By Mary Carpenter
A RECENT New York Times magazine article on “strange nocturnal visions” provoked by the pandemic has inspired an update of Mary Carpenter’s post on nightmares. Her post featured Rubin Naiman, psychologist and sleep and dream specialist at the University of Arizona Andrew Weil Center for Integrative Medicine, who is also quoted in the story, who said, “We are at least as dream-deprived as we are sleep deprived.”
A pandemic study of 100 nurses in Wuhan, China, found that 45% were having nightmares —“many times higher than among the 5% of the population which suffers from “nightmare disorder.” That disorder is one of the parasomnias, or undesirable sleep experiences, which include talking while asleep, or somniloquy, which is the most common.
Nightmares are disorders that require medical attention only if they “routinely” disrupt sleep; or cause either daytime sleepiness or major distress—such as anxiety, that interferes with functioning—or fear of recurrence that impedes going to sleep at night.
Most nightmares can seem vivid, real and upsetting and are usually related to threats, safety or survival. But nightmares can also be rich fonts of learning about yourself as well as helpful for working through difficult issues —especially if you “dialogue” and “practice courage” with your demons in those dreams, according to Naiman.
Dreams are like the stars in the sky: always there but not always visible to us, Naiman says. While dreams occur throughout the night, we are most aware of them during REM sleep—which occurs every 90 minutes or so in ever-lengthening periods until waking. Because the longest REM periods occur in the final third of the night, he is opposed to using wake-up alarms, which can snip off the end of an important dream.
“Morning grogginess is an exquisite hybrid state of consciousness,” according to Naiman: part waking, part sleep, and part dream—and arising slowly to tap into that state can help us access our dreams. And, if we are more sensitive to the importance of our dreams, he believes we will have an easier time recalling them. Naiman recommends “bridging our dream experiences and the waking world” by journaling or jotting notes about the dreams, also by talking about them with a “receptive bed partner.”
“Dream loss is the basis of the modern epidemic of depression,” Naiman contends, and traces problems commonly blamed on sleep loss to dream loss instead. Rats die in experiments where they are prevented from dreaming. He points to anti-depressants and sleep medications along with addictions and over-exposure to light at night as wreaking havoc with our dreams by suppressing them.
When we suppress REM sleep with drugs or by sleeping too little, dreams move to earlier in the night and interfere with normal sleep patterns, according to Naiman. With PTSD, nightmares come earlier and during non-REM sleep. To help counter REM suppression, he recommends melatonin, because it “appears to support REM sleep and dreams.”
Nightmares give us an important opportunity to practice courage, Naiman says, that generalizes to our waking life. Image Rehearsal Therapy (IRT) is one approach to nightmares, based on the idea that we can change our dreams. If you dream of a dragon in the closet, ask yourself what you wish to say to it, or take up a weapon or turn it into a fruit tree. Rehearse this new script during the day, or write a description of the new dream and read it over.
“Lucidity” is another approach, in which the dreamer makes an effort during the dream to remember that they are in a dream —where everything is harmless—and to maintain an attitude of “intrepid curiosity” towards the dream content. Studies on particularly adept lucid dreamers have found more activity in the part of the brain that enables self-reflection (the anterior prefrontal cortex) than in those less skilled.
“Conciliatory dialoging” with dark dream characters is a third approach, which can turn “demonic beings into puppies,” Naiman said. He recommends treating demons as equals and asking them: who are you, who am I and why are you here? By “conciliatory,” he means friendliness—not submission—to encourage dark dream characters to transform.
Finally, shadow work is the approach Naiman employs most often. “The shadow is everything we wish not to be,” he said. For example, a woman who dreamed about a shadow figure slicing her open with a knife was struggling with fears of opening her heart. Naiman advised: “Even when it’s painful, stay in dialogue with the bad sides of yourself.”
Setting “an intention to become receptive to our dreams” can be a good strategy before going to bed —by considering beforehand that there will be something worthy of our attention in our sleep, Naiman has written. Instead of thinking about the next morning as we close our eyes, we can consciously descend into the sea of sleep with our ‘third eye open.’
Most people have trouble remembering their dreams either because they don’t sleep well, because they allow lifestyle factors (worrying about the next day, using alarms to wake up) to get in the way or because they don’t “offer [dreams] sufficient regard.”
Sleep time affects dreaming—which diminishes dramatically for those who sleep six hours instead of eight: “You lose almost half—and exactly the dreams that will be the most vivid, bizarre and memorable,” Harvard psychiatrist Deidre Barrett told the New York Times.
And sleep timing may have a dramatic effect on heart health, according to a new study at the University of Exeter in England. Of more than 88,000 people followed over five to seven years, the heart-healthiest went to sleep between 10 and 11pm—with a 12% greater risk of cardiovascular disease for those who went to sleep between 11 and 11:59, and around 25% higher risk both for those who fell asleep at midnight or later, and for those who went to sleep before 10pm.
People who find it hard to get to sleep before 11 may find inspiration in the anticipation of dreams—as opportunities to be courageous or creative, or at least of paying attention to see the stars of dreams when they appear.
Mary Carpenter regularly reports on topical subjects in health and medicine.