Dreaming – we all do it, yet it remains a bit of a mystery. Scientists haven’t quite unraveled the purpose of dreams, but they do know dreams occur during REM sleep, a crucial stage for mental and cognitive health. Dreams and mental health have a bidirectional relationship, which means they both affect each other.
In this article, let’s explore the different sleep stages, the role of dreaming, and how dreaming impacts your overall well-being.
Understanding dreams and REM sleep
When discussing how dreams affect mental health, it’s important to first understand the stages of sleep. Overall, there are 4 stages of sleep, which can be split into two broad categories: rapid eye movement (REM) sleep and non-REM sleep[1].
Non-REM sleep
Non-REM sleep (NREM) is comprised of stages N1, N2, and N3.
Stage 1 of NREM (N1) is the lightest stage of sleep; it’s the stage of sleep you enter right away when you start falling asleep. You typically only stay in N1 sleep for 5 to 10 minutes. It only takes up around 5% of your total sleep, and is often thought of as the transitional period between wakefulness and sleep.
Stage 2 (N2) of NREM sleep typically lasts around 20 minutes. In this stage, your body moves deeper into a resting state. You become less aware of your surroundings, and your eyes stop moving. Your body temperature and heart rate lower. Your body is preparing itself for deeper stages of sleep.
Stage 3 (N3), also called delta sleep, is the deepest stage of NREM sleep. In this stage, your brain starts producing slow brain waves (called delta waves). Your muscles are completely relaxed, and you’re typically completely unaware of your surroundings. For example, if someone says your name when you’re in N3 sleep, you likely won’t wake up. This is also the sleep stage when your body starts repairing itself and your brain consolidates memories and information.
REM sleep
After N3 sleep, your body briefly goes back to N2 sleep. Then, your body cycles through the deepest overall stage of sleep: REM sleep. REM is named after the rapid eye movements that happen during this deep sleep stage. You typically enter REM around an hour to 90 minutes after falling asleep.
Although REM sleep is known as the deepest stage of sleep, it’s also the stage when your brain waves most closely mimic activity during waking hours. Your brain is lit up, but your muscles are relaxed and paralyzed. Like N3 sleep, REM sleep is essential for consolidating memories and information, especially emotional information.
Importantly, REM sleep is also when dreams happen, due to the increased brain activity (although newer research has shown dreams can happen in any stage of sleep). When we’re woken up during the REM sleep cycle, we’re typically able to recall vivid dreams that are laden with emotions.
There are several theories as to why we dream during REM sleep, but no one knows for sure. Some experts believe dreams are just an accidental by-product of the increased brain activity that happens during REM sleep. Others claim dreams help us consolidate memories and process emotional experiences, and allow us to rehearse certain experiences[2].
How mental health affects your dreams
The state of your mental health, and your lifestyle habits during your waking life, can significantly affect your dreams.
Nightmares and mental health conditions
Most of us have had a nightmare at some point in our lives. Nightmares are unpleasant dreams with vivid, frightening, or disturbing content that can cause feelings of fear, sadness, or despair upon waking. They can be about imaginary or fantastical topics or real-life ones. For example, you might have had a nightmare about a monster chasing you, or a nightmare replaying a recent argument you had.
Nightmares can be caused by certain mental health conditions. For example, research shows up to 70% of people with post-traumatic stress disorder (PTSD) suffer from chronic nightmares[3]. If you live with PTSD, you may have frequent nightmares reliving what happened to you, or reflecting your fears of what could happen in the future.
Chronic nightmares are also a common feature of other mental health disorders, including mood disorders like depression, anxiety disorders, and psychotic disorders (like schizophrenia).
Stress and dreams
How stressed you are in your waking state also affects the quality of your dreams. You’ve probably experienced this yourself; for example, you may have had an important presentation coming up and dreamt you lost all of your materials.
One study found a link between waking stress and anxiety and dream content. When healthy participants (without a diagnosed mental health condition) reported symptoms of anxiety while awake, they were more likely to have unpleasant dreams. Those who reported more peace of mind while awake had more pleasant or positive dreams[4].
Psychiatric medications and dreams
Lastly, some psychiatric medications can affect the quality of your dreams and even your ability to dream. This can sometimes be a positive effect – for example, people with depression may have frequent nightmares, which are reduced when their symptoms are well-managed.
Some psychiatric medications that can affect dreaming include[5]:
Beta-blockers, which are used for anxiety, often cause nightmares. In one study, around a third of people having nightmares were taking a beta-blocker[6].
Selective serotonin reuptake inhibitors, a type of antidepressant medication, can cause vivid dreams and make it more likely you remember your dreams.
Some medications that treat insomnia (called sleep aids) can increase your risk for nightmares.
Sedatives can make it less likely you will remember your dreams.
How dreams and REM sleep affect mental health
The relationship between dreams and mental health goes both ways. Your mental state during waking hours can affect the quality and content of your dreams, but your dreams and sleep quality can also affect your mental health.
Interestingly, research shows REM sleep isn’t necessary for biological survival in the same way that N3 sleep is[7]. In sleep deprivation studies, people who are deprived of REM sleep for long periods do not face the same cognitive and memory deficits as those who are deprived of N3 sleep.
However, this doesn’t mean REM sleep isn’t important for mental health; we just don’t yet fully understand the role REM and dreams play.
We do know the mental health impact of dreams continues into waking life, which can affect mood and mental health. You may have had the experience of waking up from a vivid dream and continuing to feel the emotions you felt while dreaming, even after you realize it was “just a dream.” In one study, dreams about death or the body were linked to worse mood in the morning. Dreams about leisure activities or ingestion were linked to more positive morning mood[8].
Some researchers say dreaming can be a form of “overnight therapy.” According to them, our brains are free of the stress molecule norepinephrine during REM sleep – the only time (both sleeping and waking) this chemical is absent. This may allow us to reprocess our emotional memories in a calmer state while dreaming[9].
How to improve your sleep and dream quality for better mental health
It’s not clear whether dreaming, overall, is positive for mental health. But most experts saygetting enough REM sleep every night is important. Here are some tips to ensure you get restful sleep, including deep “delta” sleep (N3) and REM sleep.
Set a sleep schedule and stick to it, even on weekends.
Create a relaxing bedtime routine.
Make your bedroom cool, dark, and quiet.
Limit screen time before bed.
Avoid caffeine and alcohol in the evening.
Exercise regularly, but not too close to bedtime.
See a doctor if you have trouble sleeping.
What to do if you have nightmares
Frequent nightmares can disrupt sleep and negatively affect your well-being. If you’re struggling with nightmares impacting your daily life, here are some steps you can take:
Talk to your doctor: There may be an underlying medical condition contributing to the nightmares.
Improve sleep hygiene: The tips listed above can promote better sleep quality and potentially reduce nightmares.
Stress management: Stress and anxiety can worsen nightmares. Relaxation techniques like deep breathing or meditation may be helpful.
Consider therapy: If your nightmares are severe, a therapist can teach you techniques to manage them, such as image rehearsal therapy.
Get support for insomnia and mental health
If your sleep difficulties, including bad dreams, start interfering with your daily life, seeking professional help may be needed. Mental health professionals can provide effective coping strategies for nightmares and other sleep problems.
At The Center • A Place of HOPE, we offer specialized treatment programs for anxiety, PTSD, depression, and other mental health conditions that may cause sleep difficulties. Our founder, Dr. Gregory Jantz, created the proven Whole Person Care method in the 1980s to care for you as a whole person instead of just treating your symptoms.
1 – https://www.nhlbi.nih.gov/health/sleep/stages-of-sleep
2 – https://www.ncbi.nlm.nih.gov/books/NBK11121/
3 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763994/
4 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109051/
5 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674595/
6 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914867/
7 – https://www.ncbi.nlm.nih.gov/books/NBK11121/
8 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382969/
9 – https://greatergood.berkeley.edu/article/item/why_your_brain_needs_to_dream
