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Following disease into our dreams

Posted by Dr. Sushrut Jangi  January 21, 2014 10:09 AM

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A scene from the 2010 blockbuster science-fiction film, Inception, in which Leonardo DiCaprio's character leaps into a dream to change a person's behavior and extract crucial information.  (Picture Courtesy Warner Bros. Pictures, 2010)
 
Boston doctors and scientists use new tools to link dreams and disease

There are places doctors can now go where they couldn't go before. 

In less than a day, a human being can have his DNA entirely sequenced. Colonoscopies collect bacterial samples from deep within the gut. Tiny monitors on the skin upload heart rate and body temperature data to a smartphone. Modern medicine is hunting for telltale signs of health and disease in every piece of data the human body generates. 

Some of this is sure to be important, but can't we hide a part of ourselves away from the light of examination? Isn't it possible that our body and mind generates ethers and currents that are immeasurable? 

Dreams go big data 

I should hope that the dreams we have at night - at least - would remain beyond the grasp of the big data revolution. 

Nope. 

If the study of dreams has been historically padlocked, modern methodologies are giving us a new set of keys to peer inside the sleeping brain. 

Earlier this year, the journal Science reported that a team from Japan was able to guess what people were seeing in their dreams after putting the sleeping subjects through an MRI machine. 

And novel software makes dream-sharing practical and potentially useful for researchers. An iPhone App called Shadow revolves around the creation of a social network where you can text and upload your nightly visits to la-la land. Some online dream communities, like Dreamboard, store more than 200,000 dreams. 

Not only are dreams becoming as accessible as tweets, but we may even have the conveniences to edit them as well. 

Three Bostonians, including MIT alumnus Doug Feigelson, developed a program for smartphones called Sigmund that whispers words into your ear during the time of night you are most susceptible to dreaming. "It's worked on me numerous times," he said. "It's the kind of thing you've probably experienced naturally when you're falling asleep while people around you are talking, and you start dreaming about their conversation." 

Dreams and disease 

Since dream content is becoming more available, people are curious if there are clues buried within that hold information about our health. "Oh, yes," said Patrick McNamara, Ph. D., a neuroscientist at the Boston University School of Medicine. "The content of dreams, especially among older adults, can serve as a warning sign for the onset of certain diseases."

For instance, people who go on to develop Parkinson's disease and other dementias may physically act out their dreams during sleep, years before they develop the illness. 

"Some kinds of dementias result in dreams where the dreamer is being attacked by an intruder, and they struggle to protect themselves and their bed partner," said McNamara.

Early morning heart attacks may be triggered by high blood pressures and heart rates that accompany the stage of sleep most associated with dreaming. Running from an enemy in a dream is a bit like putting the heart through a stress-test. 

Consequently, McNamara said that it wouldn't hurt for doctors to ask patients about their dreaming habits. Although the practice of dream-telling might be unusual in Western medicine, it is routinely used in Eastern medical systems to assess the mental status of the patient. "Dreams are faithful reports of a patient's emotional life," said McNamara. "They aren't just fluff, but have a function in the mental economy. If you work with them, they can yield insights about the self." 

After September 11th, another local sleep researcher at Tufts University, Dr. Ernest Hartmann (who passed away last year) and his colleague Tyler Brezler discovered that people tended to dream more intensely after that date than before the terrorist attacks. In other words, dreams, the exhalations of our sleeping brains, can contain signatures of trauma that we've experienced during waking life. And in the case of post-traumatic stress disorder, dreams may replay the trauma, keeping the memory of the initial event terribly alive. 

Dreams or nightmares themselves can also plant the seeds of depression or fear. Soldiers who returned from the Gulf War on the dream-triggering malaria drug, mefloquine, described traumatic nightmares that were so vivid, the fear elicited by their dreams carried over when they woke up. But McNamara said you can also entrain your brain to dream happily. "A few studies show that if you can learn to dream pleasantly, you can regulate your mood the next day." 

Should doctors enter dreams?

If happiness and trauma are embedded in the fabric of our dreams, social apps such as Shadow and Sigmund will help investigators like McNamara to link the information in dreams to how we live during waking hours. Some have previously suggested that physical symptoms - such as chest pain - are first noted in a dream, before they are experienced in real life. "We've never really had any statistical power to test that claim," said McNamara. "These big databases will revolutionize dream studies and really demonstrate the clinical relevance of dreams." 

The day is closer when we may know how dream content may correlate with a person's risk for a heart attack, depression, or dementia. 

For now, in my own practice, I occasionally ask patients about their dreaming behavior. While their answers alone won't drive me to make any clinical decisions, they are a part of understanding the person holistically. 

But even as study of dreams advances, they will remain an intensely subjective experience. A dream can make you fall in love again or help you to make a decision.  They are a kind of wellspring of individual reflection and inspiration, the realm of the artist and the poet, not just the scientist and the physician. 

To better understand them myself, I recently decided to keep a dream journal, as McNamara suggested. 

I set a new notebook on my bed stand and went off to bed. The next morning, even before I opened the notebook, the faint tendrils of the dream slipped from my mind. 

"Dream recall is tricky," McNamara says. "But you'll get better the more you try it." 

So I tried again. The next time, the dream came to me in vibrant watercolor. I was walking along the ocean, I wrote, feeling a bit self-conscious. 

And . . . you know what?

I'd rather keep this to myself. 

What does the world want with my dreams anyhow?


This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Sushrut Jangi is an internist at Beth Israel Deaconess Medical Center and an editorial fellow at The New England Journal of Medicine. More »

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