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Thursday, May 23, 2013
For the past couple of months I hve had very "real" vivid and excessive dreaming. I always remember my dreams the next morning and most are not pleasant. Some give me a real sense of dread throughout the following day. I have recently begun to text people asking for help. These texts are hardly legible and I am unaware that I am doing it. It is only til someone tells me the next day. I am not on any medication other than the contraceptive pill which I have not changed and have been on for years.
This reply to your question is partly a reiteration of an answer we have posted on this site. The question that we answered was related to excessive dreaming during the use of antidepressant medication. Your question is different because your dream state seems most consistent with having a nightmare. You also mention some associated automatic behaviors (namely: sending text messages). Automatic behaviors are routine, almost thoughtless behaviors that can be performed without particular awareness that you are doing them or have completed the task.
Let’s define a few terms first: “Excessive dreaming” is a feeling that a dream is never-ending. This includes dreaming about activities that are continuous, trivial, or physical in nature such as repetitive housework, or endless walking through snow or water. Most excessive dreaming is devoid of emotions.
This is different from “vivid dreaming”, where there is an abundance of details that carry high emotional burden. In an extreme situation, a stressful vivid dream is described as a nightmare. Other undesired events that can occur during sleep include sleep walking and confusional arousals. Both conditions may result in automatic behaviors. It sounds as though you may fit more into the vivid dreaming category, where the dreams may feel excessive due to the stress associated with them.
Usually there is no clinical abnormality in people who have excessive or vivid dreams; and in these cases, no specific treatment is indicated. Cognitive therapy, hypnosis, relaxation, and medications have not been shown to be of benefit in treating these conditions. Stress may be a precipitating factor, and if this is present, addressing this may be of some help. Medications can be responsible for vivid dreams, too. When using short acting antidepressants medications, or when abruptly stopping them, vivid dreams may occur. Hormonal contraceptive pills don’t seem to be directly related to these pathways and therefore may not be the reason for your problem. Rarely, a pathologic reason, such a brain abnormality, may underlie this condition.
The content of our dreams is influenced by many factors. Sometimes, events in our daily lives are revisited during sleep as nightmares. Other times, environmentally and physiologically upsetting circumstances (something as simple as a full bladder, or an uncomfortable room temperature) may change the content of our dreams and make them unpleasant. Experts in dream content interpretation believe that dreams are subconscious thoughts that have been ignored or suppressed, and that their only outlet is during sleep.
Automatic behaviors during sleep, such as sending incomprehensible text messages, can occur with many primary sleep disorders. Limiting sleep, either by sleep restriction (too little sleep) or by disrupting the continuity of sleep (sleep apnea and sleep-related seizures), can precipitate these behaviors, too.
Either way, it’s a good idea to discuss these findings with your doctor, who may refer you to a Sleep Specialist to determine if the problem requires further investigation. Until then, some general methods that may help you with your dreams include:
- Assure a comfortable, quiet, cool, and dark sleep environment
- Minimize volitional sleep deprivation, and keep a regular sleep/wake schedule
- Minimize alcohol, caffeine, and tobacco use close to sleep time
- Avoid benzodiazepines and other sleep aids, even those available over the counter
Additional information regarding sleep, and a listing of sleep centers near you, is available on website for the American Academy of Sleep Medicine www.aasmnet.org.
May you have happy dreams.
Ziad Shaman, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University