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Although some patients believe that their dreaming process has ceased, they might experience impoverished dreaming. This condition is characterized by an attenuation of the dreams, but they do not cease completely. Different conditions, such as alexithymia or PTSD can cause it; patients who have alexithymia (not able to express their emotions verbally) reported that they had had colorless dreams. Dream impoverishment in patients with PTSD might be linked to the adaptive strategy of the organism that allows avoiding nightmares connected to trauma. Thus, dreams of patients are related to their real medical conditions or experiences that they find traumatic.
Excessive dreaming can produce various dreams which content includes fantastic settings or routine daily activities. Patients who had experienced this complained that they felt exhausted or dizzy. Although it is still not clear why excessive dreaming occurs, it makes patients feel as if they have experienced that what they saw in dreams.
Repetitive Dream Content
Repetitive dream content, as the author points out, can be triggered by REM sleep behavior disorder and Parkinsonism. Patients see vivid dreams that are filled with action, violence, and stressful scenes. Many patients saw a dog in their dreams that tried to bite them; they began to defend themselves or hit the dog, and, in reality, they hit their spouses or walls/beds. Some of them jumped out of bed, or ran, and also hurt themselves.
One of the patients with PTSD charged his weapon (while dreaming) and injured himself. Such dreams trigger reactions that do not stay in the dream; they affect individuals or objects around the patient. Patients with epilepsy saw short episodes of the seizures in their dreams that could be reflections of their previous seizures that they did not remember. Repetitive dreams are common for patients with epilepsy too, but the patients’ ability to recall those dreams depends on the type of a seizure.
Dreams of PTSD patients are often connected to reality because patients experience traumatic experiences repeatedly in these types of dreams. Especially exact are the dreams about combat or war traumas. Thus, episodic memories in these dreams become extensive and remind the patient about the trauma.
Prodromal cardiac dreams are often related to the cardiac issues patients have, but the dream content can indicate possible problems in direct and indirect ways. While some patients saw blood and death related scenes and then experienced cardiac arrest or similar cardiac events, others felt chest and heart pain in the dream because they were fighting or attacked.
Dream-Reality Confusions
Reality can be confused with dreams if the latter become too vivid or is connected to a recent highly emotional or stressful event (loss, labor, illness, etc.). Patients who had lost someone close saw dreams with these individuals, experienced sadness or guilt in both dreams and reality. Mothers who recently had a baby often dreamed about settings where they tried to find the infant, felt that they had lost the child, and cried. In reality, mothers also showed anxious behavior while they were asleep.
Patients in intensive care also saw nightmares connected to operations and treatment, or their content simply was horrifying and dreadful, as patients stated. Some patients remembered and suffered from nightmares five or six months after they had left IC.
At last, dream-reality confusion is common in psychotic patients who might perform violent acts towards nurses or relatives because of the content of their dreams. Some patients dream about voices that command them to act aggressively. Thus, such dreams can often cause dangerous behavior in reality.
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