Did Sleep Deprivation Lead to Attack on U.S. Rep. Gabrielle Giffords?

Politicians and pundits continue to argue whether vitriolic partisan politics inspired the shooting of U.S. Rep. Gabrielle Giffords on Saturday. Another factor that may have pushed alleged gunman Jared Lee Loughner to go on a killing spree that left six dead and 14 injured remains left out of the discussion.

Bizarre online ramblings allegedly posted by Loughner reveal he may have had insomnia prior to the Arizona attack. He writes:

“All humans are in need of sleep.
Jared Loughner is a human.
Hence, Jared Loughner is in need of sleep.”

Other passages in the YouTube rant mention sleepwalking and so-called conscious dreaming about the government. It’s unclear whether his message is intended to be literal, symbolic or just the incoherent ramblings of someone with serious mental health problems. Former classmates indicate it may be the latter.

And it all could have started with insomnia. Young adults with long-term sleep deprivation have an increased risk for mental illness, a study published last year in the journal SLEEP reported. A history of depression, anxiety or general emotional distress further raises the risk.

So was the shooting a product of partisan speech with violent undertones? Was it long-term insomnia? Or was the alleged gunman simply seriously disturbed? Chances are we will find out more in the coming months.

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Review: "Inception" Limited Science, Spectacular Fiction

If all dreams were like “Inception” I would never sleep.

Every dream in the film seems to end unpleasantly. Try going to sleep knowing you’ll likely get mauled by a mob of angry rioters or stabbed in the chest by a beautiful French woman. It doesn’t sound pleasant.

Not to give away the film’s convoluted plot, but the dream world is a violent place where everything happens for a reason. In that sense Christopher Nolan’s vision is more “The Matrix” than the ICSD-2.

That isn’t to say “Inception” is a bad movie, it’s actually fantastic. Just don’t expect it to be an educational experience. The film has its own rules Nolan reportedly came up with well before he reinvented the Batman franchise.

“Inception” is a heist movie at its core. Only instead of breaking into a money vault ala “Ocean’s 13” the protagonists try to crack companies’ deepest secrets. A fugitive Leonardo DiCaprio assembles a global team of highly skilled specialists for one last job. His roster includes a dream architect (Ellen Page), a master of disguise (Tom Hardy) and a chemist/ anesthesiologist (Dileep Rao).

The squad infiltrates dreams by drugging their target and hooking themselves up to a special suitcase. Once inside, the dreamer’s subconscious, or the dream world’s citizens, tries violently to drive them out. Die in the dream and you wake up. Except for that aforementioned one last job where the stakes are higher. Die there and you go to dream limbo where you’ll spend agonizing many decades alone waiting to wake up.

Alternatively, falling or waiting for time to run out also wakes up the dreamer. But minutes in the real world can last hours or days inside dreams within dreams within dreams. Each level of the dream hierarchy is more difficult to penetrate, with a more advanced subconscious security system.

And there are still more rules, involving “dream totems” and gravity. It’s all complicated but if you suspend your disbelief you’re in for some incredible set pieces.

There is some real-life basis to this science fiction. “Inception” was inspired by Nolan’s lucid dream experiences.

Lucid dreaming involves being aware that you are dreaming while you’re still asleep. Most people are unable to have lucid dreams unless they train themselves using pre-sleep “autosuggestion.”

The process is somewhat like how the Ellen Page character designs dreams. You can prepare yourself to see certain images and recognize the bizarre events of the dream. The same sort of rehearsal process can be used to improve learning or treat recurring nightmares.

Some of the rules inside of the dreams also apply. Most of us have woken from the “kick effect” of falling dreams. It doesn’t happen for most people but death can occur in the dreams of the elderly or terminally ill. Multilayered dreams can also occur outside of “Inception.”

The rest of the concepts of “Inception” fall well into the realm of psychobabble. It doesn’t take a clinical sleep specialist to know you can’t dive into someone else’s dreams and steal their secrets. But you can influence them by suggestion. A lifetime in dream limbo is also ridiculous, though it works well as a plot device within the film.

“Inception” is a wildly original movie in a summer movie sea of sequels and remakes. Go see “Inception” right away, or better yet see it twice. Don’t wait for it to come out on DVD.

Photo by Warner Bros. Pictures

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The Dream Team: Nolan’s “Inception” getting high praise

From the art house to the megaplex, we’ve seen countless attempts at recreating dreams for the big screen. Dream depictions date back to the beginning of film, and the success stories are limited. Most of the time dreams in film are hackneyed plot devices or lazy attempts at character development.

The few exceptions are artsy surrealist films. Luis Buñuel and Salvador Dali best portrayed the shocking incoherence of nightmares in the 1929 silent short “Un Chien Andalou.” David Lynch is the modern master of the tradition. His films like Mulholland Drive and Eraserhead paint dark, unsettling dreamscapes where the rules of the waking world don’t apply.

Reviews show “Inception”, opening at midnight Friday, appears to sets a new benchmark for movies about dreams. Accessible to audiences but impossible to describe on paper, it’s not your typical summer blockbuster.

Roger Ebert said it best when he wrote in his review “Here is a movie immune to spoilers: If you knew how it ended, that would tell you nothing unless you knew how it got there. And telling you how it got there would produce bafflement.”

Here’s what we know from the previews and press releases:

Leonardo DiCaprio leads a team of specialists who infiltrate people’s dreams to steal their secrets. He’s offered one last job as a chance at redemption. Instead of stealing an idea he has to plant one. Something of course goes wrong as the trailers and commercials are filled with images of the world bending and cities collapsing.



"Inception's" pedigree is unmatched on paper. Director Christopher Nolan is the man who reinvented Batman and set records with “The Dark Knight.” Oscar winners and rising stars fill out the large ensemble cast. Joseph Gordon-Levitt, Ellen Page and Michael Caine are just a few to name aside from DiCaprio.

The Rotten Tomato ranking, which averages all positive and negative reviews, is at a very respectable 87 percent. Mr. Ebert himself gave “Inception” four stars.

Look for a full review on the Sleep Education Blog in the coming days.

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Learning in your sleep, dreaming with a purpose

A new study is shedding light on one of sleeps biggest mysteries: why we dream. While it’s been known for some time that dreaming helps memory function, findings published Thursday in Current Biology indicate we continue to learn as we dream.

Subjects in the study spent an hour navigating navigated a complex 3D maze and then took a 90 minute break.

Half the volunteers napped during that period, while the others stayed awake.

When the break ended participants were asked to solve the same maze as quickly as possible.

Those who stayed awake the entire time had a drop in performance compared to previously. The nappers who did not dream only modestly improved.

The four people who reported dreaming about the maze turned in an impressive performance, completing it in half their previous time. Matched up against the group that didn’t nap, the dreamers’ scores were 10 times better.

Find out the details of their dream in this New York Times article.

CNN’s Dr. Sanjay Gupta explains the physiological processes of learning while dreaming in the video below.

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Treating REM Sleep Behavior Disorder: Best Practices

People with REM sleep behavior disorder act out vivid, action-packed dreams while remaining asleep. They may shout, punch, kick, run and even jump out a window.

RBD was first reported in the journal Sleep in 1986. Sixteen years later a follow-up report was published by the same research team.

Recently the AASM reviewed all of the current research and developed a best practice guide for the treatment of RBD. It was published last month in the Journal of Clinical Sleep Medicine.

The guide recommends two steps in the treatment of RBD. The first step is injury prevention. The second step is the ongoing use of medication to control the symptoms.

People with RBD often injure themselves or their bedpartner during sleep. So it is important to create a safe sleeping environment.

The bedpartner may need to sleep in another room. Other examples of how to modify the sleep environment include:

• Placing your mattress on the floor
• Using a sleeping bag
• Moving furniture away from the bed
• Adding soft padding to the corners of furniture
• Securing and blocking windows
• Removing weapons and sharp objects from the bedroom

These methods of injury prevention should be continued while taking medication. One drug that is suggested for the treatment of RBD is clonazepam.

A typical dose is 0.25 mg to 2.0 mg, taken 30 minutes before bedtime. But a dose as high as 4.0 mg has been reported.

There can be significant side effects when taking clonazepam. These may include morning sleepiness, confusion and memory problems. It should be used with caution in people with dementia.

Clonazepam also can increase the severity of obstructive sleep apnea. So it should be used with caution in people with OSA.

Melatonin also is suggested for the treatment of RBD. The effective dose may range from 3 mg to 12 mg at bedtime.

An advantage of melatonin is that there are few side effects. Dose-related side effects may include morning headache, morning sleepiness and hallucinations.

A variety of other medications may be useful in treating RBD. But the evidence is limited.

Treatment for RBD should be supervised by a board-certified sleep specialist. You can get help from a board-certified sleep specialist at an AASM-accredited sleep center near you.

Read more about REM sleep behavior disorder.

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Sleepwalking, Sleep Terrors & Dreams

A new study shows that episodes of sleepwalking and sleep terrors may be related to short, unpleasant, dreamlike mental activity. The study suggests that people with these sleep disorders may be acting out dreamlike thoughts. The results were published yesterday in the journal Sleep.

The French study involved 43 people with severe sleepwalking or sleep terrors. Their age ranged from 11 years to 72 years. They were compared with 25 healthy controls. Sleep was monitored during an overnight sleep study.

Participants also were interviewed. They were asked, “What was going through your mind at the very moment of the episodes, whenever the night?”

Thirty-eight people were able to reliably answer questions about their mental content during the sleepwalking and sleep terrors episodes. These recollections covered a lifetime span.

Results show that 71 percent of people reported at least one incident of dreamlike mental content associated with an episode of sleepwalking or sleep terrors. The action in the dreamlike thoughts corresponded with the observed behavior.

A total of 106 reports of dreamlike mental activity were collected. The mental content was brief; 95 percent of the reports involved a single visual scene.

These dreamlike thoughts were frequently unpleasant. About 84 percent involved apprehension, fear or terror; and 54 percent involved misfortune. In 24 percent of the reports the dreamer was the victim of aggression.

People with sleepwalking and sleep terrors reported more severe daytime sleepiness. They also had four times as many arousals from slow-wave sleep.

The authors noted that dreaming typically is associated with the sleep stage of rapid eye movement sleep. REM sleep dreams tend to be long, complex and vivid.

Complex mental activity has been reported in non-REM sleep during slow-wave sleep. But are these dreamlike thoughts really dreams? The authors reported that this question is still debated.

So what does this dreamlike mental activity represent? The authors suggested that it could be the final part of a longer dream. The rest of the dream may be forgotten after waking up. Or it could be a short mental creation that is formed before or just at the time of arousal.

Learn more about parasomnias such as sleepwalking and sleep terrors. Get tips for preventing parasomnias on SleepEducation.com. Compare the common features of four parasomnias.

Image by Xava du

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Acting Out Dreams: Fear and Laughing

A new study shows that healthy young adults are likely to report dream-enacting behaviors. The results were published today in the journal Sleep.

The Canadian study involved 1,140 first-year college students. About two-thirds of participants were women. They responded to different types of questions about dreaming.

One group answered questions that described specific types of dream-related behavior. Results show that 98 percent reported experiencing one of these behaviors at least “rarely” in the last year.

“Fear” was the most common behavior subtype. Ninety-three percent reported that they had felt signs of fear in their body after waking from a scary dream.

But not all dreams were frightening. Seventy-two percent reported smiling or laughing while waking from a happy dream.

Sexual arousal also was common. Seventy-eight percent reported that they had felt sexually aroused after waking from an erotic dream. This was more common in men than in women.

Each of the other behavior subtypes was reported by more than 50 percent of participants. They woke from a dream to find that they were talking, crying, punching or kicking, or making other motions such as waving or pointing.

Some of the behaviors were more common in women. They reported more fear, smiling and laughing, talking, and crying than men.

Lead author Tore Nielsen, PhD, noted that these were “normal” behaviors. They were unlike the extreme actions that occur when a person has REM sleep behavior disorder.

People with RBD act out vivid, action-packed dreams while remaining asleep. They may shout, punch, kick, run and even jump out a window. Injuries may occur to the dreamer or a bedpartner. Vigorous or violent episodes typically occur about once a week.

In contrast, the dream-related behaviors reported in the study were less intense. And they tended to be rare, occurring only once or twice a year.

“Normal episodes are usually extremely mild,” Nielsen told the AASM.

Read more blog posts about REM sleep behavior disorder. Learn more about dreaming.

Image by Krisztina Tordai

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NOVA Explores Dreams Tonight on PBS

The TV program NOVA will explore the world of dreams tonight. “What Are Dreams?” will premiere on your local PBS station.

Leading dream researchers will explain how they study the world of sleep and dreams. And they’ll attempt to answer some of the most intriguing questions about why we dream.

Do dreams improve memory? Do they enhance our creativity? Do they help us solve problems? Are they crucial to our survival?

The program also will focus on the sleep disorders that seem to bring dreams to life. Nightmare disorder. Sleepwalking. REM sleep behavior disorder.



You can watch a two-minute preview of the program online. You also can read a transcript of the program.

NOVA also accepted questions about sleep and dreams. Harvard sleep researcher Robert Stickgold, PhD, provided answers on the NOVA Web site.

Earlier this month the Sleep Education Blog reported that a researcher had proposed a “theory of protoconsciousness” to explain dreams. Studies also have provided some support for the “threat simulation theory.”

Learn more about dreaming and dream theories.

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Why Do We Dream?

A new paper suggests that the purpose of dreams may be more than just psychological.

Author Dr. J. Allan Hobson proposes a “theory of protoconsciousness.” He is a professor of psychiatry at Harvard Medical School.

Hobson writes that REM sleep provides “a virtual reality model of the world.” Most dreams occur during this sleep stage.

He thinks that dreams have a functional use. They allow the brain to get tuned up for wakefulness.

“It helps explain a lot of things, like why people forget so many dreams,” Hobson told the New York Times. “Dreams are tuning the mind for conscious awareness.”

This dream theory fits within his broader concept of the purpose of sleep. He summarized his perspective in the title of a 2005 paper: “Sleep is of the brain, by the brain and for the brain.”

Recently Hobson was the co-author of a study in the journal Sleep that investigated lucid dreaming. Results suggest that lucid dreaming is a “unique, hybrid state of sleep;” it involves features of both REM sleep and wakefulness.

In 2008 Hobson and colleagues explored similarities between the normal mental state of dreaming and the abnormal mental state of psychosis. They reported that normal dreaming and schizophrenic thinking share a common degree of “cognitive bizarreness.”

Other dream theories abound: Dreams depict your emotions. They reflect the issues and concerns of your life. They act as a defense mechanism by simulating waking threats.

Read more about interpreting dreams and why we sleep on the Sleep Education Blog. Learn more about dreams and nightmares on SleepEducation.com.

Image by Cornelia Kopp

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Changing Nightmares: Imagery Rehearsal Therapy

“Your Health” columnist Kim Painter reports in USA Today that imagery rehearsal therapy is helping some people change their nightmares.

This method is just one form of cognitive behavioral therapy. A variety of CBT techniques have been used to reduce nightmare frequency.

One method is to record your nightmares in a diary. Relaxation exercises also may be helpful. Exposure techniques involve “reliving” a nightmare in your imagination during the daytime.

Cognitive-restructuring techniques involve changing a nightmare. One technique is lucid dreaming treatment; you change the nightmare as it occurs during sleep.

Imagery rehearsal therapy involves changing the nightmare while awake; you “rehearse” the new version in your mind during the day.

The first step is to write down a recent nightmare. Then you change the nightmare. Usually you change it to a more positive version.

You write down this new version. Then you rehearse it in your mind daily; you imagine the imagery of the changed nightmare.

In 2008 a review in the Journal of Clinical Sleep Medicine noted that CBT has become the treatment of choice for nightmares. It reported that imagery rehearsal therapy and exposure are effective at reducing nightmares; the methods also reduce other sleep complaints and mental distress.

The authors noted that the drug prazosin also may be effective at reducing nightmares. But it appears that treatment requires ongoing use of the drug; nightmares may return after drug withdrawal.

One of the review’s co-authors was sleep specialist Dr. Barry Krakow. He is founder of the Maimonides International Nightmare Treatment Center in Albuquerque, N.M.

In 1992 Krakow and colleagues at the University of New Mexico published a study of imagery rehearsal therapy in the journal Sleep. They found that the therapy reduced nightmare frequency by 72 percent.

Nightmare rehearsal was first reported as an effective treatment option in a 1978 case study. The method was adapted into an imagery rehearsal technique at the University of New Mexico; the first case studies were reported in 1991.

In June the Sleep Education Blog reported that imagery rehearsal therapy also can be helpful for children with nightmares. Learn more about dreams and nightmares on SleepEducation.com. Get help for nightmare disorder at an AASM-accredited sleep center near you.

Image by Cornelia Kopp

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