The Stuff Insomniac Dreams Are Made Of

Back when my insomnia was chronic, I had a lot of scary dreams. They left me with a pounding heart and fear that could keep me awake for a couple of hours.

Surprisingly little is known about the dreams of people with insomnia. So when a new article about insomnia sufferers’ dreams came out in Sleep Medicine, I snapped it up.

Insomniac dreams can be scaryI remember dreams much less now than when my insomnia was chronic. Then, just as I felt myself about to slide over the brink of consciousness, I sometimes got a horrifying send-off: a plane exploded in a fireball overhead! I was on the road and a Mack truck was coming at me full on! I was on a roller coaster that ran off the track and was plunging to the ground! Scary dreams left me with a pounding heart and fear that could keep me awake for a couple of hours.

Surprisingly little is known about the dreams of people with insomnia. So when a new article about insomnia sufferers’ dreams came out in Sleep Medicine, I snapped it up.

Negativity in Dreams

Among humans overall, a majority of dreams with emotional content are disturbing. One hypothesis about dream content holds that dreams are mainly reflections of experiences we’ve had during our waking hours, and research suggests that one function of dreaming is to replay disturbing events in order to attenuate their emotional charge. The event gets filed away in long-term memory but some of the negative emotion accompanying the experience is lost. The result is that the person dreaming wakes up feeling less bad about it as time goes on.

Results of a few previous studies done on dreams and insomnia are mixed but, overall, they suggest that the dreams of insomniacs may be more unpleasant than the dreams of good sleepers. Insomniacs have reported more nightmares and more negative elements in sleep-onset dreams. They tend to characterize themselves more negatively in their dreams (as in feeling low self-esteem or lacking in something).

This might be because insomniacs are prone to worry and rumination at night. Worries like these—“Taxes are due in 3 days!” “I’ll never get back to sleep!” “Tomorrow I’m going to feel wasted!”—may spill over into sleep. And because insomniacs are more inclined to awakenings during the night (and to arousal overall), dream content might move more easily from short- to long-term memory, enhancing dream recall.

REM Dream Activity of Insomnia Sufferers

The new study was small (12 insomniacs and 12 matched good sleepers) but well designed. On 5 nights, participants underwent polysomnogram tests to record their brain waves and assess their sleep. On 2 of those nights, during several REM sleep episodes (when dreams were more likely to occur) they were awakened by an 80-decibel tone. Then they had to narrate their dream over an intercom, recall all memorable elements of the dream, and describe the mood associated with it.

The investigators found that the dreams of all participants contained more negative elements than positive elements, which confirms findings in past research. But when they examined the two groups separately, here’s what they found:

  • Only the insomniacs’ dreams contained significantly more negative elements (aggression, misfortunes, failures, and negative emotions) than positive elements (friendliness, good fortune, success, and positive emotions). Subjectively, too, the insomniacs appraised their dreams as being more negative than good sleepers did.
  • Good sleepers reported significantly more joy and happiness in their dreams, and a higher degree of vividness.
  • Insomniacs’ sleep was more broken than the sleep of the good sleepers. In other words, the sleep of insomniacs was less efficient. And the lower the sleep efficiency, the higher the number of negative elements in insomniacs’ dreams.

The one prediction these researchers made that didn’t hold up concerns dream and nightmare recall, which they expected would be higher among insomnia sufferers than good sleepers. In contrast to the results of previous studies, participants’ responses on a questionnaire showed that dream and nightmare recall was similar between the 2 groups.

As in Waking Life, So in Sleep

The waking hours of people with chronic insomnia are skewed toward the negative, with moodiness, low energy, and mental dross our daily fare. So it’s probably no surprise that the struggle and negativity carry over into our sleep by way of dreams.

If you have a recurring dream, please share it here.

Insomniacs: Are We Dreaming About Sleeplessness?

Rapid eye movement sleep (REM sleep) is when most dreams occur. Episodes of REM sleep also help defuse negative emotions and improve the learning of motor skills.

Until recently, insomnia wasn’t thought to be a problem of REM sleep. Insomnia, the thinking went, was caused mainly by phenomena occurring—or failing to occur—during quiet, or non-REM, sleep: insufficient deep sleep, for example, or wake-like activity occurring in other stages of non-REM sleep, resulting in insufficient or poor sleep.

In the past few years, though, REM sleep has become a suspect in the quest to identify what causes people to wake up frequently in the middle of the night and too early in the morning. (This type of insomnia is called sleep maintenance insomnia). Here’s more about this intriguing proposition.

Insomnia sufferers may be remembering dreams of sleeplessness rather than lying awake for hoursRapid eye movement sleep (REM sleep) is when most dreams occur. Episodes of REM sleep also help defuse negative emotions and improve the learning of motor skills.

Until recently, insomnia wasn’t thought to be a problem of REM sleep. Insomnia, the thinking went, was caused mainly by phenomena occurring—or failing to occur—during quiet, or non-REM, sleep: insufficient deep sleep, for example, or wake-like activity occurring in other stages of non-REM sleep, resulting in insufficient or poor sleep.

But in the past few years, REM sleep has become a suspect in the quest to identify what causes people to wake up frequently in the middle of the night and too early in the morning. (This type of insomnia is called sleep maintenance insomnia). Here’s more about this intriguing proposition.

Do Insomniacs Really Underestimate Sleep Time?

It’s said that insomniacs tend to underestimate the amount of sleep they get. Polysomnography (PSG), the test conducted in the sleep lab, often shows that insomnia sufferers are sleeping more than they think.

Investigators now agree that PSG, as conducted and scored in standard fashion, is too crude a measure to capture what’s going on in disturbed sleep. Finer measures are needed. One such measure involves counting the number of arousals and micro-arousals—brief awakenings—during sleep.

In a seminal study published in 2008, a team of German scientists used PSG, sleep time estimates of study participants, and micro-arousal analysis to ascertain what the differences were between insomniacs and good sleepers. The results showed that compared with good sleepers, insomniacs

  • Got less non-REM and REM sleep overall
  • Experienced more micro-arousals during both non-REM and REM sleep, but the number of micro-arousals during REM sleep was more pronounced: about 2 to 3 times larger than the number experienced by good sleepers. Further, the more REM sleep insomniacs got, the greater was the mismatch between their sleep time as recorded by PSG and the sleep time reported by the insomniacs themselves.

These results suggest that (1) it may be disturbances that occur during REM sleep, more so than during non-REM sleep, that account for the discrepancy between PSG-measured sleep and insomniacs’ perception of their sleep, and (2) disturbed REM sleep may be the main problem for people with sleep maintenance insomnia.

How Disturbed REM Sleep Might Develop

Not much brain activity occurs during non-REM sleep. But REM sleep is marked by a mix of arousal in some parts of the brain and quiescence in other parts. The same group of scientists in a 2012 paper describe REM sleep as “a highly aroused ‘paradoxical’ sleep state requiring a delicate balance of arousing and de-arousing brain activity.” This brain activity involves many different groups of neurons. The over- or underexpression of any of these groups might disturb that “delicate balance,” causing fragmented REM sleep.

This idea fits in with the dominant explanation for chronic insomnia: it’s a manifestation of hyperarousal, which may come about in part due to stress. Stressful life experiences often cause sleep loss. If the poor sleep continues, then sleeplessness and worry about the daytime consequences themselves become stressors and insomnia becomes a chronic affair. The chronic stress accompanying chronic insomnia also leads to changes in the brain. These changes could cause REM sleep fragmentation and disrupted or poor sleep.

Remembering Dreams of Sleeplessness

The idea of REM sleep fragmentation as a driver of sleep maintenance insomnia also fits with the continuity hypothesis of dreaming, which posits that the content of dreams comes from everyday concerns. Not much research exists on the content of insomniacs’ dreams. What is known is summarized in a paper published in Sleep Medicine Reviews:

  • Compared with normal sleepers, insomniacs tended to experience themselves more negatively in their dreams
  • Problems that occurred in dreams were related to current real-life concerns
  • Health problems also appeared more frequently in insomniacs’ dreams.

People with chronic insomnia are prone to worry about sleep loss and its consequences, and these concerns might well dominate the content of our dreams. And if we’re experiencing lots of micro-arousals as we’re dreaming, the content of those dreams would be more accessible to conscious recall. Instead of actually lying awake for hours at night, sleep maintenance insomniacs might be awakening briefly but often to dreams of sleeplessness, making it feel like we’re sleeping less than we are.

Precisely how REM sleep becomes fragmented remains to be seen. But the finding that REM sleep is significantly unstable in sleep maintenance insomniacs is a step in the right direction.

Does the idea of REM sleep instability as a driver of sleep maintenance insomnia seem plausible to you?

Six Misconceptions about Sleep and Insomnia

Most of us know that drinking coffee after dinner will probably disrupt our sleep and that regular exercise will improve it. But some ideas I see tossed out about sleep and insomnia are not quite accurate. Here are six misconceptions followed by information that is evidence based.

insomnia | many people have beliefs and attitudes about sleep that are not factualMost of us know that drinking coffee after dinner will probably disrupt our sleep and that regular exercise will improve it. But some ideas I see tossed out about sleep and insomnia are not quite accurate. Here are six misconceptions followed by information that is evidence based. Find sources by clicking the links in the blog.

Insomnia mainly has to do with a lack of REM sleep (when most dreaming occurs).

Overall, studies comparing people with insomnia to normal sleepers show that insomnia is associated with reductions in both deep sleep and REM sleep. Deep sleep enables the consolidation of memories for factual information and events, and persistent insomnia tends to interfere with this process. Shortened REM sleep, on the other hand, leads to alterations in the processing of emotion—another symptom of insomnia.

The fact that I don’t remember my dreams means I don’t get enough REM sleep.

No evidence shows that sufficient REM sleep is tied to the remembering of dreams. What does seem to be true is that people who remember dreams typically wake up more often during REM sleep than people who don’t remember dreams. But these awakenings are so brief that the dreamer may not be aware of them.

I need several hours of deep sleep to function well.

Young children spend about a third of the night in deep sleep. But the amount of deep sleep humans get declines dramatically during adolescence. The average middle-aged adult spends about 15 percent of the night in deep sleep, and older adults may get as little as 10 percent. As critical as deep sleep is to our ability to function, it accounts for a small percent of the total sleep we get. Our descents into deep sleep occur mostly in the first part of the night.

Rates of insomnia are highest among people in high-status, high-stress jobs.

Stress has a huge impact on sleep, and high stress reactivity may be a defining characteristic of people who develop insomnia. But all else equal, people who earn large salaries are not the ones most likely to toss and turn at night. People of low socioeconomic status with lower education levels are more vulnerable to insomnia than surgeons and CEOs.

Waking up for a stretch in the middle of the night is a sign that something is wrong with my sleep.

Not necessarily. Historical evidence suggests that until the widespread use of electric lighting, this segmented sleep pattern was not unusual. People went to bed soon after nightfall and woke up later to make love, tend to animals and crops, or simply lie awake with their minds adrift. Then they went back to sleep for the rest of the night.

Being awake in the middle of the night may be inconvenient, and with strategic use of light and sleep compression you may be able to whittle that wakefulness down. But if you’re functioning OK in the daytime, being awake at night does not signal something amiss.

If my sleep is lousy, I should make a point of going to bed earlier.

If you have insomnia, going to bed early will likely make the problem worse. The arousal system is fully engaged in the hours leading up to bedtime, early research has shown: most people have a hard time falling asleep in the evening. Here’s a better rule of thumb: If your sleep is lousy, make a point of staying up until you feel sleepy. Only then should you go to bed.

Questions or doubts about sleep or insomnia? Share them here, and I’ll do my best to respond and clarify.

Dreams Recalled: What They Say about Your Sleep

My husband is a champion sleeper. He’s also prodigious when it comes to remembering his dreams. Often his dreams are unpleasant: He’s running to catch a plane and realizes he doesn’t have his bag, or he’s shouting at a class full of students. By the time he gets to the dessert table at a party, all the chocolate (i.e. real) desserts are gone.

Still, I envy his amazing powers of recall. I’d love to have half as much access to what goes on in my head at night.

A new study in the journal Neuropsychopharmacology sheds light on why some people tend to remember dreams and others don’t. Could it explain why I remember fewer dreams now than ever before?

dreamingMy husband is a champion sleeper. He’s also prodigious when it comes to remembering his dreams. Often his dreams are unpleasant: He’s running to catch a plane and realizes he doesn’t have his bag, or he’s shouting at a class full of students. By the time he gets to the dessert table at a party, all the chocolate (i.e., real) desserts are gone.

Still, I envy his amazing powers of recall. I’d love to have half as much access to what goes on in my head at night.

Why Only Some People Remember Dreams

A new study in the journal Neuropsychopharmacology sheds light on why some people tend to remember dreams and others don’t. It has to do with activity in a part of the brain called the “temporoparietal junction (TPJ).”

The sleeping brain cannot store new information in long-term memory. But in people who dream prolifically, the TPJ—which receives and processes information from the environment—is more active at night than it is in people who rarely remember dreams. This suggests that frequent dreamers actually experience a lot of nighttime wake-ups, authors of the study say. The wake-ups are brief enough to go unnoticed, yet they’re long enough to enable the encoding of dreams into long-term memory.

Who knew there could be such a mechanistic explanation for why people like my husband have such marvelous access to their dreams and people like me do not?

Looking for Meaning in Dreams

For many years, I had two kinds of dreams: either I was doing a boring task like following a never-ending trail of breadcrumbs, or I was witnessing the horrifying crash of a plane or train. Rare was the dream that featured movie-like scenes where I was interacting with others and moving from event to event.

But then I moved to San Francisco and went on a Carl Jung kick. I became convinced that dreams had meaning and could acquaint people with hidden knowledge in their unconscious. If I could remember more of my dreams—and surely some were worth remembering–I imagined I’d find a trove of knowledge buried inside.

Together with friends, I launched a group that met once a month to interpret our dreams. The only trouble was, I had to remember a meaningful dream to have something to work with. Just how was a person like me supposed to accomplish that?

A Way to Remember

“No problem,” one of my friends said. “Everyone has meaningful dreams—you’ve just got to find a way to remember yours. As you’re falling asleep, just ask a question about a problem you want to solve—send it out to the universe—and then, every time you wake up at night, write down what you were dreaming so you won’t forget.”

Seriously?! I, a person with world-class insomnia, was now going to have to

  1. think about a problem as I was trying to fall asleep, and
  2. rouse myself enough to record communiqués from my unconscious every time I woke up at night? How exactly would I be able to get any sleep at all?!

I was obsessed by the idea of exploring my dreams, so I vowed to do whatever it took. I started writing down some of my dreams at night.

Dreams Recalled

I did remember more dreams in the eight months our group met. In fact I had one of the most memorable dreams of my life: instead of driving my car over the Bay Bridge in rush hour traffic, in the dream I was carrying the car on my back. There’s no mistaking the meaning of that! But I’m pretty sure I didn’t need that dream to know how much I hated my commute over the bridge.

Now that I’ve got my insomnia under control, I remember even fewer dreams than I did in the past. Could the fact that I now sleep more soundly–with fewer nighttime wake-ups–be part of the explanation, as the study above might suggest?

All else equal, I’d prefer to awaken to cinematic dreams like some of my husband’s, which take him to Nepal and Thailand and other far-flung parts of the globe. But we’re none of us equal in sleep and waking. If relinquishing knowledge of my dreams is a price I have to pay for better sleep and daytime stamina, I’ll stick by the choice I’ve made.

If you remember your dreams, what’s the most common type of dream you have? Have you noticed that dreaming has any relationship to the quality of your sleep?

"Sleep on It" Is Good Advice

Do you remember your dreams?

People who recall certain types of dreams—those in which they’re rehearsing a skill like riding a unicycle or skiing downhill—have a leg up on people who do not recall such dreams. They’re generally able to master skills faster.

Sleep helps you learn new tasks and skills more quicklyDo you remember your dreams?

People who recall certain types of dreams—those in which they’re rehearsing a skill like riding a unicycle or skiing downhill—have a leg up on people who do not recall such dreams. They’re generally able to master skills faster.

This is one of many fascinating bits of information I learned listening to Terry Gross’s interview of neuroscientist Penelope Lewis, whose new book, The Secret World of Sleep: The Surprising Science of the Mind at Rest, is set for release this month. (Click here to listen to the full interview on NPR’s Fresh Air.)

Lewis, who directs the Sleep and Memory Lab at the University of Manchester in England, is mainly interested in how sleep affects memory. “Memories evolve constantly,” she said, “and a lot of that evolution occurs when we’re asleep.”

Excerpts from the Interview

1)    Sleep helps to strengthen memories. “Supposing you are learning to play the piano,” Lewis said. “You’re moving your fingers a lot. That’s associated with responses in motor areas of your brain. . . . Those areas will become active again while you’re asleep, and that replay—or reactivation—is what we think is responsible for the strengthening. So it’s kind of like your brain is rehearsing stuff without you knowing, while you’re asleep.”

2)    But sleep doesn’t only strengthen memories. Sleep helps us synthesize information and understand what’s important and what’s not. “It’s about extracting out the gist or maybe the main points” of what you’ve learned, she said.

3)    At the same time as sleep serves to strengthen memories, it also enables us to forget. “Across the day while we’re busy doing things, experiencing things, seeing things, hearing things, learning things, processing different kinds of information, the connections between neurons in the brain get strengthened because they’re trying to retain all of this information,” Lewis said. “And an awful lot of it is garbage; it’s stuff you don’t want to remember or don’t care about—what you had for breakfast, or the color of a stain on the cover of a book or something. It’s really not useful or interesting.”

“And the problem is, if you keep storing all of this stuff, you reach capacity and you can’t keep storing more. And so what happens during sleep, and specifically during the deep stage of sleep that we call slow-wave sleep, is that all of those synapses get downscaled again. So where they’ve been strengthened up, they all get proportionally downscaled.”

These are just a few points Lewis touches on her interview, which, for those of us interested in what goes on in our heads at night, is well worth a listen. I’m guessing her book will make for a good read.

Quick Quiz on Sleep

How much do you know about sleep? See if you can answer these eight questions correctly. Check your answers at the bottom of the page.

computer-quizHow much do you know about sleep? See if you can answer these eight questions correctly. Check your answers below.

1. Most dreams occur

a)      At the beginning of the night

b)      In the middle of the night

c)       At the end of the night

2. We sleep most deeply

a)      At the beginning of the night

b)      In the middle of the night

c)       At the end of the night

3. In a sleep cycle, we move from light sleep to deep sleep and back to light sleep, and then into REM sleep. How many sleep cycles do we typically go through each night?

a)      2-3

b)      4-5

c)       6-7

4. Rapid eye movement (REM) sleep is when most dreams occur. During quiet (non-REM) sleep, the brain is mostly inactive. The 3 stages of non-REM sleep are stage 1 (very light), stage 2, and stage 3 (deep sleep). Healthy adults spend the greatest percentage of the night in

a)      Stage 2 sleep

b)      Deep sleep

c)       REM sleep

5. During deep sleep, there’s a spike in

a)      testosterone

b)      Melatonin

c)       Growth hormone

6. The pineal gland starts secreting melatonin

a)      About 2 hours before bedtime

b)      When it gets dark outside

c)       Just before we enter deep sleep

7. Which of the following is untrue? As we age,

a)      We get slightly more REM sleep

b)      We get less deep sleep

c)       Men experience more dramatic sleep stage changes than women.

8. Which is the most common sleep problem?

a)      Restless legs syndrome

b)      Insomnia

c)       Sleep apnea

 

ANSWERS

  1. C. About 80 percent of our dreams occur in the last half of the night.
  2. A. Deep sleep is discharged in the first half of the night.
  3. B. 4-5 cycles/night
  4. A. About 50 percent of the night is spent in stage 2 sleep.
  5. C. The production of growth hormone spikes during deep sleep.
  6. A. Melatonin secretion begins about 2 hours before bedtime.
  7. A. REM sleep slightly decreases as we age.
  8. B. Insomnia is the most common sleep problem.

How did you fare? Let me know if any of these answers need explaining.

Four Ways to Fall Asleep

I used to be a “disordered” sleeper. That, at least, is the term I’ve heard applied to someone with a sleep schedule as erratic as mine was. One night I’d start nodding off after dinner, and the next night I’d be up till 3:30 in the morning. There was no rhyme or reason to it that I could see.

I used to be a “disordered” sleeper. That, at least, is the term I’ve heard applied to someone with a sleep schedule as erratic as mine was. One night I’d start nodding off after dinner, and the next night I’d be up till 3:30 in the morning. There was no rhyme or reason to it that I could see.

falling

Falling asleep in those days was so much more exciting. Especially when, just as I was drifting off, I experienced a hypnic jerk—a muscle spasm accompanied by a feeling of falling. Red alert! Suddenly I was plunging down an elevator shaft, my arms and legs flailing madly in the air. My heart was hammering in my chest, my breathing ragged. And even when the breathing finally slowed, a racing sensation in my torso and limbs could keep me tense long into the night.

A voice then came out nowhere: “Thought you were falling asleep, my pretty? Not . . . so . . . fast.”

Another scenario was this: after a perfectly fine day—work gone smoothly, family happy, a special delivery even come in the mail—I was just about to part with consciousness when, tzasssssssss! A plane exploded in a fireball overhead! Or a trestle gave way and a train plunged into a valley below! A sociopath was clapping a hood over my head and tying a noose around my neck! I was face to face with a man with a gun!

Horrific images came hurtling out of my unconscious just at the moment I was drifting off. They all wreaked a familiar havoc: pounding heart, labored breathing, and stress hormones racing around my body causing mayhem for a couple hours.

A Gentler Send-Off

There were other nights when sleep announced its coming in tantalizing snippets carved from dreams. A strange child lept on a man in a Teflon overcoat and slid down him with glee. Or I picked up the phone and ordered an “Isthmé” T-shirt, an act that made perfect sense on the threshold of sleep. A sweet burbling sensation in my brain accompanied these images. It was a signal that I was in fact on the verge of sleep, one of the purest pleasures I knew.

All that changed when I gave up my disorderly habits for the more regular sleep schedule I observe today. In bed by 11:30 or 12, and up at 5:30. No jerks or spasms as I’m falling asleep, no crashes of planes and trains. No cute dreamlets, either. Just a clean and pedestrian break with consciousness, what I always imagined falling asleep should be.

Sound boring? I could certainly never write about it in a blog. But I’m not tempted to return to my wayward habits. Some things are better off unexceptional, and sleep is one.

Tired of Waking Up to a Bad Mood? Try Dreaming

Waking up on the wrong side of the bed often has to do with being short on sleep, and in recent years scientists have begun offering theories about why this is so.

Rosalind Cartwright’s research suggests that one function of sleep is the down-regulation of negative emotion so we can wake up in a happier frame of mind.

P1000151It’s one of those days: you’re depressed and defeated the moment you open your eyes. The weight of things you should have done and all the things you need to do makes it a struggle to crawl out of bed. Or it’s the kind of day when you wake up feeling sullen and out of sorts. Anyone who crosses your path—partner, child, colleague, friend—gets the crabby treatment.

Waking up on the wrong side of the bed often has to do with being short on sleep, and in recent years scientists have begun offering theories about why this is so.

Sleep scientist Rosalind Cartwright discusses her theory in her latest book, The Twenty-Four Hour Mind: The Role of Sleep and Dreaming in Our Emotional Lives. Cartwright’s research suggests that one function of sleep is the down-regulation of negative emotion. This leveling out of emotion does not occur during quiet sleep, which takes place mostly in sleep cycles in the first half of the night. Rather, it occurs toward the end of the night during episodes of REM sleep, when you’re having dreams.

REM Sleep Deprivation

The evidence that REM sleep regulates mood comes mainly from studies where subjects have been deprived of REM sleep. Invariably, they awaken in a bad mood. Overall they’re more fearful, more easily thrown off kilter by problems that arise during the day, and less able to enjoy events that would normally bring pleasure.

So how could REM sleep deprivation lead to waking up in a bad mood? Cartwright notes that the majority of dreams with emotional content are disturbing rather than pleasurable. The function of these disturbing dreams, she claims, is to enable you to process the negative experiences you have during the daytime.

How Dreaming Works

Your waking experiences get reactivated during sleep, carried forward into REM sleep, and matched to memories of earlier experiences of a similar emotional tone. Dreaming does not lead to the forgetting of recent disturbing events but rather helps to defuse their emotional charge. You then awaken in a more positive frame of mind.

So getting a full night’s sleep helps you smooth out negative emotions and stock up on emotional reserves. If you can’t sleep your fill, whether you’ve gotten to sleep too late or awakened too early, it’s REM sleep and dreaming that often get shortchanged. And “loss of REM,” Cartwright says, “may equal direct expression of negative mood.”