Frequently, I am asked about the importance of dreams. It is actually difficult to respond to this inquiry, as we still are not sure why we dream. There are various schools of thought, but we are certain that dreams are important to mental health, physical health, and emotional well-being.

All of us dream, although many patients do not remember dreaming. About every 90 minutes or so we enter rapid eye movement sleep, which is commonly called REM sleep. At one time, it was thought that we only dreamed in REM sleep, but we now know that dreaming can occur in all stages of sleep. During REM sleep, we all experience atonia, which is believed to occur to keep us from acting out our dreams.

There are sleep disorders that can occur during REM sleep, including sleep paralysis and REM sleep behavior disorder. Sleep paralysis is the inability to move during the transition into or out of sleep, and it can be quite frightening. Patients often have a sense that someone is in the room or feel as if they are suffocating. Interestingly, if someone touches them it will break the paralysis, but it usually resolves on its own in a few seconds to minutes.

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REM sleep behavior disorder is a disorder in which patients break through the atonia and act out what they are dreaming. This can cause harm to the patient and the bed partner. There have been cases tried in court for murders that have occurred when patients acted out their dreams, which are typically violent in nature. 

Patients with REM sleep behavior disorder also have a higher risk of developing neurological disorders. About 60% to 70% of these patients develop Parkinson’s disease within 10 years.

Research has shown that if REM sleep is interrupted, patients become anxious, depressed, experience weight gain, and may have hallucinations. Patterns of brain activity that are seen during the day appear to be replayed in sleep, which means it is possible that we are consolidating our memories during sleep.

Other research has shown that patients can go to sleep with a problem that needs resolution and wake up with an answer to their problem. Although it is not well understood, this emotional processing during sleep suggests that dreaming be may a tool for processing emotional issues.

Sleep researchers continue to try to find the answer to why we dream, but it is currently believed that dreaming is a sophisticated process that allows us to learn and process emotional issues while we sleep.

Sharon M. O’Brien, MPAS, PA-C, is a practicing physician assistant and health coach in Asheville, NC.