Dreaming is such an unusual and awesome experience, yet many people are confused about how to interpret their dreaming behavior. While it is certainly a very complex thing to interpret one’s dreams, I am only referring to the behavior of dreaming itself. That is, many sleep disorders’ patients seem to wonder about whether or not their dreaming activity is normal.
Dreaming is clearly normal, and one common factoid commonly misunderstood is the belief you dream only in REM sleep. Actually, we dream in all stages of sleep, but REM sleep appears to create either the dreams that somehow we are more likely to remember or dreams that appear in our consciousness more vividly. Perhaps the vividness makes them more memorable. So, when anyone is talking about dreams, most of the time he or she would be talking about dreams experienced in the stage of REM sleep.
What then constitutes normal dreaming as well as abnormal dreaming behavior?
First and foremost, among those who report no dream activity, including no memory of dreaming and no memory of dream content, such behavior is clearly abnormal with the possible exception of an individual who might be so severely repressed or emotionally blocked that the mind somehow prevents the person from dreaming or any memory of the experience. Patients who suffer brain damage may also fall into this category. Whereas, the vast majority of individuals who do not remember dreaming or dream content do so because their sleep disorders are most likely kicking them out of REM sleep. Theoretically a short sleeper who tends to lop off a big chunk of REM sleep by waking after say 4 to 5 hours might also notice fewer dreams as the largest proportion of REM would have occurred during hours 6 and 7. Then again, we would want to know if there is a physiological or psychological reason for such short sleep, because most short sleepers suffer from fairly complex sleep disorders that would explain a lot about their abbreviated sleep cycles.
If you are not dreaming and you recall no dreams, a sleep study is imperative to examine why you are likely experiencing a shortage of REM sleep.
At the opposite end are the folks who always remember dreaming and always remember some content in the morning. Among this group, there are two very distinct sub-groups. Normal sleepers—meaning those with no sleep disorders whatsoever—invariably remember dreaming and their dreams. Indeed, these are the individuals who might annoy or entertain everybody at the office water cooler with their titillating or graphic visions from the night before.
However, paradoxically, the sign of dream remembrance capacity is also linked to sleep fragmenting disorders, and the reason is obvious once you understand one particular way to remember your dreams. That way of course is waking up during or “after” the dream “completes” itself. Sleep disorders, especially OSA and UARS, cause sleep fragmentation. Sometimes, fragmentation leads to arousals but other times a person comes to full awakening. Because sleep apnea events and oxygen desaturations tend to worsen in REM sleep, conceivably, a person experiencing sleep apnea during REM might be dreaming and waking in alternation a fair amount of time. The result is greater ease in remembering dreams, because if you awaken and reflect on your dreams for a few minutes and then return to sleep, there is a chance the experience will stay in your retrievable memory banks.
Thus, from the above, you can see that among people who are not seeking care at a sleep center, they would make the assumption they are normal sleepers because they are normal dreamers. The problem with this reasoning is that most people know so little about sleep and sleep disorders, it is more common for people to ignore, discount, or downplay any hint of a sleep problem, and therefore they would stick with their original perspective…."I dream all the time so I must be a normal sleeper."
Yet, if you were to ask such individuals whether or not they wake up at night to urinate, or suffer from borderline hypertension, or drink caffeine for an energy boost midday, most people do not like to hear how these behavior or symptoms are closely linked to OSA or UARS. Often, they will report something like, “my doctor has never asked me about my sleep,” to which your reply might be, “That’s sort of my point.”
In sum, dreaming behavior only seems most reliable for predicting a sleep disorder in the case of the person who notices a drop off in his or her dream activity or otherwise recalls not having dreamt for a very long time. These individuals may show greater receptivity toward the idea of possible sleep disorders as an underlying cause in this change from normal behavior.
To close, however, we must discuss the important caveat of medication effects on REM and therefore upon dreaming. As above, we dream in all stages, but because REM dreams appear more vivid or memorable, then medications suppressing REM will often suppress dreaming activity or awareness of dreams. Not much has been written in this area, largely because the suppression of REM sleep was originally discovered to be an important clinical finding of anti-depressant effectiveness. In the late 1950s REM sleep was discovered, and then in the 1960s, it was noted depressed patients entered REM sleep more quickly in the night than normal sleepers. Subsequently, by the 1970s, antidepressants were used on these patients, and it was noted REM sleep onset was delayed. This objective change was associated with beneficial effects on the depression. Thus, from a biological model of depression the main characteristic of REM was whether or not it could be suppressed by medications. This thinking was quite narrow compared to that of dream researchers who have long held that dreaming, if not REM sleep itself, is a critical function of the brain that directly influences memory, learning and emotional processing. As a nightmare researcher since 1988, I embrace this point of view as well.
Many antidepressants act on REM to suppress it, but a number of other drug categories may also limit the amount of REM sleep you generate each night. The most common categories are sleeping pills, tranquilizers, and opiates. Not every drug in these categories causes the same degree of REM suppression or REM fragmentation, but if you use these drugs and notice a decrease in dreaming behavior, you are probably experiencing a reduction in REM sleep due to the drug. Clearly, you may be taking the drugs for various mental or physical health issues, so there is no recommendation here to suggest you need to stop the medication or change it.
The goal for introducing this caveat is to realize that aside from sleep disorders, medications are the single other most common reason individuals may experience less dreaming and usually less REM. In these circumstances it would not be easy to use this data point to predict whether someone suffers from a sleep disorder, notwithstanding the fact that many people who use these types of medications for various health conditions often suffer co-morbid sleep disorders.
As you can see, looking at your dream behavior to assess whether or not it is normal may prove very illuminating in the case of those with low dream activity, but it may prove more tantalizing than clarifying among those who regularly report dream behavior yet are not quite sure about the nature of their sleep and their potential for sleep disorders.