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I awoke from a dream this morning in which actor Tom Selleck was my Trust advisor telling me to be careful about depositing money into my Trust account. He cautioned strongly that the State would find out about the deposit and confiscate all of my cash receipts from 2014. I awoke in a strange mood, wondering if I had done something illegal or unethical. I had not deposited any money into my Trust account recently. Where on earth did this dream come from? It came from the land of slumber.

Sleep is a pretty odd thing. From simple calculations, I realized that we spend about one third of our lives in the state of sleep. We just are not there. There was little known about sleep when I was in medical school some thirty years ago. Recent work shows that during periods of sleep, our brains are more active than when we are awake. But there are also periods of time when we dream, it seems that our brains make no sense at all. People have been known to talk and walk in their sleep, sometimes drool. And one of the great mysteries of all, nocturnal penile and clitoral erections that seem to come and go during the night. What's that about?

From what science reveals, sleep occurs in stages. We experience shallow sleep, deep sleep and REM (Rapid Eye Movement) sleep. We oscillate our sleep patterns. Shallow sleep is followed by deep sleep and then REM. These stages repeat about every ninety minutes or so. Without going into extreme detail, essentially deep sleep is restorative. The brain gets quiet. During REM sleep, there is an overall increase in brain activity. The parts of the brain that regulate muscle movement, breathing, heart rate, emotion get revved up. The same holds true for areas involving memory and sensory processing. At the same time, the metabolism of the area of the frontal cortex goes way down. This activity disinhibits the limbic system which allows us to have the most bizarre ideas. Bottom line, sleep can be exciting or terrifying. Without it we die.

I wonder about dreams. Dreams have captivated our lives in many ways. Dreams have become something to live for. All of us have heard the phrase, live for your dreams. But perhaps that idea, living for our dreams is a bit misplaced. People speak of dreams as if they were some sort of truth, or a revelation of a deeper meaning in life. I have heard patients tell me that they have dreamed about having sex with a neighbor down the street, someone to whom they are not even attracted. Then when they say "Hello" to that person from a chance encounter while taking an evening stroll, they want to ask them if they had the same experience. How weird it that? Some of us experience that same dream over and over again. I have one of those dreams.

I keep dreaming that I enrolled in college again. The name and place of the college is a mystery. I only attend half of my classes on a haphazard way. The rest of the time I am essentially goofing off in some form or fashion. Then I realize that final exams are coming and I have not attended half of my classes. I begin to study feverishly. In the end I panic and awaken. I realize it was just a dream. Then I go back to sleep, happy that I am not in college. I have come to realize that my happiness is not related to not being in college, it is more related to the fact that I did not screw off in college as my dream would suggest, nor would I undertake any knew educational challenge with a half-hearted approach. The dream is more disturbing to me than enjoyable. I cannot forget it.

There is no question that unrelenting stress will ultimately create sleep deprivation. As expected, sleep deprivation leads to the lack of problem solving capacity. The frontal cortex's metabolism shuts down as a result of a lack of sleep. Executive function disappears. Unfortunately our inability to make rational decisions in a time of stress just leads to more stress and more thought disturbances. What was so strange was when I was in medical school and residency, my mentors placed very little value on sleep. Our rotations were every other night call for years. We spent over a hundred and forty hours a week in the hospital caring for the infirm. We were lucky to get twenty four hours a week of sleep. Yes mistakes were made and often. I am sure people died because of those mistakes. Thank goodness the system has changed.

The problem now is that doctors who were interns or residents during my era of training deny sleep deprivation as a potential disease agitator. They themselves operate out of sleep deprivation all the time. These doctors over activate their own stress responses because of sleep disturbances and it is no wonder that they themselves experience cardiovascular disease, immune suppression, gastrointestinal disease and infertility problems. What is even more disheartening, because they themselves are ill, they believe the state if illness is normal. Therefore they deny the illnesses their patients manifest. To admit their patients are ill from their disturbed life styles is tantamount to admitting they themselves are unhealthy. And that self admission would seriously implode their huge towering ego that they have spent years and years to build.

People should see dreams for what they are: Mysterious and not necessarily profound. If you are dreaming, you are sleeping. That's good. I prefer people to live out their fantasies instead of their dreams, because their fantasies are created when they are awake and alert. I hope this New Year brings people lots of fantasies, prosperity, health and joy.

But most of all, I hope the New Year brings people the necessary sleep to live healthy, vibrant, productive lives.

Posted by Amanda Sanders at 8:48 AM
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