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Sleep Disorders

Excessive Dream Sleep

03/06/2007

Question:

I have an unusual problem with excessive dream sleep. This results in numerous awakenings at night and leads to severe bouts of insomnia. I wake between 5-10 times a night while dreaming. I will often return to the same dream when falling back to sleep (if I fall back to sleep at all.) If I nap during the day, even for 15 minutes, I immediately begin to dream upon falling asleep. As a young child, 6 years old, I was given an EEG due to episodes of fainting. The technician told my mother "There is absolutely nothing wrong with her brain. As a matter of fact, she thinks more when she`s asleep than most people do when they`re awake." Of course, this was years ago as I am 49 years old at present. I feel that I have a "sleep disorder" but I don`t seem to fit into any "category". Could you offer me some insight into this problem?

Answer:

It's hard to know exactly what to make of your problem without further sleep-related history. However, with the limited information available, I can comment on some of the possibilities that may be associated with frequent dreaming, particularly those occurring with sleep onset. This sleep-associated symptom could represent a medication effect, sleep-related hallucinations, a primary sleep disorder or possibly a psychiatric condition.

There are a number of medications that can lead to frequent and intense dreams. Most common of these include some of the beta blockers (used for treatment of hypertension and heart disease), some of the antiparkison's drugs and some psychiatric medications. A review of your medication list, if you are on any, would be a good idea. However, you should not stop any medications without talking to your doctor first. In addition to the medications themselves, stopping some medicines or certain substances (such as alcohol in a regular user) can also lead to intense and frequent dreams.

Sleep-related hallucinations can present as vivid dreamlike states that are usually visual (seeing things), though they can be auditory (hearing things), tactile (sensation of feeling something) or kinetic (feeling of motion or movement). They more commonly occur with sleep onset (known as hypnagogic hallucinations) but can happen with morning awakenings (hypnopompic hallucinations) as well. Sleep related hallucinations can be frightening and may, at times, be associated with other sleep behaviors such as sleep walking or sleep talking. Factors known to bring these about or increase the frequency of occurrences include younger age, current drug use, past alcohol use, anxiety, mood disorders, insomnia and lack of sleep. These hallucinations may also be a sign or symptom of another sleep disorder, such narcolepsy, a primary nightmare disorder, migraine headaches, or, rarely, they could be part of sleep-related seizures (epilepsy). Psychiatric disease (such as schizophrenia) should also be included as a possibility, though assuming these hallucinations occur only with sleep, then this would be less likely.

Narcolepsy may also present with an overlap between dreams and wakefulness, resulting in dreaming as soon as you fall asleep. Individuals with this condition tend to be extremely sleepy (they do not usually suffer from insomnia) and may have other related symptoms such as sleep paralysis (feeling unable to move upon awakening) and cataplexy (sudden loss of muscle control during waking hours associated with emotional stress).

It certainly sounds as though your symptoms are bothersome to you. It would be a good idea to discuss her problems with her Primary Care Doctor. Referral to a Sleep Specialist, Psychiatrist and/or a Neurologist may be needed, depending on specifics in your history and examination. Additional testing may be required to help sort out the cause of the hallucinations.

To learn more about sleep or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you. The website Sleep Education.com also provides plenty of good consumer friendly information. Good luck and here's to better sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University