We all know that stress and a lack of sleep are directly related, but did you know obstructed sleep apnea (OSA) during the stage of sleep known as REM sleep can affect our dreams? Here we look at what REM sleep is, what happens when we experience REM-related sleep disorders, how they affect our dreams, what are the health implications, and how they can be treated.
What is REM Sleep? Understanding the Dream State
In sleep studies, it has been shown that OSA has been known to occur predominantly during the stage of sleep known as REM sleep, which is characterized by the motion your eyes make while dreaming, hence the name rapid eye movement. Most people usually enter REM sleep about 90 minutes after falling asleep. Their brains become more active and their breathing rate, heart rate and blood pressure tend to increase. A sleeper can average three-to-five intervals of REM sleep during an eight-hour sleep cycle. This is compared to the other stages of sleep, which are considered non-rapid eye movement (NREM) sleep.
OSA During REM Sleep
An REM OSA sleep disorder occurs when a partial (hypopnea) or full airway blockage (apnea) happens during REM sleep. Although sleep apnea can occur during any stage of sleep, according to the article, Obstructive sleep apnea during REM sleep: Clinical relevance and therapeutic implications, there can be an increased tendency for upper airway collapse during REM sleep due to the decreased tone of the genioglossus muscle in the tongue. This may the reason why some individuals only experience OSA during REM sleep.
Waking from a Nightmare
“I am buried under the sand and fighting my way to a surface that I can't seem to reach. I wake gasping for air.” This was how one sleep apnea patient described waking from a nightmare in the published study, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index by J. F. Pagel and Carol Kwiatkowski.
The report indicated that patients with sleep apnea-related disorders can, at times, report intense nightmares on waking from apneic events, while others studies suggested that OSA patients can report lower dream recall frequency, indicating that significant OSA suppresses the cognitive experience of nightmare recall.
While we have little to go by when it comes to how OSA affects our dreams, we do know that those who experience breathing disorders during sleep can experience all kinds of health issues.
Compared with NREM sleep, REM OSA sleep has been associated with higher activity to the sympathetic nervous system and cardiovascular instability. According to one sleep study, patients who experienced an above normal apnea-hypopnea index (AHI), which measures how many apneas and hypopneas (partial airway blockages) a person has per hour during sleep, experienced prevalent and incident hypertension when in dream sleep.
Recent research, published in an article on how Sleep Apnea Affects REM Sleep, also showed how OSA-induced REM sleep disruption can affect spatial memory even when other sleep stages are intact. This type of memory loss is similar to those with Alzheimer’s disease.
Treatment for REM OSA Sleep Disorders
While there are very few effective medications to treat OSA REM sleep disorders, it has been shown that Continuous Positive Airway Pressure, or CPAP therapy, is an effective treatment in helping OSA patients stop snoring or waking up through all the sleep stages, as it allows for a flow of airway pressure to the throat to ensure that the airway stays open during sleep.
People suffering from OSA should discuss their symptoms with a sleep doctor to find the most effective treatment for them.
For more information, read our article on how OSA Can Affect the Different Stages of Sleep.
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