Sleep is an essential function that protects physical and mental health in addition to enhancing overall quality of life. For decades, researchers have debated various issues regarding the functions of sleep and the effect of sleep deprivation on adults.
Preventative Care: Why Sleep Matters
Sleep & Dreaming: Origins, Nature and Functions, sleep serves several important functions that are particularly noteworthy for young people (children and adolescents), people recovering from medical issues, and individuals recovering from substance abuse issues.
- Sleep is essential in the functioning of the human brain. During sleep, the brain forms and develops neural pathways that are associated with the formation of new memories, repairing and strengthening existing connections, and developing new neural connections that help individuals control their emotions and coping skills. For example, getting inadequate levels of sleep has been empirically demonstrated to be associated with an increase in risk-taking, depression, and potential suicide.
- Sleep plays an essential part in the consolidation of new memories. The neural pathways that function to encode and store memories develop during sleep. One way to learn information better is to attempt to memorize it within an hour of going to sleep; however, stop memorizing material at least 30 minutes prior to bedtime in order to prepare for sleep. Dreaming may be an important process of memory consolidation.
- Sleep plays an essential function in repairing and healing other systems in the body, including organs like the heart, liver, lungs, etc.
- Sleep is important in the maintenance of hormone levels, such as insulin levels. Individuals who have sleep disorders have a higher risk of having a stroke, cardiovascular disease, kidney disease, diabetes, etc.
- The quality of immune system functioning is associated with the quality of an individual’s sleep. Individuals who are sleep-deprived are at increased risk for infection and illness.
- Growth and development in younger individuals occurs during the sleep process.
- Sleep is an important aspect of cognition (besides memory). Individuals who do not get adequate amounts of sleep often have slower reaction times, make more mistakes on problem-solving tasks, and take longer to finish even routine tasks.
Thus, an important aspect in an individual’s recovery from any substance use disorder is to ensure they get adequate amounts of sleep. Individuals who have trouble sleeping may need to develop a sleep hygiene program, a program of healthy sleep habits that can improve the person’s ability to fall and stay asleep as well as the quality of their sleep.
Sleep hygiene can be taught to by therapists, particularly those who practice forms of Cognitive Behavioral Therapy (CBT). CBT helps individuals to change both their dysfunctional or irrational thinking patterns and behaviors. In addition, CBT teaches stress management techniques that can help an individual improve the quality of their sleep. Individuals who have sleep disorders or sleep-related disorders, such as sleep apnea, narcolepsy, or insomnia, should get formal treatment from a sleep medicine physician and psychotherapist.
Healthy Sleep Habits
According to the American Academy of Sleep Medicine, most people can establish healthy sleep habits by adhering to a few principles.
- Maintain a consistent schedule. Go to bed and get up at the same time every day even on weekends and during vacation.
- Go to bed early enough to get a minimum of seven hours of sleep.
- Establish a relaxing routine before bedtime. Avoid caffeinated beverages several hours before bedtime; keep the bedroom at a comfortable, cool temperature; limit exposure to bright light 30 minutes before bed; and do not eat large meals before bed.
- Keep stimulation to a minimum around bedtime. Turn off electronic devices 30 minutes prior to going to bed. Keep the bedroom quiet.
- Do not consume alcoholic beverages before bedtime; individuals in recovery should not consume alcohol at all. Alcohol use interferes with one’s quality of sleep, particularly REM sleep.
- Reduce intake of liquids before going to bed.
- Eat a healthy diet and get regular exercise, but do not exercise within a few hours of going to bed.
- Only use sleep medications, such as sedatives, benzodiazepines, etc., as a short-term solution to promote sleep. Individuals who have chronic difficulty sleeping should get involved in formal treatment to establish habits that can help them sleep more efficiently.
Again, individuals who have a formal sleep disorder should seek professional consultation from a licensed therapist and from a physician who specializes in sleep disorders. Maintaining proper sleep hygiene habits can reduce the incidence of distressing dreams that individuals may have when they are asleep; however, most individuals experience dreams that they find distressing at one time or another.
How Dreams Function
Dreams have fascinated people for centuries. History is full of accounts where individuals’ dreams had the power to predict the future or represented some symbolic conflict that an individual was dealing with. Dreams are also considered an important reflection of an individual’s unconscious mind – the part of the mind that stores memories, drives, desires, etc., that are not available to one’s conscious awareness except through dreams and other clinical means.
While the notion that dreams represent some symbolic meaning was not originated by Sigmund Freud, it was Freud that popularized the use of dream interpretation in psychotherapy. For Freud, the human mind consisted of these three basic levels:
- Conscious mind: the part of the mind that is in awareness at the moment
- Subconscious mind (sometimes labeled as pre-consciousness): the part of the mind that is not in immediate awareness but can be brought into immediate awareness (e.g., as a result of using memory)
- Unconscious mind (often mistakenly labeled as subconscious): the part of the mind that is not in immediate awareness, cannot be brought into immediate awareness by the individual, and must be subjected to psychoanalysis and interpretation by a therapist to be brought into awareness
According to traditional Freudian thought, the mind can be conceived by the metaphor of an iceberg. A very small proportion of the iceberg is above the surface of the water (consciousness), and the vast majority of the information that is in the mind is below the surface of the water (subconsciousness and unconsciousness). The unconscious mind is the largest portion of Freud’s three components/levels of the mind and responsible for the vast majority of behaviors that people engage in.
Freud initially used hypnosis to understand aspects of the unconscious mind and unconscious conflicts in individuals. Later, Freud believed that dreams were a window into an individual’s unconscious mind and used dream interpretation as a major part of his psychoanalysis. Eventually, Freud began to use free association, a therapeutic technique where the patient simply speaks what is on their mind at the moment and the therapist listens intently for clues to unconscious conflicts, in combination with dream interpretation to understand the unconsciously driven issues that occurred in his patients.
Many of Freud’s followers also used aspects of dream interpretation, but many of his most esteemed followers, such as Carl Jung, did not consider them as important as Freud did. The Freudian notion of dream interpretation has fueled many of the more popular notions of dream interpretation used by modern-day therapists and others, even though many of Freud’s original concepts are no longer considered to be relevant.
The Significance of Dreams
Interestingly, many individuals in recovery experience different types of dreams. A common, distressing dream for individuals in recovery involves them relapsing. Some sources interpret these types of dreams to indicate that the individual is actually about to relapse. In essence, that may or may not be true. There are numerous books and websites that claim to be able to interpret the symbolic meaning of an individual’s dreams by referring to universal archetypes that occur in dreams that have a shared meaning for nearly everyone. This notion may have some relevance to it, but in truth, dreams most likely have several different purposes that are related to the functions of sleep and their actual ability to predict the future is quite poor.
Individuals reporting that dreams have the power to predict the future are engaging in a cognitive bias known as the confirmation bias, where they concentrate on information that only confirms their pre-existing beliefs and ignore information that is not consistent with these beliefs. People have numerous dreams every night, and as it turns out, the vast majority of dreams that people have offer no predictive value at all regarding what will happen in the real world, and only a very small proportion of them actually come true to any extent at all. People who provide evidence that dreams have predictive value concentrate on the very small proportion of dreams that display some relevance in the real world and ignore the vast majority of dreams or events that occur in dreams (most likely well over 95 percent of the events that occur in dreams) that have no predictive value regarding what happens in the real world.
Instead, research indicates that any individual’s dreams will often represent certain types of conflicts or important issues the individual has experienced during the day or represent issues that are personally relevant to them and have been ongoing; Freud was probably correct in assuming that some dreams had personal relevance to the individual. Because important areas of the brain, such as the frontal lobes, are inactive when an individual is dreaming, many dreams are often rather illogical and irrational, and they shift back and forth from image to image (which is one reason the notion that dream images are symbolic has retained its popularity). In reality, they are just often illogical.
Sleep researchers such as the late Dr. Ernest Hartman have described several common themes that occur in dreams that may indicate that individuals are undergoing some type of traumatic experience or involved in making some type of emotionally charged decision One of these is the repeated experience of individuals having dreams regarding tidal waves. Dr. Hartman was able to demonstrate empirically that individuals having these dreams were often involved in dealing with some type of traumatic or emotionally charged experience that was overwhelming for them. In his book Functions of Dreaming, Dr. Hartman goes on to explain the relevance of dreams in individual cases and to identify common themes in dreams that are associated with certain types of events. However, outside of this connection, their predictive validity is extremely poor. Because of the method that Dr. Hartman used to collect his data, the relevance of these findings is quite limited.
Some individuals who report having recurring dreams about tidal waves may have had some traumatic experience, but the actual traumatic experience is often different from individual to individual. Some events may have involved a fire; other people may have lost a loved one; others may have been involved in an abusive situation, etc. Thus, some individuals who have recurrent dreams about tidal waves or drowning may be dealing with some type of emotionally charged experience, but the specific type of dream has no predictive value regarding the type of experience the individual is dealing with.
The vast majority of individuals who suffer from traumatic experiences do not report having dreams about tidal waves, and the vast majority have numerous other dreams as well. It is not known how many individuals have dreams about waves or tidal waves and are not dealing with traumatic experiences.
In addition, the subjective recall of dreams is often contaminated because individuals tend to “fill in the gaps” or attempt to make the illogical images of dreams more coherent once they begin verbally recounting them. Thus, this type of data is extremely limited in its predictive validity and an individual who is dreaming about tidal waves may or may not be dealing with an emotionally charged situation such as trauma.
Dreams in Recovery
Likewise, an individual in recovery dreaming about relapsing may be related to numerous different issues. For instance, relapse is common in recovery, and there is no data reported anywhere to indicate that all or even the majority of individuals who relapse had dreams regarding it prior to the relapse. So, how do dreams about using drugs or alcohol relate to individuals in recovery?
Based on the research on dreams, these types of dreams most likely reflect important issues the individual faces and may reveal specific concerns, fears, or feelings regarding attitudes, desires, or struggles. Many individuals in recovery experience cravings, urges to use their drug of choice again, and these cravings are considered common responses to environmental triggers.
If a person in recovery dreams about relapse, it should be treated in the same way as cravings for drugs or alcohol. During therapy, clients are trained how to deal with cravings and not to consider cravings as failures of one’s recovery program. Eventually, these cravings dissipate significantly. Likewise, dreams about using one’s substance of choice can be considered in a similar manner. They may cause the individual distress and lead the individual to think that their recovery program is failing; however, this is not the case. These dreams, like cravings, are relatively common, even in individuals who have been in a successful recovery program for years, and they represent many of the concerns, conflicts, and issues the individual has in their life. These types of dreams only have predictive value if the individual gives in to them.
Instead, individuals who are concerned about these types of recurrent dreams should discuss these issues with their therapists, sponsors in recovery programs, peers in recovery, and other treatment providers. This can help individuals understand issues that are personally relevant to them and how to address their issues in a practical manner. It is a mistake to assign the relevance of these types of dreams to anything other than individual conflicts, concerns, questions, and unexpressed or expressed desires a person has regarding their recovery.