Dreams and their associated meanings vary across different cultures and periods of time. By the late 19th century, Austrian psychiatrist Sigmund Freud had become convinced that dreams represented an opportunity to gain access to the unconscious. By analyzing dreams, Freud thought people could increase self-awareness and gain valuable insight to help them deal with the problems they faced in their lives. Freud made distinctions between the manifest content and the latent content of dreams. Manifest content is the actual content, or storyline, of a dream. Latent content, on the other hand, refers to the hidden meaning of a dream. For instance, if a woman dreams about being chased by a snake, Freud might have argued that this represents the woman’s fear of sexual intimacy, with the snake serving as a symbol of a man’s penis.

Freud was not the only theorist to focus on the content of dreams. The 20th century Swiss psychiatrist Carl Jung believed that dreams allowed us to tap into the collective unconscious. The collective unconscious, as described by Jung, is a theoretical repository of information he believed to be shared by everyone. According to Jung, certain symbols in dreams reflected universal archetypes with meanings that are similar for all people regardless of culture or location.

The sleep and dreaming researcher Rosalind Cartwright, however, believes that dreams simply reflect life events that are important to the dreamer. Unlike Freud and Jung, Cartwright’s ideas about dreaming have found empirical support. For example, she and her colleagues published a study in which women going through divorce were asked several times over a five month period to report the degree to which their former spouses were on their minds. These same women were awakened during REM sleep in order to provide a detailed account of their dream content. There was a significant positive correlation between the degree to which women thought about their former spouses during waking hours and the number of times their former spouses appeared as characters in their dreams (Cartwright, Agargun, Kirkby, & Friedman, 2006). Recent research (Horikawa, Tamaki, Miyawaki, & Kamitani, 2013) has uncovered new techniques by which researchers may effectively detect and classify the visual images that occur during dreaming by using fMRI for neural measurement of brain activity patterns, opening the way for additional research in this area.

Alan Hobson, a neuroscientist, is credited for developing activation-synthesis theory of dreaming. Early versions of this theory proposed that dreams were not the meaning-filled representations of angst proposed by Freud and others, but were rather the result of our brain attempting to make sense of ("synthesize") the neural activity ("activation") that was happening during REM sleep. Recent adaptations (e.g., Hobson, 2002) continue to update the theory based on accumulating evidence. For example, Hobson (2009) suggests that dreaming may represent a state of protoconsciousness. In other words, dreaming involves constructing a virtual reality in our heads that we might use to help us during wakefulness. Among a variety of neurobiological evidence, John Hobson cites research on lucid dreams as an opportunity to better understand dreaming in general. Lucid dreams are dreams in which certain aspects of wakefulness are maintained during a dream state. In a lucid dream, a person becomes aware of the fact that they are dreaming, and as such, they can control the dream’s content (LaBerge, 1990).

Most people who have sleep apnea don’t realize it. That’s because this disorder only occurs during sleep.

Sleep apnea is when you have pauses in breathing while you’re asleep. These pauses can last from seconds to minutes. You may have difficulty breathing a few times or dozens of times an hour.

These breathing pauses can be dangerous if they cause the oxygen level in your body to drop or disturb your sleep. When oxygen drops, your brain does whatever it can to get you to resume breathing. And then you may snore, gasp, snort loudly, or make a choking sound. A family member or bed partner might be the first to notice these disruptions in your sleep.

Sleep apnea is a common disorder. Anyone can develop it. “Sleep apnea can occur in both genders, in all races and ethnicities, and in people of all sizes and shapes,” says Dr. Michael Twery, a sleep expert at NIH.

The most common type of sleep apnea is called obstructive sleep apnea. Any air that squeezes past a blocked airway can cause loud snoring. When you’re awake, the muscles in your throat help keep your airway stiff and open. In adults, the throat muscles and tongue can relax during sleep, or fat tissue in the neck can narrow your airway to cause an obstruction. In children, the airway may become blocked if their tonsils are so large they obstruct the airway opening.

The other type of sleep apnea is central sleep apnea. In central sleep apnea, the brain doesn’t send the correct signals to your breathing muscles, so you stop breathing for brief periods.

So how can you tell whether you may have this disorder? One of the most common symptoms is excessive daytime sleepiness. “Anyone who feels so tired on a regular basis that this is a drag on their daytime function—that even if they allow enough time to get enough sleep on a regular basis and they still feel this way—then they need to discuss it with their doctor,” Twery says.

Another common symptom is loud, frequent snoring. But not everyone who snores has sleep apnea. Other symptoms of sleep apnea may include feeling irritable or depressed, or having mood swings. You may have memory problems or trouble concentrating. Or, you may wake up with a headache or a dry mouth.

Your doctor can diagnose sleep apnea based on your symptoms, a physical exam, and a sleep study. For a sleep study, your doctor may send you to a sleep lab or provide a portable sleep monitor. Sleep studies record things like heart rate and oxygen level while you sleep.

A sleep study can show whether apnea is mild or severe. “The largest proportion of the population with sleep apnea has mild sleep apnea,” Twery explains. “Mild may or may not be associated with any daytime symptoms.” People who are so sleepy that they’re at risk of a drowsy driving accident are probably in the moderate to severe range.

Doctors may prescribe breathing devices that pump air or mouthpieces that adjust the lower jaw or hold the tongue. Other treatments are available and may be considered with advice from a physician familiar with your health.

Everyone deserves a good night’s sleep. For self-care tips for breathing better while you’re sleeping, see the “Wise Choices” box. If you feel extremely sleepy during the daytime or your bed partner says that you stop breathing when you’re asleep, go talk with your doctor.

Breathe Easy!

Try these tips for improving your breathing when you’re asleep:

• Avoid alcohol before bedtime and don’t take medicines that make you sleepy. They make it harder for your throat to stay open when you’re asleep.
• Maintain a healthy weight. Extra fat in the walls of your throat can make it narrower.
• Sleep on your side instead of your back. This helps keep your throat open.
• Ask your physician about medicines. Some medications can help open your nasal passages.

Everyone dreams. You spend about 2 hours each night dreaming but may not remember most of your dreams. Its exact purpose isn’t known, but dreaming may help you process your emotions. Events from the day often invade your thoughts during sleep, and people suffering from stress or anxiety are more likely to have frightening dreams. Dreams can be experienced in all stages of sleep but usually are most vivid in REM sleep. Some people dream in color, while others only recall dreams in black and white.

Summary

• Nightmares can start when the child is about two years old, and reach a peak between the ages of three and six years.
• About one quarter of children have at least one nightmare every week.
• Nightmares usually occur later in the sleep cycle, between 4am and 6am.
• Try to be supportive and understanding.

Most children experience nightmares from time to time. Frightening dreams can start when the child is about two years old, and reach a peak between the ages of three and six years. Nightmares usually occur later in the sleep cycle, from 4am to 6am, but the frequency differs from one child to the next.

Your child may have only a few scary dreams a year, or be troubled by nightmares much more often. About one quarter of children have at least one nightmare every week. A common theme is being chased by a frightening person or animal.

The cause of nightmares isn't known, but it is thought to be the ordinary stresses and strains of growing up. Children who have experienced a traumatic event, for example, tend to have frequent nightmares for the next six months or so.

A range of possible causes

Some of the possible causes of nightmares include:

• The ordinary stresses and strains of growing up
• A traumatic event, such as an accident or surgery
• Fever
• An active imagination.

Coping with your child's nightmare

Suggestions include:

• Go to your child as soon as you can. If your child's bedroom is far from yours and you can't be sure to hear them when they call or cry, consider installing a baby monitor.
• Cuddle and reassure your child. Talk calmly and gently.
• Appreciate that your child's feelings are genuine.
• Be prepared to stay with them until they have calmed down. If your child is particularly frightened, you may need to soothe them with a favourite (but relaxing) activity, such as reading a book together.
• Your child may want to talk to you about their nightmare. Encourage them to come up with alternate endings for the nightmare that are happy or funny.

Don't make things worse

You may, without meaning to, make the situation worse. Do not:

• Ignore the child – if you refuse to go to them, your child will only get more upset and frantic.
• Get angry – you may think your child is 'putting it on' for attention, or else you don't appreciate a broken sleep. Either way, expressing anger or tension will only upset your child even more.
• Allow them to sleep with you – when you're tired and wishing for an easy solution, it's tempting to take the child back to bed with you, but this tactic suggests to the child that sleeping in their own bed is what causes the nightmare. Eventually, they may insist on sleeping with you all the time.

Prevention suggestions

It isn't possible to stop your child from ever having another nightmare, but you may be able to reduce the frequency of bad dreams. Suggestions include:

• Make sure your child doesn't watch frightening shows on television, or read scary books.
• Consider your child's daily routine. Is anything troubling them? Stressful events that could trigger a spate of nightmares include a new sibling, moving house or starting school.
• Talk about dreams together, and explain that everyone has dreams and occasional nightmares.
• If your child is troubled by a recurring nightmare, help them to explore its meaning through drawing, writing or play acting. Thinking about the nightmare creatively – especially when the child comes up with a happier ending or 'makes friends' with the nightmare character – can help to defuse the power of the dream.
• Seek professional advice if needed. See your doctor for information and referral.

A parasomnia is one of a group of sleep disorders in which unwanted, disruptive motor activity and/or experiences during sleep play a role. Parasomnias can occur in either REM or NREM phases of sleep. Sleepwalking, restless leg syndrome, and night terrors are all examples of parasomnias (Mahowald & Schenck, 2000).

Sleepwalking

In sleepwalking, or somnambulism, the sleeper engages in relatively complex behaviors ranging from wandering about to driving an automobile. During periods of sleepwalking, sleepers often have their eyes open, but they are not responsive to attempts to communicate with them. Sleepwalking most often occurs during slow-wave sleep, but it can occur at any time during a sleep period in some affected individuals (Mahowald & Schenck, 2000).

Historically, somnambulism has been treated with a variety of pharmacotherapies ranging from benzodiazepines to antidepressants. However, the success rate of such treatments is questionable. Guilleminault et al. (2005) found that sleepwalking was not alleviated with the use of benzodiazepines. However, all of their somnambulistic patients who also suffered from sleep-related breathing problems showed a marked decrease in sleepwalking when their breathing problems were effectively treated.

REM Sleep Behavior Disorder (RBD)

REM sleep behavior disorder (RBD) occurs when the muscle paralysis associated with the REM sleep phase does not occur. Individuals who suffer from RBD have high levels of physical activity during REM sleep, especially during disturbing dreams. These behaviors vary widely, but they can include kicking, punching, scratching, yelling, and behaving like an animal that has been frightened or attacked. People who suffer from this disorder can injure themselves or their sleeping partners when engaging in these behaviors. Furthermore, these types of behaviors ultimately disrupt sleep, although affected individuals have no memories that these behaviors have occurred (Arnulf, 2012).

This disorder is associated with a number of neurodegenerative diseases such as Parkinson’s disease. In fact, this relationship is so robust that some view the presence of RBD as a potential aid in the diagnosis and treatment of a number of neurodegenerative diseases (Ferini-Strambi, 2011). Clonazepam, an anti-anxiety medication with sedative properties, is most often used to treat RBD. It is administered alone or in conjunction with doses of melatonin (the hormone secreted by the pineal gland). As part of treatment, the sleeping environment is often modified to make it a safer place for those suffering from RBD (Zangini, Calandra-Buonaura, Grimaldi, & Cortelli, 2011).

Other Parasomnias

A person with restless leg syndrome has uncomfortable sensations in the legs during periods of inactivity or when trying to fall asleep. This discomfort is relieved by deliberately moving the legs, which, not surprisingly, contributes to difficulty in falling or staying asleep. Restless leg syndrome is quite common and has been associated with a number of other medical diagnoses, such as chronic kidney disease and diabetes (Mahowald & Schenck, 2000). There are a variety of drugs that treat restless leg syndrome: benzodiazepines, opiates, and anticonvulsants (Restless Legs Syndrome Foundation, n.d.).

Night terrors result in a sense of panic in the sufferer and are often accompanied by screams and attempts to escape from the immediate environment (Mahowald & Schenck, 2000). Although individuals suffering from night terrors appear to be awake, they generally have no memories of the events that occurred, and attempts to console them are ineffective. Typically, individuals suffering from night terrors will fall back asleep again within a short time. Night terrors apparently occur during the NREM phase of sleep (Provini, Tinuper, Bisulli, & Lagaresi, 2011). Generally, treatment for night terrors is unnecessary unless there is some underlying medical or psychological condition that is contributing to the night terrors (Mayo Clinic, n.d.).