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Sleep Disorders

Why Suddenly Having Vivid Dreams?

04/07/2009

Question:

I have never dreamnt very much before in the 18 years I have been alive, once a week, maybe even less, but all of a sudden I have started experiencing very vivd dreams every night, and I wake up and I remember them. My dreams are using people I know, but it`s not actually the person I know. However it is making me react wierdly to them when I am around people who have been in my dream, because my dreams themselves are always wierd. I remember all the feelings and everything.

I am actually worried as to why I am dreaming such stupid things all of a sudden when I have hardly ever dreamt before and always forgotten they few dreams I have had. I really want them to go away because while half of my mind wants to stay in the dream, the other half of my mind wants to stop it. Part of me is scared because I do have a boyfriend and I haved missed a period and I have heard you have vivid dreams when you are pregnant (not yet had a pregnancy test), but I don`t know whether I am. Can you have vivid dreams while you are pregnant without knowing it? I wondered if there was any way to get rid of these dreams.

Answer:

Dreams are a very interesting subject and still not all that well understood. We do know that sleep stages cycle throughout the night (NREM or non-dream sleep alternates with REM or dream sleep), with the end of each cycle usually being dream sleep and is often accompanied by an arousal or awakening. Thus, awakening from sleep with recall of a dream occurs frequently and would be considered normal.

Particularly vivid dreams, while disturbing, may still be classified as being a normal occurrence or, they may represent a sleep disorder called nightmare disorder. When vivid dreams are associated with discomfort or unpleasant emotion or fear, they are usually classified as a nightmare. The recurrence of the vivid dream, the context of the dream, along with concern the patient feels are all factors that make a recurrent vivid dream more of a nightmare.

Factors that may increase the likelihood of having strange and vivid dreams, that might not be considered nightmares, include stress, sleep deprivation, use of alcohol or illicit drugs and certain medications (such as some blood pressure medicines or some antidepressants). Post-traumatic stress disorder, as well as depression and anxiety disorders, can have similar effects. Sleep disorders can also cause excessive dream recall as well as nightmares by disrupting the architecture (sleep stages) of sleep and promoting frequent arousals (brief awakenings) from sleep. These sleep disorders include obstructive sleep apnea and periodic limb movement of sleep. In the absence of any other identifiable cause of nightmares, the patient is considered as having a “nightmare disorder.”

One important cause of changes in sleep duration and architecture in women is hormonal changes. Hormonal effects can impact sleep during pregnancy, the postpartum time (after delivery), during normal menstrual cycles, and in menopause. For example, it has been reported that in the course of a normal menstrual cycle, women experience more REM sleep in the first half of the cycle than in the second half. Intense hormonal changes also occur during pregnancy and affect sleep. However, to date, these hormonal effects on sleep have not been well characterized. Some authors have reported increased sleep time in the first trimester followed by gradual reduction in the following two trimesters.

From what you describe, it is more likely that anxiety, or worrying about the possibility of pregnancy may be the cause of your sleep disruption. Any of the conditions listed above could also be responsible for your symptoms and should be considered if the symptoms persist. In addition to determining if you are pregnant or not, I suggest that you follow the following general sleep hygiene recommendations for few weeks and then reassess your situation. These rules of sleep hygiene include:

If you do not note improvement after following these measures, then you may want to see a sleep physician to help determine if another sleep problem may be present.

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Response by:

Rami N Khayat, MD Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University