One of the less talked about side effects of obstructive sleep apnea (OSA) is that people with OSA may dream less frequently. The good news is that if you miss it, there are treatment options available that may help you get those sweet dreams back.
Non-REM Sleep and REM Sleep
There are three states of being: wakefulness, non-Rapid Eye Movement (REM) sleep and REM sleep. Non-REM sleep is about 75-80 percent of sleep, and for most adults, REM sleep is about 20-25 percent.6 Dreaming is most often associated with REM sleep.1
OSA can occur during any stage of sleep.2 In this study, Obstructive sleep apnea during REM sleep: Clinical relevance and therapeutic implications, findings suggest that “there is an increased tendency for upper airway collapse during REM sleep due to the decreased tone of the genioglossus muscle in the tongue.”2 This causes some individuals to experience OSA during REM sleep.2
OSA and dreaming
Of course, not all dreams are entirely pleasant, and the jury’s still out on the science behind whether OSA affects the content of the dreams you do experience.
A study published in the Journal of Clinical Sleep and Medicine suggests that “patients with sleep apnea have dreams that are more negative emotionally than do people without apnea.”3
Findings from another study concluded that this might be because obstructive sleep apnea "induce[s] recurrent sleep fragmentation and intermittent desaturations in patients, which may trigger different parasomnias, including nightmares."4
However, in different study, researchers Pagel JF. and Kwiatkowski C. found an interesting conclusion between OSA and nightmares: “those with more severe OSA had a significantly lower nightmare frequency.”5
Once you begin treatment for sleep apnea with continuous positive airway pressure (CPAP) therapy, your throat will have enough air pressure in the airway so it doesn’t collapse when you breathe in your sleep. This will help you get better sleep, increasing their chances of falling into REM sleep and dream once again.
1 Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 2, Sleep Physiology. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19956/
2 Alzoubaidi, Mohammed, and Babak Mokhlesi. “Obstructive sleep apnea during rapid eye movement sleep: clinical relevance and therapeutic implications.” Current opinion in pulmonary medicine vol. 22,6 (2016): 545-54. doi:10.1097/MCP.0000000000000319
3 Fisher, Samantha et al. “Emotional content of dreams in obstructive sleep apnea hypopnea syndrome patients and sleepy snorers attending a sleep-disordered breathing clinic.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. 7,1 (2011): 69-74.
4 BaHammam, Ahmed S, and Aljohara S Almeneessier. “Dreams and Nightmares in Patients With Obstructive Sleep Apnea: A Review.” Frontiers in neurology vol. 10 1127. 22 Oct. 2019, doi:10.3389/fneur.2019.01127
5 Pagel JF, Kwiatkowski C. The nightmares of sleep apnea: nightmare frequency declines with increasing apnea hypopnea index. J Clin Sleep Med. 2010 Feb 15;6(1):69-73. PMID: 20191941; PMCID: PMC2823279.