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Narcolepsy and Vivid Dreams

Posted on February 25, 2021
Medically reviewed by
Allen J. Blaivas, D.O.
Article written by
Annette Gallagher

People with narcolepsy report a range of symptoms, and not all people have the same symptoms. Although cataplexy (muscular weakness triggered by strong emotions), extreme fatigue, excessive daytime sleepiness, and others may be common, one symptom that isn’t discussed as often is vivid dreams.

“I had a dream on top of a dream, over and over, about five times,” said one member of MyNarcolepsyTeam. “The main idea of the dream never changed, but little details changed each time.”

“It’s hard to distinguish between reality and dreaming,” said another member.

Narcolepsy is a chronic neurological sleep disorder. In people with narcolepsy, the brain has trouble regulating the sleep cycle, resulting in disruptions of normal sleep and wakefulness patterns. People diagnosed with narcolepsy frequently have vivid dreams or nightmares, but data isn’t available with exact numbers of those who experience this symptom.

What Are Vivid Dreams Like for People With Narcolepsy?

Although most people experience vivid dreams and nightmares from time to time, the vivid dreams narcoleptics experience are different.

When we sleep, our brains cycle between rapid eye movement (REM) sleep and non-REM sleep. Most people experience about two hours of REM sleep per night, which is when dreaming occurs. That REM sleep typically begins an hour or two after someone falls asleep. But people with narcolepsy may have episodes of sleep onset REM periods (SOREMPs). They can be in a REM state of sleep in just a couple of minutes.

MyNarcolepsyTeam members have described their vivid dreams:

  • “They’re very stressful.”
  • “I thought I was losing it.”
  • “I can’t wake up.”

How Do Vivid Dreams Affect People With Narcolepsy?

Vivid dreams and nightmares can be disruptive to those with narcolepsy. Although people with narcolepsy are often sleepy and have trouble staying awake during the day, they may also have trouble staying asleep at night. Vivid dreams can be one factor in that sleep disruption.

“I seem to sleep for a few hours, then wake constantly, day and night. All it does is make me more tired, which causes vivid dreams,” one MyNarcolepsyTeam member wrote.

Dreams may be so vivid that the dreamer isn’t certain if they are awake or asleep. “Sometimes I have to pinch myself or blink twice to make sure that I am awake,” said another MyNarcolepsyTeam member.

“To this day, I can’t remember whether I dreamed something or someone told me something,” a third member shared.

Sleep that’s regularly disrupted can lead to physical and mental issues, including brain fog, an inability to focus, depression, anxiety, and decreased immunity. Lack of sleep can also cause people to be more prone to injuries and accidents.

"I have vivid dreams and dreams that continue immediately upon closing my eyes, and I'm physically exhausted," wrote a MyNarcolepsyTeam member.

What Causes Vivid Dreams in Narcolepsy?

The way we view sleep has changed dramatically over the past 100 years. Sleep was once seen as passive, a time when the brain was quiet and at rest. The invention of the electroencephalogram (EEG) in the late 1920s allowed scientists and doctors to visualize brain waves — including during sleep — and note distinct sleep cycles. The EEG allowed science to measure and define the two primary kinds of sleep: REM and non-REM. REM sleep is when we do most of our dreaming.

Narcolepsy may be caused, among other factors, by the brain’s inability to correctly regulate REM sleep. The research is ongoing as to what effect levels of neurochemicals, including hypocretin (also known as orexin), have on the brain and how that regulation does or does not happen. People with normal sleep cycles generally enter REM within an hour to 90 minutes after falling asleep. In contrast, people with narcolepsy may enter a REM state in under 15 minutes, and they can wake up directly from REM sleep. As a result, they tend to remember their dreams more clearly and vividly.

A study at the University of Bologna investigated the brain waves of 30 people with narcolepsy in the SOREM state. They discovered that the participants’ brain waves during the SOREM phase — the phase you enter almost immediately after falling asleep — more closely resembled REM sleep brain waves than non-REM sleep waves. Researchers hope that identifying the similarity will lead to discoveries about the specific causes of the unusually vivid dreams experienced by people with narcolepsy.

It’s important to note that many other conditions beyond narcolepsy can cause vivid dreams, including:

  • Excessive stress
  • Medications (including some antidepressants and beta blockers)
  • Short-term sleep deprivation
  • Pregnancy

How Can Vivid Dreams Be Managed?

Narcolepsy is often treated with stimulants, including Adderall (amphetamine and dextroamphetamine) and Ritalin (methylphenidate). People with narcolepsy are also encouraged to make lifestyle changes when possible, such as adhering to regular schedules and bedtimes, practicing meditation, and managing stress.

Recent work with lucid dreaming techniques appears to show promise for managing the vivid dreams of narcolepsy.

What Is Lucid Dreaming?

Lucid dreaming occurs when the dreamer has enough awareness to know that they are dreaming. People with narcolepsy have more lucid dreams than average, about seven each month. In contrast, most people typically have one lucid dream every two months. Scientists suspect that the lateral prefrontal cortex — the region of the brain that controls lucid dreaming — is more active in people with narcolepsy than it is in most people. This difference may account for the increased frequency of lucid dreams.

Researchers believe that lucid dreaming can be beneficial to people who experience disruptive vivid dreams. For example, if you have a lucid nightmare in which you are falling, the fact that you know you’re dreaming can help you wake yourself up. Therefore, developing lucid dreaming as a skill may help you control your excessively vivid dreams.

How To Increase Your Lucid Dreaming Ability

Researchers recommend keeping a dream diary to develop lucid dreaming abilities. You should write down the dreams you remember, then think about them throughout your regular waking days. The theory is that associating the topics of vivid dreams with dreaming in an awake and aware state will make them easier to control while you’re asleep.

You Are Not Alone: Finding Support for Narcolepsy and Vivid Dreams

By joining MyNarcolepsyTeam, the social network for those living with narcolepsy, you’ll join a support group with thousands of others who understand how the condition can impact your life. Vivid dreams are just one of the topics members talk about. New topics are posted every day.

How do vivid dreams and narcolepsy affect your life? Have you found ways to manage the dreams or wake up from them more easily? Share your tips and experiences in a comment below or on MyNarcolepsyTeam. You'll be surprised how many other members have similar stories.

All updates must be accompanied by text or a picture.
Allen J. Blaivas, D.O. is certified by the American Board of Internal Medicine in Critical Care Medicine, Pulmonary Disease, and Sleep Medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Annette Gallagher has a Bachelor of Science in broadcast journalism and political science from the University of Miami. Learn more about her here.

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