To sleep, perchance to dream … for in that sleep … what dreams may come

I had a fascinating discussion yesterday with the group of people who are spearheading a worldwide community that focuses on sleep disorders. I have mentioned this group before and as part of full disclosure, I am working with them to develop their entire field of interest. I am extremely attracted to their drive and honest desire to find practical and real solutions to the very common problem of poor quality sleep. Although none of this group are formally trained as physicians, they have all of the qualities that I consider to be most important in doctors. It is an honor for me to work with them.

One of the issues we spoke about yesterday was the quantification of sleep. I believe that it is general knowledge at this point that a key area of interest, especially amongst the developers of smart watches, specifically, and physiological sensors in general, is the topic of sleep. These days, one can find a whole array of devices and software that work together to measure the quality of a person’s sleep. The analysis of the data that comes from measuring a person’s sleep gets presented back to the individual in the form of graphs and tables that transform sleep from a nonspecific black-box into a very detailed and measured period of 6 to 8 hours [on average].

I have read at least one commentator, on the whole issue of sensors and measuring ourselves, who states that even the area of sleep has become a competitive  field. People wake and immediately check their “numbers”, which in some cases are even automatically posted to their social media feeds. I have no doubt that there are people who view these results and say to themselves “how does that other person manage to get so much REM sleep at night”. The risk in adding stress to the process of sleep is self-evident. But it seems, such is the nature of the human-beast.

I also discussed the topic of dreams with my colleagues. There are specialists who will help an individual analyze their dreams in order to identify foci of psychological distress, that can, in turn, negatively affect sleep. I for one often have unpleasant dreams, but by the morning, I have forgotten almost all of the details except for the fact that the dreams were unpleasant.

I am wondering out loud if something like dream content should be quantified. For the person who is already suffering from disturbed sleep, perhaps there is value in having a mobile phone app, that allows the individual to record the details of dreams. For the person who is woken up at 3 AM because of a nightmare, it may actually be beneficial to open their mobile phone and record a textual and oral description of the dream that was just experienced.

I have no doubt that there would be those  who would argue that this will only further disturb these individuals’ sleep. I do not agree. My focus is on those people who already have disturbed sleep and are looking for answers. In this case, I suspect that the information that comes from a recording of dreams would help a professional counselor to diagnose a specific problem.

Our dreamworld is by no means out of our control. I am by no means expert in this area, but do hope to learn much more about it as time goes by. I do know that there are ways of manipulating the kinds of dreams we have and even our experience of those dreams. I personally think that any group that is working on understanding and improving the quality of sleep, also needs to understand the role of dreams in our lives.

As a physician, I appreciate that the classical medical world usually leaves the analysis of dreams to psychoanalysts.  On the other hand, the quantity and quality of dreams are two factors that probably should be measured and addressed by physicians, just like other symptoms and signs, as part of a standard workup, similar to the assessment of back pain and depression which are handled by classical doctors.

I think it is fair to say that there are huge gaps in our understanding of dreams. And at this point, I am talking about very specific physiological issues that could affect our nighttime experiences. Do changes in thyroid function alter our dreams? Do various medications cause fewer or more nightmares? Does anyone ever even ask if there is a change in a person’s nighttime experiences (not just insomnia) after starting a given therapy?

The only way to turn the study of dreams into a field of research that is accepted by classical medicine, is to measure things. While I appreciate that such measurements might have the Heisenberg characteristic of altering the very thing being measured, it is critical to have data. Perhaps classical medicine should embrace sleep sensors and even formally suggest additional types of sleep-related measurements in order to transform the ethereal topic of sleep into the named topic of major medical conferences.

Sleep disorders are causing people a great deal of distress. I think the time has come for classical medicine to find a way to better understand these disorders. And part of the understanding of these disorders will likely include a quantification of dreams.

Thanks for listening

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About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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