by Dr. Ziad Shaman
For years I have been "suffering" from excessive dreaming. I have dreams that are extremely graphic, detailed and vivid. Most of the time I am aware that I am dreaming and cannot wake up. It does not occur every night, but several nights a week. I wake up feeling exhausted. I nod off during the day, cannot keep my eyes open.
For example, I will get 8 hours of sleep and yet the next day fight off falling asleep. I fall asleep almost instantly and I immediately begin to dream. There are some days where I "fall asleep" at work and begin to dream instantly. It feels like I'm hallucinating at times. My husband says I'm lucky to fall asleep when I hit the pillow but, I'm to the point where if sleeping makes me THIS tired I don't want to. The dreams are often about traumatic events.
I'm not suffering from depression, I have a regular schedule in terms of sleep, I usually get at least 6.5 to 8.5 hours of sleep every night. My diet is pretty good, and I get an average amount of exercise. Everything I do is in moderation and I don't take any drugs. Can someone shed some light on this? Why am I dreaming so much and why do I feel exhausted after a "good" night's sleep?
There are plenty of details in your question, and that is good when dealing with questions that relate to dreams. It seems that you have multiple manifestations of excessive or vivid dreaming, that are sometimes lucid in nature, where you are aware of being asleep and dreaming.
There is no clear reason for what people call "excessive dreaming," but it's known that some people suffer from dreams that seem to last long periods of the night and are "vivid." This means that there is an abundance of details that carry high emotional burden to the point of becoming nightmares (such as in your case). Usually there is no clinical abnormality in people who have either excessive dreams or vivid dreams; also, there is no specific effective treatment.
However, you also describe having dreamlike images that start as you are falling asleep. These images and sounds are sometimes called hypnagogic hallucinations. They can be scary in nature and particularly distressing if accompanied by the inability to move.
Inability to move during dreams is a normal phenomenon called sleep paralysis. It's the reason we don't act out our dreams. This reminds me of what William Dement (the father of sleep medicine) said once on this issue: "Dreaming permits each and every one of us to be quietly and safely insane every night of our lives."
The main issue for you is probably having unrefreshing sleep and excessive daytime sleepiness in spite of seemingly normal seep duration. This makes me think that your sleep is somehow getting interrupted in a way that is too subtle to notice. Sleep interruption can be the underlying reason for vivid dreams and for hypnagogic hallucinations.
A few common reasons for sleep interruption include:
- Medications and substances such as smoking and caffeine. The effect of these substances is usually underestimated (but you report using none).
- Pain and anxiety. This can make sleep very fragmented but would also be obvious to the sufferer.
- Periodic limb movement disorder. This can result in your legs kicking and waking you up from sleep for short, but frequent periods throughout the night.
- Obstructive sleep apnea syndrome. OSAS is probably the most likely reason for interrupted sleep.
OSAS is easily discovered by asking a bed partner if you snore loudly or stop breathing during sleep. However, there is another form of sleep apnea called central sleep apnea that is not associated with snoring, and is more likely to get missed when a health interview if carried out by a doctor.
A few unfortunate people have genetic tendency for sleep and sleeplike events to intrude into their wakefulness. This tendency gives them a disease known as narcolepsy. But narcolepsy sufferers, unlike you, usually feel refreshed after taking a nap. Another group of people are too sleepy during the day for no clear reason, and no matter how long they've slept. This disorder is called idiopathic hypersomnia.
Both of these disorders and most of the above mentioned sleep fragmenting conditions need an evaluation by a sleep specialist. I strongly encourage you to pursue such an evaluation and possibly to get a monitored overnight sleep study in a sleep lab to get to the bottom of what's keeping you from getting a good night's rest.
A list of sleep centers across the country can be found on the website of the American Academy of Sleep Medicine. This way you can find a sleep center near you and start the evaluation process.
I wish you good and restful sleep.
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