Historically, dementia has been used as a catch-all phrase for symptoms of degenerative disorders of the brain. Several of these disorders are associated with vivid dreams and sleep disturbances as well as the more common symptoms of confusion, daytime hallucinations and progressive loss of mental functioning. However, having vivid dreams is not necessarily a warning sign of early-stage dementia.
Today, conditions of dementia are generally divided into Alzheimer’s disease and non-Alzheimer’s dementias. In both groups, vivid dreams are a lesser-known symptom and may be a side effect of anti-psychotic medication. Yet, the connection between dreams and mental illness runs deep. Psychiatrists often refer to daytime hallucinations as “waking dreams.” In his 2002 book “The Dream Drugstore,” Dr. Allan Hobson describes dreaming as a “normal” psychotic event. Unless vivid dreams disturb sleep, such as recurrent nightmares, or begin to intrude into waking life, vivid dreams at night are not considered a medical issue.
Vivid dreams occur in roughly 10 percent of patients with the early-moderate stage of Alzheimer’s, according to a 2007 study published in “Neurological Sciences.” Although patients with Alzheimer’s disease have fewer daytime hallucinations than patients with non-Alzheimer’s dementias, this study suggests that those who do hallucinate are more likely to have vivid dreams as well. Both experiences may be related to sleep disorders involving REM, or rapid eye movement, sleep.
Dementia With Lewy Bodies
Lewy body dementia affects 1.3 million Americans, according to the Lewy Body Dementia Association's article "What is LBD?" Perhaps the most distinguishing feature of this degenerative dementia is the wide occurrence of a sleep disorder called REM sleep behavior disorder (RBD). This dream-related disorder may be the first symptom of developing dementia. In normal REM sleep, the stage of sleep in which most dreams occur, the brain sends out signals to paralyze the major muscle groups, therefore preventing people from moving when dreaming. In RBD, this process breaks down, resulting in individuals who physically act out their vivid dreams, causing harm to themselves and others. According to the Alzheimer’s Association, 50 percent of sufferers from Lewy body dementia have REM behavior disorder.
A New Definition
As neurologists continue to make connections between dreams and mental illness, they create new definitions and descriptions of dementia. “Oneiric” is a term derived from the Greek root “dream.” Oneiric dementia is one such classification that addresses degenerative dementias that are associated with sleep disorder symptoms as well as vivid dreams and hallucinations. For example, a 2002 study published in the “Archives of Neurology” reported a new syndrome characterized by dementia, REM behavior sleep disorder and an absence of slow wave sleep.
Although people with early stages of dementia have vivid dreams, this does not necessarily suggest that vivid dreams are an early sign of dementia. Rather, vivid dreams can be a sign of creativity and an active lifestyle. Nightmares and disturbing dreams may also be caused by poor sleep habits and other environmental factors. However, the frequent acting out of dreams can be a serious health risk that demands medical attention.