It is also said that "the interpretation of dreams" reads the signals sent by nightmares

In outpatient clinics, patients often come to the clinic because of insomnia, and there are also patients who often have nightmares during sleep. Some people will be surprised, is it a disease to have frequent nightmares? Do you also have to see a doctor when you have nightmares? It should be noted that normal dream activity is one of the important factors to ensure the normal vitality of the body, and nightmares are dream experiences that cause extreme uneasiness or panic. Nightmares may not only be related to psychological background, but may also indicate unhealthy physical and physiological conditions.

"Stimulation" is an important cause of dreams

Nightmares occur during sleep, which is an essential physiological process for maintaining the health of the body, and its importance is second only to breathing and heartbeat.

Normal human sleep has two phases, namely the "non-REM sleep (NREM) phase", in which most nerve cell activity decreases during the NREM phase and the "REM sleep (REM) phase", in which electrical brain activity is similar to that of wakefulness. In a normal person's one-night sleep, there are 4-6 NREM/REM cycles.

Dreams are produced during sleep, when people sleep, brain cells enter a resting state, but some brain cells do not completely rest, weak stimulation will cause their activity and trigger dreams. Dreaming is a normal, essential physiological and psychological phenomenon, everyone dreams in their sleep every day, but some people remember clearly, some people can't remember clearly. The study found that 80% of people who were awakened during the rapid eye movement sleep (REM) phase were dreaming, and only 7% of those who were awakened during the non-RAPID EYE movement sleep (NREM) phase were dreaming.

Normal dream activity is one of the important factors to ensure the normal vitality of the body, and it is a way to coordinate the balance of the human psychological world. Nightmares are dream experiences that cause extreme uneasiness or panic. Dreams are diverse, and the factors for their formation are extremely complex, and it is generally believed that "stimulation" is an important cause of dreams. These stimuli include:

(1) External stimuli of the body, such as the rustling of wind-blown leaves to produce rainy dreams;

(2) The internal stimulation of the body, such as thirst, will dream of finding water to drink;

(3) The continuation of mental activity during the day, the so-called "day to think, night to dream";

(4) Memories of the past reappear in our dreams;

(5) The role of the subconscious.

In general, dreams are based on physical physiology and set against the background of individual psychology, which is a reflection of objective reality. In addition to the psychological background, nightmares also indicate unhealthy physical and physiological conditions. Thus nightmares can be a manifestation of physiological abnormalities or diseases, such as increased or slowed heart rate, cerebral ischemia and hypoxia, local brain lesions, depression, anxiety, etc. caused by nightmares; it can also be a disease state, or indicate the pathogenesis of certain diseases.

May predict certain neurodegenerative lesions

Some patients often have nightmares, dreaming of horrible dreams such as being chased, accompanied by shouting, physical and physical activities related to the dream, such as rolling, punching and kicking, etc., and appearing harmful behavior. This is a sleep disorder that occurs in the rapid eye movement sleep (REM) phase, called rapid eye movement behavior disorder (RBD).

RBD is a heterogeneous sleep characterized by constant specific dream behavior and detection of resymbly sleep (REM) phase tension failure in polysomnography (PSG). Specific dream behaviors are a core clinical feature of RAPID EYE movement disorder (RBD), while detection of REM phase tension relaxation on polysomnography (PSG) is an adjunctive test for the diagnosis of RBD.

However, there are also cases of rapid eye movement sleep (REM) phase dystrophic relaxation detected in PSG, but there are no clinical manifestations of specific dream behaviors, which is more common in patients taking antidepressants.

RBD is divided into primary and secondary, secondary RBD is seen in Parkinson's disease, Lewy body dementia, Alzheimer's disease, sleepy episodes, tumors, related drugs (especially antidepressants) and so on. Primary RBD can go some way to predicting certain neurodegenerative lesions, particularly Parkinson's disease, Lewy body dementia, and parkinsonian-like symptoms such as multisystem atrophy.

In 1996, Dr. Carlos H and his team reported that of the 29 elderly patients with primary RBD, 38% were diagnosed with Parkinson's syndrome within 3.7 ± 1.4 years. This was the beginning of research into the relationship between RBD and Parkinson's syndrome. Since then, there have been relatively large-scale clinical studies in various countries, all of which confirm that primary RBD predicts that the disease is heading towards such Parkinson's syndrome-like diseases.

Pathological changes in Parkinson's syndrome are mainly the production of Lewis bodies in brain tissue. When The Lewis body invades the gray matter nuclei of the substantia substantia, midbrain, and forebrain, it leads to Parkinson's-like clinical manifestations. However, when The Louis body has not yet invaded the gray matter nucleus of the substantia substantia substantia and midbrain and forebrain, and is confined to the medulla oblongata or pontine cover, it does not cause Parkinson's clinical manifestations, but it can cause the onset of RBD. This also pathologically explains why idiopathic RBD can be used as a predictive indicator of Parkinson's-like disease.

However, an interesting clinical phenomenon is that Parkinson's syndrome will be improved during RBD, which is manifested by more agile, powerful, fluent, and clearer speech. At present, its mechanism is not yet clear.

Whether it's because RBD itself can cause physical harm to patients and their coleptmates, or because of its close relationship to Parkinson's syndrome, RBD requires aggressive treatment. In addition to external protective measures such as sleeping in separate beds, sleeping in separate rooms, and increasing guardrails next to the bed, the drugs with improved clinical symptoms of RBD are mainly clonazepam and melatonin, but none of them can interrupt the progression of the disease. In addition, there have been some small-scale clinical studies of levodopa, pramipexole, and donepezil for RBD, but the efficacy is not yet certain.

RBD in Chinese medicine belongs to "sleepless", TCM treatment of sleeplessness in the basis of supplementing the weakness of diarrhea, adjusting the internal organs, blood and yin and yang supplemented by calming the spirit and concentration. Empirical evidence should be diarrhea, such as liver soothing and depressiveness, fire reduction and sputum removal, dissipation and neutralization; false evidence should make up for its deficiencies, such as beneficial qi and blood nourishment, healthy spleen, liver supplementation, and kidney benefit. Empirical evidence over time, qi and blood depletion, can also be transformed into false evidence, virtual and real mixed, the treatment should be attacked and supplemented at the same time. The use of tranquility should be combined with clinical, and specific treatment methods such as blood nourishment, tranquility, and tranquility should be selected, and spiritual treatment should be paid attention to to eliminate tension and anxiety and maintain mental comfort.

Create a "comfortable sleep" environment to sleep well

So, how do we reduce nightmares in our daily lives?

First of all, keep the mood comfortable, learn to regulate emotions, release stress; at the same time pay attention to the combination of work and leisure, work and rest rules, do not often stay up late.

Secondly, reduce the occurrence of nightmares caused by external environmental factors, such as avoiding overexcitement before going to bed, avoiding watching horror movies, avoiding a lot of alcohol and coffee strong tea; sleeping in a comfortable environment, avoiding noisy, odorous sleep environment, and avoiding poor sleeping posture.

In addition, the possible drug-related effects are reduced, and aggressive treatment may lead to the primary incidence and cause of nightmares.

If after physical and mental adjustment, or frequent nightmares, there are shouting, physical and physical activities in the dream, it is recommended to go to the hospital for treatment, you can intervene in Traditional Chinese and Western medicine to alleviate symptoms, and clarify whether further diagnosis and treatment is needed.

(Wang Yu, Zhang Yunyun, Neurologist, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine)

Source: Wen Wei Po