have developed in almost every patient. A coma can also trigger oneiroid syndrome.

Other risk factors arise from brain injury, massive starvation, severe burns, and traumatic psychosis. People who have been in a coma for a longer period of time often report afterwards about events that did not happen, but were definitely real for them. This also means that those affected can hardly remember their actual time in the hospital, for example. Instead, they report on fantastic events – the oneiroids.

Symptoms, Ailments & Signs

It is not difficult for an outsider to diagnose oneroids as such, especially when considering patients at risk. The people report on events they experienced while they were lying in their sickbed, for example. As a rule, the events are strongly negative. Most cases involve kidnapping or abuse.

The ideas are often accompanied by the feeling of being completely at the mercy of the underlying disease. Although the people are awake during the oneiroid, they primarily experience what is happening passively. This means that you have no influence on what is happening and have no way of intervening yourself or of controlling the development of the dream for yourself. The subject of death is also often raised.

An example is a woman who, upon her final awakening, reported the death of her son and was herself upset at seeing him well. Only in rare cases are oneiroids seen as positive. The typical symptomatology also includes the patient’s clinging to their stories. For them, the dream states are real and cannot be separated from reality, even after waking up.

Diagnosis & course of disease

Oneiroid syndrome is not so much a disease as an accompanying symptom of various diseases such as locked-in syndrome, psychosis, encephalitis, brain injuries and brainstem ischemia. It is not dangerous in the narrower sense, but triggers states of confusion in those affected. People react irritably if they are not believed or are desperate.

A medical professional will diagnose the diagnosis based on the descriptions of the patient and their environment. Before doing so, however, he must clarify whether the person concerned is not suffering from delusions or schizophrenia. Oneiroid syndrome is not easily differentiated from all mental illnesses. There are no more detailed studies on the subject, which may be due to the lack of diagnostic differentiation. The prognosis is good.


Due to the oneiroid syndrome, those affected suffer from various psychological complaints and disorders. These complaints have a very negative effect on the quality of life and reduce it enormously. As a rule, patients with oneiroid syndrome are also dependent on the help of other people in their lives and are often no longer able to cope with everyday life on their own.

Even to outsiders, those affected can appear bizarre and confused, so there may also be social discomfort due to the syndrome. The patients themselves cannot intervene in the events themselves and cannot free themselves from them either. Furthermore, this disease can lead to severe psychological problems and depression if the patient sees friends or relatives who have passed away.

In serious cases, the patient must be admitted and treated in a closed clinic. Treatment of oneiroid syndrome is carried out with the help of medication and psychological therapy. There are usually no particular complaints. However, it cannot be predicted whether the disease will progress positively. In many cases, it takes a long time for the treatment of oneiroid syndrome to actually take effect.

When should you go to the doctor?

People who notice signs of oneiroid syndrome in another person should see a doctor together with them. States of confusion or aggression indicate a corresponding condition and must always be clarified by a doctor before serious complications arise. It is advisable to go to the doctor at the first sign of illness so that it can be treated if possible before the person concerned injures himself through an accident or fall. Since oneiroid syndrome is very rare, there is a high probability that the symptoms are caused by another condition.

In any case, the typical dreamlike state of confusion must be examined by a doctor. Should there be any side effects or interactions from the prescribed medication during therapy, medical advice is also required. People who already suffer from a mental illness or have a family history of it are particularly at risk. People who use drugs or are exposed to psychological stress for other reasons also belong to the risk groups and should be presented to a doctor if oneiroid syndrome is suspected. In addition to the family doctor, a neurologist or a specialist in mental illness must be consulted. In addition to drug therapy, a therapeutic consultation is always necessary.

Treatment & Therapy

Treatment of oneiroid syndrome is primarily through treating the underlying cause when possible. Important for patients suffering from oneiroids is the psychological support of their fellow human beings or close confidants. This requires a lot of patience. The persons concerned believe that they have experienced real events. The people around you need to be aware of this.

Annoyed or even aggressive reactions to the stories told to them are counterproductive and trigger a lack of understanding and defensive reactions in those affected. Psychopharmacologically, a doctor will treat you with neuroleptics, for example. In the foreground, however, should always be the respective underlying disease. Stabilizing the patient’s fluid and vitamin balance is important as a supplementary treatment.

Outlook & Forecast

In the case of oneiroid syndrome, doctors can only make a limited prognosis. It’s not always a disease. It involves very intense dreams where the dream state is not perceived as a dream state. Rather, those affected consider it to be reality because of the intense feeling. You perceive yourself as awake. This can lead to significant confusion.

In oneiroid syndrome, the boundaries between reality and waking consciousness become blurred with dream sequences during sleep. People who suffer from a psychosis or an injury to the brain, encephalitis or a locked-in syndrome are often affected. Such conditions can be misinterpreted as schizophrenia. They are similar to some mental illnesses. Therefore, the diagnosis ultimately determines the prognosis.

The overall prognosis for oneiroid syndrome is positive. The only problem is that some patients are so confused by the dream sequences that appear real that they develop psychological problems. In severe cases, admission to a psychiatric hospital must be considered. In this case, a disease value is given. That worsens the prognosis.

Oneiroid syndrome is usually treated with medication and, if necessary, with psychotherapy. Some of the patients experience a clarification of perception. Another part remains stuck for a long time in the oneiroid syndrome, which cannot be influenced voluntarily. It takes time for symptomatic treatment to have an effect.


To date, there are no reliable studies reporting effective prevention of oneiroid syndrome. Prophylaxis is questionable.


In most cases, those affected with oneiroid syndrome have very few measures or options for aftercare. The person concerned should see a doctor early on to avoid further complications or other symptoms. An early diagnosis always has a very positive effect on the further course of the disease, so that the person concerned should consult a doctor at the first signs or symptoms of the disease.

Most of those affected depend on the help and support of close friends or family. Loving and intensive conversations in particular have a very positive effect on the further course of the illness and can also prevent depression or other psychological complaints and upsets. In many cases, oneiroid syndrome is also treated by taking various medications.

The person concerned should always ensure that the dosage is correct and that the medication is taken regularly. In general, you should drink a lot to compensate for the loss of fluids. Supplements can also be taken to rebalance the body’s vitamin balance. As a rule, oneiroid syndrome does not reduce the patient’s life expectancy.

You can do that yourself

Individuals suffering from oneiroid syndrome are unresponsive during the dream-like states. The most important measure is to look after the sick person after they wake up. Relatives and friends should talk to the sick person a lot and thereby help them to come to terms with the often traumatic experiences.

At the same time, the person concerned must take care of themselves. In consultation with the doctor, it may be possible to do lighter sports. This can alleviate the mental suffering and the dream-like states can be weakened. Depending on the clinical picture, a change in diet can also be useful. Since the oneiroid syndrome can occur in connection with a wide variety of diseases, the self-help measures must always be worked out together with the doctor and with regard to the symptoms.

In principle, the relatives should inform themselves about the syndrome so that the necessary steps can be taken in the event of an attack. It is advisable to read books about the syndrome and, if necessary, visit a sleep laboratory to better understand oneiroid syndrome. The patient should also be informed about the condition and talk to other people affected in a self-help group.