Dear Dream Doctor,

I have been having vivid recollections of what I think are dreams. These usually happen to me at the most inopportune times (e.g.. during meetings at work, etc.). The feeling is so overwhelming that I have no choice but to concentrate on the thought. During an episode I can see individuals that I have never met. The more I concentrate the further I seem to be pulled from this reality.

The feeling during this state is euphoric. However, when I finally snap out of it my brain feels totally confused and I get a sick to my stomach feeling. It then takes me at least 2 hours for my brain to reset and the sick feeling to go away. After that I am fine until it happens again. (usually 3 or 4 times a week)

I do have a stressful position at work. I have also gone for a CAT scan and it showed nothing. Am I just going nuts or what?!

—Anonymous

Hi Anonymous—

You’re not going nuts! All you need to do is go to a sleep disorder center in your area to get your symptoms diagnosed—and to receive treatment. In the meantime, though, I will try to give you some food for thought—which I hope will encourage you in both regards.

Your symptoms sound very much like an intrusion of dreaming (or REM sleep) into a period of waking. As a rule, it is very difficult for adults to transition directly into dreaming sleep from waking; we almost always have a period of Quiet sleep, (non-dreaming), prior to beginning a dream. One exception to this rule occurs when we are significantly sleep deprived. If you have a sleep disorder at night that is interfering with the quality of your sleep—this could be responsible. Sleep apnea—characterized by loud snoring in men, mild to moderate snoring in women—would be a likely candidate. Are you known to snore and sleep restlessly at night?

A second cause would be a condition known as narcolepsy. Known to affect approximately one out of every two hundred people, narcolepsy’s primary symptom is chronic daytime tiredness. Its secondary symptoms are the intrusion of dreamlike imagery into waking experience, accompanied by occasional, sudden losses of muscle tone.

In his new book “The Promise of Sleep,” (Delacorte Press, 1999), sleep researcher William Dement writes, “For people with narcolepsy, the most important and debilitating effect of the disorder is that they are unbearably sleepy all the time. Their struggle to stay awake is relentless, and whenever they let down their guard, sleep immediately overcomes them. Even when they are on guard, they are often overtaken by sleep—in the middle of a sentence, while eating, or even during sex. Such unintended sleep attacks may last up to 10 or 20 minutes, and then victims wake up feeling somewhat refreshed. Soon afterward, they become sleepy again.”

He continues, “Occasionally people with narcolepsy are neither clearly awake nor clearly asleep; they may be existing simultaneously in two entirely different states of mind. While we were examining one patient in the laboratory, he reported that as he listened to us he was aware that he was in the laboratory, but he felt that he was also lying paralyzed in the street outside and was terrified that he would be struck by a car.”

The good news is that sleep apnea and narcolepsy both are almost entirely reversible conditions. Sleep apnea is most commonly treated with a device known as Nasal CPAP (which, incidentally, also eliminates snoring), while narcolepsy is treated with medications that promote alertness. To differentiate which condition you have—make an appointment with your local sleep disorder center. You will be relieved to find yourself in skilled and knowledgeable hands, and you will have relief from your symptoms in a matter of weeks.

P.S. Spread the word: Don’t take sleep disorders lying down!