Not Dreaming

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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rested gal
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Post by rested gal » Fri Jun 29, 2007 10:18 am

denise1768 wrote:This subject got me thinking. I'm usually a vivid dreamer and can remember most dreams. Since starting cpap a few weeks ago, I can't remember one dream.
That's good, imho, Denise. To me that means you're sleeping peacefully through REM instead of having it interrupted by an apnea that wakes you enough to allow you to be aware of having been dreaming.

I've been getting great cpap treatment for almost four years. I rarely remember a dream. If I do, it's usually from being awakened by the alarm on some mornings. Our longest REM cycle is during the last part of our sleep before we get up in the morning.

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Post by denise1768 » Fri Jun 29, 2007 11:09 am

rested gal wrote: That's good, imho, Denise. To me that means you're sleeping peacefully through REM instead of having it interrupted by an apnea that wakes you enough to allow you to be aware of having been dreaming.

I've been getting great cpap treatment for almost four years. I rarely remember a dream. If I do, it's usually from being awakened by the alarm on some mornings. Our longest REM cycle is during the last part of our sleep before we get up in the morning.
Pretty cool. Now if I can only get through one night of sleep without waking up!! I don't think it's my mask, but I think it's cause i have to go to the bathroom!! I'm so thirsty that I drink (water that is!) all night. I decided to stop drinking about 30 minutes before bed. It's helped so that I only wake up once. Gonna try cutting back even more so hopefully I get a full night sleep again.

Denise

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Post by Wulfman... » Fri Jun 29, 2007 11:20 am

denise1768 wrote:
rested gal wrote: That's good, imho, Denise. To me that means you're sleeping peacefully through REM instead of having it interrupted by an apnea that wakes you enough to allow you to be aware of having been dreaming.

I've been getting great cpap treatment for almost four years. I rarely remember a dream. If I do, it's usually from being awakened by the alarm on some mornings. Our longest REM cycle is during the last part of our sleep before we get up in the morning.
Pretty cool. Now if I can only get through one night of sleep without waking up!! I don't think it's my mask, but I think it's cause i have to go to the bathroom!! I'm so thirsty that I drink (water that is!) all night. I decided to stop drinking about 30 minutes before bed. It's helped so that I only wake up once. Gonna try cutting back even more so hopefully I get a full night sleep again.
If you're using the nasal mask that's in your profile, I'd put money on the probability that you're leaking air out of your mouth. There are solutions to that.

Den


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Post by denise1768 » Fri Jun 29, 2007 11:28 am

Den.. Yes, I'm using the Swift. I am going to reset my machine everynight to see the leak rate but haven't done so yet.

Thanks.

Denise

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Post by Nitro Dan » Mon Jul 02, 2007 8:52 am

[quote="denise1768"]This subject got me thinking. I'm usually a vivid dreamer and can remember most dreams. Since starting cpap a few weeks ago, I can't remember one dream.

Over 20 years in treatment...
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Post by roster » Mon Jul 02, 2007 9:30 am

Glad to see this old thread revived and hope that some newcomers find it interesting and helpful. It reminded me of starting cpap therapy - many nights of long vivid dreams, a few of them nightmarish and most of them weird - REM rebound no doubt and probably combined with many awakenings while adjusting to the equipment..

I don't remember so many dreams now, but last week I did have a very vivid detailed dream about TAP. The doc fitted me with one and showed me how to adjust the screw. I then adjusted it myself. It was very comfortable and allowed me to breathe and sleep all night. The dream was so vivid that I still have the urge to look up a sleep dentist's office. Weird. Or is someone trying to tell me something?

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Dreaming question

Post by Koz » Wed Dec 26, 2007 12:00 pm

Actually, your dreams occur during REM sleep, which is a lighter stage of sleep which occurs in between the deeper stages. REM sleep occurs throughout the night, but you would only become aware of your dreams if you woke up just after a REM period, since dreams do not appear to remain in short term memory when sleep is not interruprted. The CPAP machine may make you less aware of your dreams because you are not waking up to capture them in your memory.


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Re: Dreaming question

Post by Wulfman » Wed Dec 26, 2007 12:42 pm

Koz wrote:Actually, your dreams occur during REM sleep, which is a lighter stage of sleep which occurs in between the deeper stages. REM sleep occurs throughout the night, but you would only become aware of your dreams if you woke up just after a REM period, since dreams do not appear to remain in short term memory when sleep is not interruprted. The CPAP machine may make you less aware of your dreams because you are not waking up to capture them in your memory.
Not necessarily. You can dream in any sleep stage. If one remembers their dreams, it's probably more likely that they were dreaming in stage 2.

Here's some further reading material compiled by Rested Gal:

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Den

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Dreams and CPAP

Post by BarryKrakowMD » Thu Dec 27, 2007 9:04 am

I cut my teeth in sleep medicine doing nightmare treatment research, starting in 1989 and continuing to this day. We have yet another website that provides a great deal of information about nightmare treatment at http://www.nightmaretreatment.com.

I've also been fascinated by the relationships between PAP therapy and dreams, and now having read through this topic and many of the illuminating posts, I wanted to offer a few points that might pull some of the disparate theories together.

1. Normal Sleepers. As far as I can tell from my clinical and research experience, normal sleepers usually report that they dream most nights, and they have the ability to remember some dream content virtually every morning either upon awakening or shortly thereafter. Last, they do not report frequent or even occasional nightmares, but they may suffer disturbing dreams once in awhile, say a few times per year.

2. PAP Users' Dreams.
From the above, we have always assumed that a successful PAP Therapy response would produce more dreaming and memories of dream content. And, in our clinical work, we use questions about dreams to clarify the patient's response. Patients that do not report more dreaming or awareness of dreams usually (although not always) are not achieving an optimal PAP response, because we presume they are not experiencing a fair amount of consolidated REM sleep.

3.Consolidated REM. Consolidation of REM sleep is a critical finding in normal sleepers and thus in most successful PAP therapy users. However, if you use antidepressants and other psychotropic medications that suppress REM sleep, then it's difficult to use REM as a marker in these patients when they use PAP therapy.

4.Contrary Views. Having said all that I've said in 1-3, we also clearly recognize that dreaming too much, say several months after a REM rebound in the first month of PAP, could be a sign that you are waking up too much during the night and that's why you remember your dreams. So, it is a tricky issue, then, because remembering your dreams could be either a good or bad sign of sleep quality. How you tell the difference is largely a matter of other symptoms, but to repeat, if you are feeling like sleep quality is good and your daytime fatigue and sleepiness are markedly reduced, we would expect you to report dream awareness and dream content. If you don't report dreams, then it's certainly possible your norm is atypical but still normal for you and nothing to worry about. But in general that scenario is much less common. More common would be that the person is not really at an optimal response to PAP therapy, but instead assumes he or she is optimal because sleepiness and fatigue are better, but not yet normal. This is what I've described previously as "normalizing" the response as opposed to "optimizing" it.

5. Dream Content. It is remarkable how many patients with disturbing dreams report less nightmares once they go on PAP therapy, and many also report less overall dream awareness. Interestingly, in our work with nightmare patients, we use an imagery technique, known as Imagery Rehearsal Therapy, and a fair proportion of these patients report a similar effect, that is, when the nightmares abate, they have a sense of less dreaming or even greater fuzziness to their dream world. I think these instances reflect a "relative to what" effect. Having had the nightmares, they are used to more intensely emotional dreams. When nightmares abate, due to PAP or IRT, it is such a huge change that the dream awareness thermostat would have to go through a dramatic adjustment for the individual to remember their dreams. I do know that some people who successfully treated their nightmares do report years later that they started having more dreams with more pleasant content.

6. Dreams as a Measure of REM. In sum, if you are able to use your dream behavior in a way to get the sense of how well you are consolidating REM sleep, then it will be a very useful metric in monitoring your response to PAP therapy.


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Post by jskinner » Thu Dec 27, 2007 12:56 pm

Dr. Krakow,

One of the nicest things about getting on PAP treatment initially was the REM rebound. Its clear the whatever goes on during REM sleep (memory consolidation seemingly being a strong contender) is very important. I'll never forget the first few weeks on PAP and the wonderful feeling of having dreams again.

Something that I have been disappointed with is the ability of a regular user to monitor their sleep stages. With a PAP device I can get a pretty good idea of how my breathing is doing. However what I really want to know is how my sleep is doing.

Cearly a full PSG can give me this data but I envision a day where we call all monitor our sleep occasional or nightly to see how things went. I realize that we are probably a way off from that point technology wise but I hope some day we can get there. Are you aware of any at home technology that is simple enough that a regular user could monitor there own sleep stages?
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Post by rested gal » Thu Dec 27, 2007 1:48 pm

Given these two things (always a scary phrase to use, since I could be oh, so wrong!)

1. Time spent in REM is at its longest during the final REM cycle before a person gets up in the morning....

and

2. Many normal sleepers probably use an alarm clock or clock radio to wake them in the morning, to get ready for work...

It doesn't surprise me at all that normal sleepers would report remembering a dream or at least vaguely being aware they had been dreaming when they wake up in the morning. In many normal sleepers' cases, that final long REM is probably being interrupted by the alarm clock. Even if they wake up on their own, it's probably as they are coming up out of that last long REM, or even out of some wispy dreaming in light stage 1 as they are waking up in the morning.

I think it's easy to confuse:

A. "actually dreaming" -- which people can do in normal amounts of REM without being aware of it at all.

with

B. "remembering a dream or remembering having dreamt" -- which indicates they had REM (or perhaps a very light stage of sleep) interrupted by an awakening.

As I understand it, the only way a person can recall a dream, or even be fuzzily aware of "I know I had a dream but the memory is so wispy, I can't recall any details at all..." is if they wake up enough AND are awake long enough WHILE the dream was happening, to commit at least the fact of having just had a dream to memory even if the details are too hazy to grasp. Awake enough, and for long enough (I think I've read perhaps 15 seconds?) to commit to memory either some specific details of the dream or at least a vague remembrance of "having been dreaming."

So, when people flatly say, "I didn't dream last night." what they really mean (if they understood the difference) is, "I don't remember dreaming."

Without being hooked up to EEG, as in a sleep lab, there's no way to really know if a person who reports "I had no dreams at all last night":

A. did not go into REM, or was bounced out of REM repeatedly by apneas -- bad.
or
B. did indeed have normal amounts of REM, but slept through it without waking up enough to be aware of dreaming -- good.

I'd think a person's statement upon waking, "I dreamed" or "I didn't dream" would be a very inaccurate indicator in most cases regarding whether they did, or did not, have normal amounts of REM.

In three consecutive nights of PSG, I did not remember a single dream or even have the vaguest awareness in the morning of having dreamed at all. Yet all three PSGs showed REM at the usual intervals and with the usual lengthening of time in REM as each night went on.
BarryKrakowMD wrote:4.Contrary Views. Having said all that I've said in 1-3, we also clearly recognize that dreaming too much,...
I hate to interrupt a quote, but I'd qualify that as "remembering dreaming" rather than (actually) dreaming "too much." I think the distinction is that important.
BarryKrakowMD wrote: we also clearly recognize that dreaming too much, say several months after a REM rebound in the first month of PAP, could be a sign that you are waking up too much during the night and that's why you remember your dreams.
I agree.
BarryKrakowMD wrote: 5. Dream Content. It is remarkable how many patients with disturbing dreams report less nightmares once they go on PAP therapy, and many also report less overall dream awareness.
That doesn't surprise me. Regardless of dream content, I'd think if CPAP treatment provides less interruption of REM and fewer awakenings to the point of being able to remember a dream, then yes...there would be less recollection of having had ANY kind of dream. Whether pleasant or nightmare quality.
BarryKrakowMD wrote: 6. Dreams as a Measure of REM. In sum, if you are able to use your dream behavior in a way to get the sense of how well you are consolidating REM sleep, then it will be a very useful metric in monitoring your response to PAP therapy.
Not having ANY recollection of dreaming at all is probably a much more useful metric (imho) that PAP therapy is effective, than is the actual content of remembered dreams. A remembered dream, be it a pleasant dream or a nightmare, is an indicator of interrupted REM and/or getting bounced up into stage 1 too often, imho.

Dreams that a "normal sleeper" or an effectively PAP treated sleeper has, but sleeps through (as they should) and is never aware of, could very well have a considerable number of terrible nightmares, imho.

If a tree falls.....

Just a layperson's opinion, though.
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Post by jskinner » Thu Dec 27, 2007 2:36 pm

rested gal wrote:1. Time spent in REM is at its longest during the final REM cycle before a person gets up in the morning....
This phenomena also explains why for those of us who's apnea is worse in REM why our encore reports always show the largest clumping of apneas in the last hour or so. Its always quite pronounced in my nightly reports.
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Post by roster » Thu Dec 27, 2007 5:00 pm

rested gal wrote:.....

Just a layperson's opinion, though.
RG,

You nailed another one correctly in my layperson's opinion.

However, my current situation is puzzling me. I am sleeping about 4 hours each night and then lying awake for the next 3 hours or so with only an occasional dozing off. What is curious is the lack of remembering any dreams.

Also, like James, I sure would like to have "home" PSG equipment (at WalMart prices:lol:).

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Post by ratkinson » Thu Dec 27, 2007 5:31 pm

Great thread!!! I have always dreamed and have continued to dream...with a great deal of REM rebound. I have found that I dream (or remember dreaming) differently with all my different masks. I understand that physically deep sleep may be better for you for your health, but, I feel that my dreams elliviate some of my psychological stresses. So I feel my REM sleep helps my daily moods. I don't have any scientific back up for this theory, just personal observation. One thing I will say is that since starting CPAP I recognize the fact that I am dreaming more often.....and I can manipulate the scenarios a little more. Weird Stuff!!!

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Dreams and More Dreams

Post by BarryKrakowMD » Thu Dec 27, 2007 11:16 pm

Here's some thoughts on the recent posts/questions.

1. No machine available to deliver sleep staging info easily at home, altho a device called the Nightcap out of Harvard I believe has some indirect capability, but don't know the expense.

2. The purpose of REM as I understand the literature is to enhance memory, learning, and mood, and for these reasons we assume REM consolidation is extremely valuable to enhance slumber and improve daytime functioning.

3. Normal sleepers probaby do not use alarm clocks, and although I can imagine many people disagreeing with this point of view, my sense is that a normal sleeper would rarely have need for an alarm clock unless they have accepted an unusual work shift requiring an odd or erratic schedule. However, once a normal sleeper accepts such patterns, it won't be too long before they are no longer a normal sleeper.

4. Remembering dreams vs Actually dreaming is a distinction I'm not that enthusiastic about relying upon. It certainly is possible that some dreams are more memorable if one is awakened after them, but memory research would then expect the dreamer to be awake for say 1 to 8 minutes to program the dreams into retainable memory. I think it's exceedingly likely that many dreams are remembered unrelated to having awakened from them. REM sleep is considered by many dream researchers to be the "3rd state of consciousness" along with wake and NREM sleep. So, I don't accept the premise that remembering dreams is related exclusively to awakening from dreams.

5. Fifteen second rule doesn't really make sense unless there is something different about remembering dreams as opposed to remembering something else post-awakening. Most people take a few minutes to encode something into memory from say a middle of the night awakening as in, "oh, yeah, I remember the dogs were barking." Presumably, this info would not be remembered if the individual was awake for only 15 seconds instead of say 3 minutes or longer.

6. Dream Awareness in general has a lot to do with personality, possibly genetics, and coping styles as far as I can tell. The idea that someone has less awareness of dreams as a positive sign of effective PAP therapy could be true for certain people, but my hunch is that the majority of those people have other reasons not to pay attention to their dreams. If they were given a one week course in dream awareness techniques, then saw the value to be gained by paying attention to dream content, my hypothesis would be that they would indeed remember more dreams thereafter, and yet they would have no more or no less awakenings. I know there is research out there regarding the awakening issue as a factor in memory of dream activity/content, I just think the research is confounded by these other factors that don't take into account the many individuals in our society who have learned or otherwise believe that dream content has no obvious value.

7. Value of Dream content is potentially very high for certain people at certain times and circumstances in their lives. Ever since my entry into the world of dream research, however, I've been amazed how many people think dreams and dream content are worthless. The point I wish to reiterate here is that I think individual sleep patient perspectives about "dreams as worthless or worthwhile" have a great deal of bearing on our different ways of interpreting the finding of less or more dream awareness with successful PAP therapy use.

Sweet Dreams!


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