- Arlene is worried that her recent dream experiences indicate that something is wrong with her. If you were Arlene’s friend and wanted to reassure her, how would you help her to understand the normal experience of sleep and dreams?
Arlene, you have upset your normal sleep pattern by too much worry followed by a loss of sleep followed by extra caffeine followed by lack of sleep. But, you can easily readjust your sleep pattern so that your dreams are not so anxiety ridden. Here is an explanation of the normal sleep pattern:
Our normal pattern of sleep passes through five stages of sleep, each with its own brain wave activity. First is the transition from wakefulness to sleep (about 1-7 minutes with theta waves). Stage 2 is identified by “fast-frequency bursts of activity called sleep spindles” (Gokalp, 1999). From stage 2 through stage 4 our bodies are gradually relaxing. About 30 minutes after falling asleep we pass through stage 3 to stage 4 where there are delta waves and it is our deepest sleep. There is a spike in secretion of the growth hormone in stage 4. We then return to stage 2 and enter what is known as rapid eye movement (REM) sleep. Here, we dream. The cycle can occur 5-6 times during 8 hours.
She has gotten into a loop of sorts, that messes with the normal pattern. When patterns are changed, there is not telling what the results will be. In your case, your dreams are about being anxious. This causes you to wake feeling anxious because you dream about it so much. Also messing with the sleep pattern leaves her never feeling genuinely rested. Her days are filled with fatigue and consequently a limited attention span fraught with worry. Then, she is so fatigued at night that she does not go through the normal sleep cycle, and her worry over not being fully attentive during the day continues to bother her in the night. This is called “REM rebound where [the] brain prioritizes REM sleep, forcing [the sleeper] to enter REM sleep earlier and for a longer amount of time” (Emerson, 2016). Since REM sleep is dream sleep, reinforcing bad dreams, the person has more bad dreams.
3How might medication help Arlene?
Anti-anxiety medication does not help because anxiety and bad dreams are processed in different areas of the brain. If her dreams were the result of PTSD, there is medication to help, but it has side effects that she might not want to deal with. Prozosin is used in the treatment of hypertension, anxiety and post-traumatic stress disorder. The common side effects are “dizziness, headache, drowsiness, lack of energy, weakness, palpitations, and nausea” (Minipress Capsules, n.d.)
The only approved medication for helping to adjust the sleep wake cycle is Suvorexant (Belsomra). It helps people to fall asleep and stay asleep longer, so to get a better night's rest. It belongs to a class of medication known as sedative-hypnotics. It acts on the brain to produce a calming effect.
More than likely any seemingly helpful medications will not help, and even might bring the dreams. “Antidepressants, narcotics, and even some blood pressure medications can also cause nightmares” (Nightmares in Adults, n.d.).
References
Emerson, S. (2016). When Anxiety Gives You Bad Dreams That Give You More Anxiety and Bad Dreams. Retrieved from
Gokalp. G. (1999). Sleep and Dreams. Retrieved from
Minipress Capsules. (n.d.). Retrieved from
Nightmares in Adults. (n.d.). Retrieved from
Why do We Dream? (n.d.). Retrieved from