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A Dream of Death

2024; Elsevier BV; Volume: 10; Issue: 4 Linguagem: Inglês

10.1016/j.sleh.2024.07.001

2352-7226

Conner Hua, Meir H. Kryger,

Sleep and Wakefulness Research

In 1891, artist Ferdinand Hodler's painting "Die Nacht" ("Night") was shown for the first time in Geneva. Although it initially caused a scandal in Geneva's art scene for its depictions of nudity, the painting would later explode in popularity years later after making its way around exhibits and museums in Berlin. Considered one of the most famous Swiss painters of the 19th century, Hodler has become well known for "Die Nacht," with many considering the work his magnum opus. Using this piece as a focal point of analysis reveals critical overlaps and insights with the artist's own history, as well as the art and science of sleep. Portrayed in the artwork are four men and three women sleeping in the nude, covered by black blankets. In the center of the painting is a man with an alarmed expression, aroused to wakefulness from a frightening dream and wrestling with a mysterious, formless, black, robed figure crouched over him. The central figure or protagonist is Hodler himself; the two women at the bottom of the work are his mistress (on the left) and his first wife (on the right). The figure entirely clothed in black robes is a common, metaphorical visual depiction of death in artwork. In art history, death is a common theme/motif depicted in tandem with sleep. In the modern age, where cardiovascular diseases are the leading cause of death worldwide,1WHO. "Cardiovascular diseases." 〈https://www.who.int/health-topics/cardiovascular〉- diseases#tab=tab_1Google Scholar patients dying in their sleep is often attributable to sudden cardiac events like cardiac arrythmias, strokes, and seizures. In fact, a 2011 study of sudden death in Denmark from 2000-2006 found that 34% of all sudden cardiac deaths occurred during sleep.2Winkel B.G. Holst A.G. Theilade J. et al.Nationwide study of sudden cardiac death in persons aged 1-35 years.Eur Heart J. 2011; 32: 983-990Crossref PubMed Scopus (303) Google Scholar Sudden unexplained nocturnal death syndrome (SUNDS), which is endemic in Southeast Asia, has been reported worldwide. It is predominant among young adult males, who die during sleep or at rest. SUNDS has been hypothesized to be related to Brugada Syndrome, a cardiac rhythm disorder.3Gaw A.C. Lee B. Gervacio-Domingo G. et al.Unraveling the Enigma of Bangungut: Is Sudden Unexplained Nocturnal Death Syndrome (SUNDS) in the Philippines a Disease Allelic to the Brugada Syndrome?.Philipp J Intern Med. 2011; 49: 165-176Google Scholar REM-related cardiac asystole has also been described in young adults.4Guilleminault C. Pool P. Motta J. Gillis A.M. Sinus arrest during REM sleep in young adults.N Engl J Med. 1984; 311: 1006-1010https://doi.org/10.1056/NEJM198410183111602Crossref PubMed Scopus (148) Google Scholar In the specific geographic and temporal context that Hodler is painting in, however, the association between sleep and death is likely not cardiac. Instead, Hodler is probably painting in reference to the tuberculosis epidemic of the late 19th century, and the many young adults it claimed.5Murray J.F. A century of tuberculosis.Am J Respir Crit Care Med. 2004; 169: 1181-1186https://doi.org/10.1164/rccm.200402-140OECrossref Google Scholar Hodler's own mother passed from the disease when he was only fourteen years old; this melancholy personal background is reflected in the frightening and grim tone of this painting. With the protagonist's face contorted in clear discomfort, fear, and alarm, the audience is immersed in the scene, potentially even empathizing from their own fears of dying in their sleep. Beyond the artistic-cultural relevance in the painting's thematic death, as a symbolist painting, Hodler invites us—the audience—to extrapolate additional symbolic meaning. Although this analysis was almost certainly not what Hodler envisioned, if we creatively interpret "Die Nacht" in several ways, we can even analyze it in the context of the science of sleep. First, if we interpret the appearance of Death as literal, we are led to a central question: why are the other people asleep while the protagonist is not? We know that in deep sleep, humans experience reduced cognitive activity and drastically reduced response to external stimuli6Burton S.A. Harsh J.R. Badia P. Cognitive activity in sleep and responsiveness to external stimuli.Sleep. 1988; 11: 61-68PubMed Google Scholar; this would explain how the others were not aroused by the ominous figure or the potential sounds that may have escaped the protagonist's mouth in his alarmed state. Second, if we are not meant to interpret Death as literally being there, then a whole host of possibilities opens up. For one, the audience could interpret that the protagonist is falsely perceiving the events in the painting. For example, if the man suffers from narcolepsy, the vision of the robed figure could be a hypnagogic hallucination, a result of a REM intrusion related to his narcolepsy, a "connection between the dreaming brain and the external world…allowing the person to awake briefly in this state and become briefly aware of dream contents."7Waters F. Blom J.D. Dang-Vu T.T. et al.What Is the Link Between Hallucinations, Dreams, and Hypnagogic-Hypnopompic Experiences?.Schizophr Bull. 2016; 42: 1098-1109https://doi.org/10.1093/schbul/sbw076Crossref Scopus (89) Google Scholar Understanding the figure as a hypnopompic hallucination would rationalize this painting, which otherwise requires a degree of suspension of disbelief. Third, Hodler's depiction could be entirely set from the protagonist's imagination. If the protagonist, for example, had nightmare disorder—a disorder of REM sleep arousal—then that would also explain his expression. Usually involving nightmares with "threats to survival, security, or physical integrity," nightmare disorder "can cause significant distress or impairment."8Stefani A. Högl B. Nightmare Disorder and Isolated Sleep Paralysis.Neurotherapeutics. 2021; 18: 100-106Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar In this sense, we might even be able to understand this painting as an insomnium or a visium, two types of dreams established by Macrobius, a Roman philosopher (living in about 400 CE) in his "Commentary on the Dream of Scipio."9Peden A.M. Macrobius and Mediaeval Dream Literature.Medium Ævum. 1985. 1985; 54 (59.73)〈https://www.jstor.org/stable/43628865〉Google Scholar While this painting could be a nightmare caused by a bodily disturbance (insomnium), it could also be a nightmare with a supernatural contact or an apparition (visium), the common understanding of Death at the time when the painting was completed. Macrobius' theory gives us various frameworks by which we might be able to understand and classify this painting as a nightmare. Regardless of the etiology of the Death figure, Hodler succeeds at evoking visceral emotions from the audience. The beauty of his symbolism lies in the fact that we are able to locate so many different explanations and analyses of his painting, ranging from literal interpretations, to narcoleptic hallucinations, to a nightmare. "Die Nacht" certainly serves as an interesting piece of artwork that explores how the art, history, and science of sleep might relate. The authors declare that they have no conflicts of interest.