To Sleep, Perchance to Not Dream
March 15, 2013 1:18 PM   Subscribe

My husband is frequently cranky/off his feed/out of sorts for hours after awakening either in the AM or after our traditional late afternoon nap (we both work from home, have for the past 10 years) and his response whenever I ask "what's wrong?" is usually "I had bad dreams." When he describes his dream it's not necessarily a nightmare, but for some reason it exhausts him mentally.

By way of comparison, I will mention that I also regularly have very vivid dreams, most of which I sort of enjoy as far as I know...but sometimes I have very "aggressive" dreams where I'm arguing vehemently with someone, or trying to dial a phone number with no success while I'm being shot at, etc. But whatever the dream, I'm able to more or less shrug it off after I wake up and then go on with my day.

Mr. Adams, on the other hand, seems to be mentally and physically exhausted when he has a dream that involves a lot of activity, especially if said dream includes a lot of decision-making (from what he's described to me when I press him for details). For example, the past two days the dreams he's recalled that upset him and made him "not sleep" (even though as far as I could tell he was sound asleep - he usually goes to bed ahead of me at night due to our work schedules, and I hear him sawing logs for hours) were one in which he was at the Joe Louis Arena and someone stole his hockey stick and he was trying to find Lost and Found (no, he's never played hockey in his life and he's not even a fan of the sport), and the other was some complicated scenario involving choosing the correct elevator. Basic dream stuff as far as my own experiences, but for some reason when he wakes up it's like he can't shake his dreams off. He's as tired as if he'd actually been traipsing around the Joe trying to find his hockey stick.

He did a sleep study two years ago in search of a solution...he was diagnosed with sleep apnea and given a CPAP machine. But even though he uses the machine regularly every time he goes to bed, he still complains upon waking that his dreams that made him "not sleep" (even though as far as I could tell he was sound asleep) and how his mind won't shut down while he sleeps....that he has to solve problems while awake, and it disturbs him to have to do it in his sleep.

Is there a word or term for this? Anyone know of a medical condition that doesn't shut the brain completely down during REM sleep or something so that a person feels actual mental exhaustion due to having to think and reason in his sleep? The sleep study and our rheumatologist haven't really provided any insight....I'm wondering where to look for assistance or how to even posit the problem.

Additional info, FWIW: Mr. Adams was dx'd with Type II diabetes a few years ago, but his blood sugar has been successfully maintained via diet and Metformin and Januvia (no insulin injections necessary). He also takes NSAIDS for ankylosing spondylitis (a type of arthritis that affects mainly the spine) and fluoxetine (generic Prozac), but he's been on the latter two since the mid-1990s, long before these dream/sleep problems started.
posted by Oriole Adams to Health & Fitness (24 answers total) 4 users marked this as a favorite
Are you sure that it's not the apnea that's making him tired, and he just thinks it's the dreaming?
posted by EmpressCallipygos at 1:25 PM on March 15, 2013 [3 favorites]

Sorry, that was glib - what I mean is, maybe what's going on is that the apnea is making him tired, but the dream is also vivid in his mind, so he's taking out his frustration at being tired on the dream itself and how it was a stupid dream anyway, I mean why was I looking for a damn hockey stick of all things and now I'm all tired, stupid dream...You know?
posted by EmpressCallipygos at 1:27 PM on March 15, 2013 [2 favorites]

I have a lot of very vivid dreams, and occasionally I'll have an aggressive dream like you describe. They are physically draining. I wake up and my head hurts, my face hurts, my mouth hurts (likely from clenching my teeth), sometimes I'm sweating, my heart is thumping, my body just aches all over--it messes me up. Sometimes it'll fuck me up for the rest of the day.

During these dreams, I think I sleep pretty soundly, and am just completely out of it. From the outside I'm sure it looks like I'm getting good, solid sleep, but inside I'm like a hamster running feverishly around in his wheel.

It doesn't happen often, thankfully, and that it seems to happen to your husband frequently is really, really unfortunate. I don't know what to tell you, but for me, the effects are very real and physical.

What helps for me is to make sure the room is cool enough, that I've got plenty of blankets but am not trapped, that I have enough room to really spread out and move around in bed, and that I'm able to clear my head before sleeping. (I often listen to soothing youtube videos before falling asleep. I don't get the head tingle effect, but ASMR videos are generally good, and this channel is just great.)

Good luck.
posted by phunniemee at 1:37 PM on March 15, 2013 [2 favorites]

THC (the psychoactive chemical in marijuana) is known to repress and/or shorten REM sleep and with it vivid dreams. If you are located in a place where medical marijuana is available, that could be an option for Mr. Adams. I am so not a doctor or anything like it, and this is not medical advice.

Luckily, if this is a viable option for you, you don't have to worry about your husband lighting up a joint before bed, or having baggies of pot laying around the house. Oral ingestion would work just fine.
posted by carsonb at 1:41 PM on March 15, 2013 [2 favorites]

Is he checking his sugars upon waking? My mom got some weird low blood sugar reactions from some of her meds and they had to be reduced. Also, taking them at the proper times, maybe needs a tiny night time snack would help, a yogurt or half an apple and a couple pieces of cheese. Has he lost weight or increased physical activity?
posted by Marie Mon Dieu at 1:57 PM on March 15, 2013

His he too warm while sleeping? That's when I get crazy dreams. I always thought that poor quality sleep meant you remembered your dreams more since you're only really supposed to remember just when close to wakefulness . Maybe that sleep cycle app I've never tried would help determine how deeply he's sleeping.
posted by carolr at 2:01 PM on March 15, 2013 [1 favorite]

Nthing what Empress said about sleep apnea - that will leave a person exhausted.

My experience has been, the more vivid my dreams (that is, the more interesting or even disturbing they are–nightmares included) the more rested I feel when I wake up. I have no idea why, but I've read that it has to do with the amount of REM sleep a person gets, which is the cycle of sleep when people dream.
posted by marimeko at 2:01 PM on March 15, 2013

Taking melatonin has given me dreams like this in the past.
posted by Quonab at 2:02 PM on March 15, 2013 [1 favorite]

It might be time to recheck the Prozac dosage or switch to a different type of med. It could be that his anxiety has been slowly ratcheting up. It can be easy to forget how much anxiety is normal.

My understanding is that part of the function of dreams is to process some of that unmet anxiety. For most people, that will mean these sorts of dreams wipe the slate clean and are refreshing. For folks with anxiety issues, beginning that process of ruminative worry starts a cycle of stress that your body can't easily turn off.
posted by politikitty at 2:07 PM on March 15, 2013 [1 favorite]

I favorited the Empress' answer, but wanted to elaborate - even if he uses the CPAP religiously, the settings might not be high enough to keep him from obstructing. I'd follow up with the doc who ordered the sleep study as a first step.

Snoring loudly while "sleeping" and waking up tired is classic for sleep apnea.
posted by treehorn+bunny at 2:13 PM on March 15, 2013 [2 favorites]

I have dreams every once in a while like what your husband describes. It feels exactly like that: as if my brain doesn't switch off properly and is very intensively frustrated on a problem. It truly feels like I don't sleep at all when that happens, even though I know that I do (have others confirm that I was sleeping). I do not have sleep apnea nor diabetes. However, it seems like this happens when I'm experiencing extra stress in real life.

Does your husband tend to silently dwell on worries? Does he have problems going on that don't seem to have a solution but provide constant back-of-the-mind stress for him? I'd address that first. For me, I don't even realize I'm especially stressed until I have one of those dreams and don't sleep well: then once I address the real-life issue, I sleep and dream normally again.
posted by Eicats at 2:34 PM on March 15, 2013 [1 favorite]

Chiming in to make sure that his sleep apnea is being managed properly, as it sounds like that may not be the case.

I don't have sleep apnea (but a relative does) but I am someone who is also deeply affected by my dreams, sometimes for days afterwards. Today has been ruined by one in which I was orchestrating the escape of innocent teenage girls from an abusive prison system located in a Walmart. I'm sure it looked like I was sleeping fine, but I'm really upset. It wouldn't have been so bad if I knew how it ended, but I woke up with just two girls left to save! Does your husband find that the dreams are more bothersome if they aren't resolved? I have successfully in the past been able to sort of snoozily write my own ending to a dream (lucid dreaming?) that would otherwise bother me, and get on with my day. (No chance of that today as I had to get up to deal with a crying baby.)
posted by peanut_mcgillicuty at 2:36 PM on March 15, 2013

This happens to my husband, too! (No sleep apnea that we know of.) He says he often has dreams about doing repetitive/boring/frustrating tasks in his dreams, and he hates it.

He's been sleeping better since we made our room darker, I think, so look into anything that might diminish stimulation--e.g., turning off the TV/computer/iPhone an hour or more before bed, get some dark curtains, cover/turn off/relocate sources of light in the room, and so on.
posted by wintersweet at 2:41 PM on March 15, 2013

Several years ago, I was on a prescription medication that made me remember my dreams every. single. night. Three or four dreams per night. They were generally benign dreams, and it was fascinating at first, but after about three weeks of it I got exhausted. I'm not sure if I was actually physically tired, but it felt like I wasn't really getting any rest.

If he's changed medications recently (even the dosage or brand vs. generic) I wouldn't rule out the dreams being a side effect of that.
posted by Metroid Baby at 3:08 PM on March 15, 2013 [1 favorite]

I will be watching this thread with interest, since the same thing happens to me almost every night and man, it is the worst. If data points help I do not have sleep apnea nor am I on medication other than birth control.

My doctor told me it was because my adrenal system was out of whack and was producing way too much cortisol at inappropriate times, a byproduct of which is a physiological response to anxiety which manifests into dreams during sleep. She advocated taking magnesium supplements (just magnesium, not the combo kind) which I have acquired but have not started taking yet so I can't vouch for their efficacy. I am in no way, shape, or form a doctor and certainly not your doctor, but perhaps that is something to explore with your own GP.
posted by stellaluna at 3:26 PM on March 15, 2013 [1 favorite]

After stellaluna's addition: Huh.

Well, I CAN vouch for magnesium being of some help - my own doctor suggested it to me for amnesia, and it took a little while to "kick in". But before it did build up to the point that it did what it was meant to do (keep me from waking up randomly in the middle of the night), I noticed that the quality of my sleep was improving overall.

So that may be a second vote for magnesium.
posted by EmpressCallipygos at 3:39 PM on March 15, 2013

I'm seconding phunnimee's comment - the same thing happens to me - is he stressed, anxious, etc.? If not it could very well be just an intense session.
posted by floweredfish at 4:14 PM on March 15, 2013

Yes, this happens to me when I'm anxious and it is absolutely the worst. And it will kill my mood and physical stamina for the day.

Exercise sometimes (but not always) helps.

I've heard it suggested that people whose anxiety disrupts their sleep take the time to write out all their crap, all the issues that are bothering them, before going to bed, thus mentally "parking" it so it isn't swirling around all free form. I haven't tried this so I don't know if it would work.
posted by fingersandtoes at 4:21 PM on March 15, 2013

Hmm, any chance he is depressed?

For example, here:
But how is dream sleep responsible for depression?

My findings show that ordinarily dream sleep does a great housekeeping job for us. Each night it brings down our autonomic arousal level. Dreams are metaphorical translations of those waking introspections – emotionally arousing feelings and thoughts – that we don't act upon while we are awake. Once aroused, our brain has to complete that cycle of arousal and, if we don't complete it in the external world, we do so in our dream sleep. The patterns of arousal are metaphorically acted out and thereby deactivated. But depressed people do so much worrying and feel so stuck that the ruminations cause an overload of dreaming which uses up a lot of energy in the brain. They also have correspondingly less of the most physically recuperative element of sleep, so-called slow-wave sleep. Which is why they wake up exhausted and unable to focus their mind outwards and motivate themselves to get on with life.

posted by anitanita at 4:33 PM on March 15, 2013 [1 favorite]

I also have AS, and it is notorious for causing bad sleep (inflammation increases during the night) and extremely unpleasant wakings. Everybody else has great suggestions, but it might also be worth talking to his rheumatologist to see if he needs more disease management. In addition to the possibility of the modern biologic drugs, many rhuematologists prescribe sleep aids ranging from muscle relaxants like Flexeril to antidepressants like Amitriptyline to help with sleep.
posted by hydropsyche at 4:49 PM on March 15, 2013

To better expand on that and how it relates to what you're asking about--when I am stiff and sore I awaken really easily and I think this leads to a feeling like I had a lot of crazy dreams because I had more short sleep cycles instead of fewer longer ones.
posted by hydropsyche at 4:56 PM on March 15, 2013

"Sawing logs for hours" while using CPAP can't be effective CPAP therapy, as treehorn+bunny noted. Maybe the pressure is set too low, or the mask is not forming a good seal, or he's sleeping with his mouth open. If he hasn't already, he could try a chin strap (which wasn't enough for me) or a full-face mask, or tape his snoring mouth shut with 2" micropore tape. Works for me!
posted by Snerd at 5:31 PM on March 15, 2013

I often experience sleep paralysis and associated Hypnagogic and Hypnopompic experiences and find some of the coping skills recommended here work for me - if he can't prevent the dreams, he may be able to alter or shorten them, at least.
posted by peagood at 7:45 AM on March 16, 2013

I take a very long time to wake up, if I have gone deeply to sleep. I do not have any sleep disorder, except that the transition between awake and asleep is hell.

For some reason, in modern society, it is entirely okay to be cranky and out of sorts for a couple of hours if you are sleepy and hoping to go to sleep soon, it is not okay to be cranky and out of sorts if you are still waking up.

By coninky dink, I had some intense dreams last night, woke up at 6, and the images are not entirely out of my head yet. I was off my game for at least two hours because, and I am totally serious, I wasn't entirely awake yet.

Try this - stay up two hours past your bedtime. See how you feel.

Given that your husband has been diagnosed with a sleep disorder and is on meds, however, you should probably look at this more closely. Maybe it's just who he is. But it may be something that needs fixing.
posted by Lesser Shrew at 4:55 PM on March 17, 2013

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