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Blog Feature

By: Reg Hackshaw, EDD on April 19th, 2018

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Insufficient Sleep and the Dancing Plague of 1518: Part II

Manic behavior is associated with psychomotor activity coupled with insufficient sleep relative to the amount typically required for functional alertness. In severe cases, episodes of sleeplessness may occur with no subjective complaint of tiredness. Choreomanic episodes, also known as “dance frenzies” or irresistible dance attacks, are considered by many medical historians as presentations of mania.

Records dating from approximately 1020 to the 1600s provide written accounts as well as images of choreomanic outbreaks across regions of Belgium, France and Germany. The earliest outbreaks reportedly affected only a few individuals. Scholars generally identify 1374 as the year of the first choreomanic epidemic in Western Europe. One of the most extensively documented of these epidemics plagued Strasbourg, France, during the summer of 1518.

Managing the Mania

Strasbourg’s leaders, who composed the city’s magistracy, viewed choreomania as a symptom as well as a cure. The frenzied dances of “unruly mobs” were indulged through the assistance of contracted musicians who discretely redirected the afflicted to less populated areas of the city. Such remedies employed during previous outbreaks may have inspired the legend of the Pied Piper, a character from Hamelin, Germany, during the 1300s who allegedly lured dancing children away from their homes with the hypnotic sounds
of his enchanted flute. Unfortunately, musical accompaniments (which also were attempted during later outbreaks) were as problematic in treating this behavior as is fighting a house fire by tossing gunpowder on the advancing flames.

Bands of music traversed the country to cure the malady and, no doubt, often caused, or at least encouraged, it. The dancing generally continued from 10-14 hours daily, and from three to six successive days, and this amount of exertion we are told gave rise to no apparent fatigue. While the morbid impulse lasted, the physical endurance was truly extraordinary. 

By early August, distraught citizens were hustling their manic relatives to various locations established for nonstop dancing with only “a few hours of occasional sleep … day after night, night after day, the dancers continued with their delirious motions.”  The infectious nature of the mysterious malady was evident from an observation that puzzled onlookers were at risk by “merely seeing another person dance.” 

City magistrates, desperate to eradicate the disruptive contagion, dismissed the musicians and canceled public performances with tambourines and drums.  The rhythms of percussive instruments were viewed as vectors of the mania because they “were infecting others to dance uncontrollably” according to a contemporary scholar.  Furthermore, authorities established a citywide curfew by fining the families of individuals caught dancing in the streets. In a final (and successful) plan to establish civic order, “wagonloads of dancers and their hired attendants” were dispatched to a remote village shrine outside of Strasbourg for rest and eventual recovery.

Possible Causes of the Mania

In the Q1 2018 issue of A2Zzz. Reg Hackshaw, EDD, discusses what the possible causes of the mania were. 

This article  is one of four designated CEC articles in this issue of A2Zzz. AAST members who read A2Zzz and claim their credits online by the deadline can earn 2.00 AAST Continuing Education Credits (CECs) per issue – for up to 8.00 AAST CECs per year. AAST CECs are accepted by the Board of Registered Polysomnographic Technologists (BRPT) and the American Board of Sleep Medicine (ABSM).


To earn AAST CECs, carefully read the four designated CEC articles and claim your credits online. You must go online to claim your credits by the deadline of June 8, 2018.

After the successful completion of this educational activity, your certificates will be available in the My CEC Portal acknowledging the credits earned.

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