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A Doctor’s View

Following disease into our dreams

Anthony Russo for The Boston Globe

There are places doctors can go where they couldn’t go before.

In less than a day, a human being can have his DNA entirely sequenced. Colonoscopies collect bacterial samples from deep within the gut. Tiny monitors on the skin upload heart rate and body temperature data to a smartphone. Modern medicine is hunting for telltale signs of health and disease in every piece of data the human body generates.

Some of this is sure to be important, but can’t we hide a part of ourselves away from the light of examination? Isn’t it possible that our body and mind generate ethers and currents that are immeasurable?

I should hope that the dreams we have at night — at least — would remain beyond the grasp of the big data revolution.

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But no.

If the observation of dreams has been historically padlocked, modern methodologies are giving us a new set of keys to peer inside the sleeping brain. Earlier this year, the journal Science reported that a team from Japan was able to guess what people were seeing in their dreams after putting the sleeping subjects through an MRI machine.

And websites make online dream-sharing potentially useful for researchers by collecting dream narratives — anonymously — and making them accessible to the curious. Some online dream communities, such as Dreamboard, store more than 200,000 dreams.

Three Bostonians, including MIT alumnus Doug Feigelson, developed a program for smartphones called Sigmund that whispers words into your ear during the time of night you are most susceptible to dreaming. “It’s worked on me numerous times,” he said.

“It’s the kind of thing you’ve probably experienced naturally when you’re falling asleep while people around you are talking, and you start dreaming about their conversation,” Feigelson said.

Because dream content is becoming more widely shared, people are curious about whether there are clues buried within that hold information about our health. The answer to that question is “Yes” according to Patrick McNamara, PhD, a neuroscientist at the Boston University School of Medicine.

“The content of dreams, especially among older adults, can serve as a warning sign for the onset of certain diseases,” McNamara said.

For instance, people who go on to develop Parkinson’s disease and other dementias may physically act out their dreams during sleep, years before they develop the illness.

“Some kinds of dementias result in dreams where the dreamer is being attacked by an intruder, and they struggle to protect themselves and their bed partner,” said McNamara.

Early morning heart attacks may be triggered by high blood pressures and heart rates that accompany the stage of sleep most associated with dreaming. Running from an enemy in a dream is a bit like putting the heart through a stress test.

Consequently, McNamara said that it wouldn’t hurt for doctors to ask patients about their dreaming habits. Although the practice of dream-telling might be unusual in Western medicine, it is routinely used in Eastern medical systems to assess the mental status of the patient. “Dreams are faithful reports of a patient’s emotional life,” said McNamara.

“They aren’t just fluff, but have a function in the mental economy,” he said. “If you work with them, they can yield insights about the self.”

After the terrorist attacks of Sept. 11, 2001, Hartmann (who passed away last year) and his colleague Tyler Brezler discovered that people tended to dream more intensely than before the terrorist attacks. In other words, dreams, the exhalations of our sleeping brains, can contain signatures of trauma that we’ve experienced during waking life. And in the case of post-traumatic stress disorder, dreams may replay the trauma, keeping the memory of the initial event terribly alive.

Dreams or nightmares themselves can also plant the seeds of depression or fear. Soldiers who returned from the Gulf War who were taking the dream-triggering malaria drug, mefloquine, described traumatic nightmares that were so vivid the fear elicited by their dreams carried over when they woke up.

But McNamara said you can also train your brain to dream happily: “A few studies show that if you can learn to dream pleasantly, you can regulate your mood the next day.”

If happiness and trauma are embedded in the fabric of our dreams, sharing them may lead investigators like McNamara to link the clues contained within the dreams to how we live during waking hours.

For example, some have previously suggested that physical symptoms — such as chest pain — are first noted in a dream, before they are experienced in real life. “We’ve never really had any statistical power to test that claim,” said McNamara. “These big databases will revolutionize dream studies and really demonstrate the clinical relevance of dreams.”

The day is closer when we may know how dream content may correlate with a person’s risk for a heart attack, depression, or dementia.

For now, in my own practice, I occasionally ask patients about their dreaming behavior. While their answers alone won’t drive me to make any clinical decisions, they are a part of understanding the person holistically.

But even as study of dreams advances, they will remain an intensely subjective experience. Dreams are, to me, a kind of wellspring of individual reflection and inspiration. To better understand them myself, I recently decided to keep a dream journal — something McNamara suggests.

I set a new notebook on my night stand and went off to bed. The next morning, even before I opened the notebook, the faint tendrils of my dream slipped from my mind.

“Dream recall is tricky,” McNamara says. “But you’ll get better the more you try it.”

So I tried again.

The next time, the dream came to me in vibrant watercolor. I was walking along the ocean, I wrote, feeling a bit self-conscious. And . . . you know what?

I’d rather keep it to myself.

What does the world want with my dreams anyhow?

Dr. Sushrut Jangi of Beth Israel Deaconess Medical Center can be reached at sushrut.jangi@gmail.com.
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