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Sleep Disorders

Interrupted Sleep / Dreams

02/02/2011

Question:

I`m on holiday from college. And at college, I would hardly dream or wake up at 2 a.m or 3 a.m. There were a few times when I was in school, that I would not get 8 hours of sleep due to studying or partying.

Since I`ve been back home, I`ve had dreams every night. Also, If I don`t dream I will wake up around 2 a.m or 3 a.m no matter the time I go to sleep. This is not my normal sleep behavior. What is causing me to wake up at this time? And why am I dreaming more?

Answer:

Thank you for using Netwellness. I apologize for the delay in answering your question. Unfortunately, based on the limited information in your question it is hard to determine why you are having trouble sleeping, though there may be some clues by what you describe.

Dreams occur during Rapid Eye Movement (or REM) sleep, which tends to become more frequent as the sleep period goes on and is most common towards the end of a usual length sleep period. Of interest, even if one does not remember their dreams, it does not mean they are not having REM sleep. This is because in order to recall our dreams, we usually need to be awoken shortly after we have them. However, remembering dreams or not remembering dreams is not necessarily associated with any disease. Some patients note dreaming associated with starting new medications or using certain substances as well. I do not know if this applies in your case.

I suspect that you may be having what is called “REM-rebound” sleep. This term refers to an increase in the amount of time spent in REM sleep when an individual has been chronically deprived of an adequate amount of REM sleep. This may occur from not getting enough sleep on a regular basis (as in common in college students), sleeping in a noisy environment where your sleep is frequently is interrupted (as can happen at college) or from treatment of a sleep disorder that may interfere with REM sleep (such as sleep apnea). It’s certainly possible that when you are home on vacation, you are increasing your sleep time in a better sleep environment and thus going into more frequent and intense REM sleep. This effect tends to resolve over time as you adjust to a new sleep schedule that is allowing for adequate sleep.

The cause of the 2-3 AM awakenings is also not clear. There are a long list of reasons for individuals to have trouble sleeping through the night that may range from a poor sleep environment (too noisy, too warm, not dark enough) to side effects of medications or substances (such as caffeine, alcohol, or nicotine) to medical problems (such as conditions associated with pain or shortness of breath, heartburn, depression, anxiety) to primary sleep disorders (such as breathing disorders in sleep, leg jerks during sleep or wakefulness and circadian rhythm disturbances). As you can see, it’s important to obtain additional information to determine which, if any, of these problems may be contributing to your sleep problems. Determining the cause of the frequent awakenings is usually the first step in treating the problem. In your case, this may be related to simply being at home again for the holidays and sleeping in a different environment. It would be interesting to see if this problem continues over time.

Sometimes, simply improving sleep hygiene and sleep-related behaviors can help. This may include simple measures such as keeping a regular sleep schedule, avoiding caffeine and alcohol within 4-6 hours of bedtime, avoiding exercise and/or hot showers near bedtime, and making sure the bedroom is quite, dark and comfortable.

Good luck and here's to better sleep!

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Response by:

Meena S Khan, MD Meena S Khan, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
Clinical Assistant Professor of Neurology
College of Medicine
The Ohio State University