Creativity in NT1 patients: clinical aspects and mental state in the prediction of creative success

Objectives/Introduction: Narcolepsy type 1 (NT1) is a chronic neu- rological disorder characterised by excessive daytime sleepiness (EDS), with rapid access into rapid eye movement (REM) sleep at sleep onset. Clinical phenomena related to state of wakefulness and REM sleep dissociation, including cataplexy, sleep paralysis, hypna- gogic/hypnopompic hallucinations, REM sleep behaviour disorder and lucid dreaming complete the clinical picture. Given the relationship highlighted by several studies between sleep and creative thinking and considering the features of abnormal REM sleep phases in narcolepsy, with privileged access to sleep and dream, a recent study hypothesized and reported higher creative po- tential in narcoleptic patients compared to a control group. With this study we aimed at investigating if creativity in narcolepsy could be associated with certain symptoms and with mental dimen- sions (such as mind wandering and daydreaming) that could predict creative behaviour. Methods: Sixty-six NT1 patients (mean age 38.62 ± 17.05, 31 fe- males), took part in this study. Several measures of creativity have been performed: creativity achievement, explored in different life domains by a self-reported questionnaire; creative beliefs, assessed with a scale measuring the creative self; creative performance, eval- uated through a test assessing divergent thinking skills (generation of alternative original solutions to an open problem). Results: In a mediation analysis we found that sleep paralysis and hypnagogic hallucinations indirectly influence, through creative identity, both creative achievement (ß = 0.091, SE = 0.054, 95% CI = 0.005, 0.211) and creative performance (ß = 0.140, SE = 0.060, 95% CI = 0.034, 0.269). In a moderation analysis mind wandering spontaneous (R 2 = 0.169, F(3,61) = 4.15, p = 0.009) influences crea- tive achievement through a moderation effect of sleep paralysis and hypnagogic hallucinations. The same moderation effect was found with mind wandering deliberate (R 2 = 0.133, F(3,61) = 3.116, p = 0.032). Conclusions: In conclusion, our results highlight the role of sleep pa- ralysis and hypnagogic hallucinations in defining both creative suc- cess and creative performance of narcoleptic patients influencing their creative identity. Probably hypnagogic hallucinations trigger the process of mind wandering that leads to greater creative success. Disclosure: Anita D ́Anselmo: no conflict of interest Sergio Agnoli: no conflict of interest Fabio Pizza: no conflict of interest Marco Filardi: no conflict of interest Serena Mastria: no conflict of interest Giovanni Emanuele Corazza: no conflict of interest Giuseppe Plazzi: advisory board for UCB Pharma, Bioprojet, Idorsia