Sleep Talk: Episode 61 - Lucid Dreaming

Posted November 13, 2021

In Audio, Health Professionals, Podcast, Understanding Sleep

Episode 61: Lucid Dreaming

Lucid dreaming has come into popular culture in recent years and may provide a way of managing nightmares and distressing dreams in the future. What is lucid dreaming? Can people make themselves lucid dreams? What insights can be gained from lucid dreaming research? To understand all about lucid dreaming we spoke with Dr Benjamin Baird, a researcher specialising in the study of human cognition and consciousness using lucid dreaming.

Dr Moira Junge (Health Psychologist) and Dr David Cunnington (Sleep Physician) host the monthly podcast, Sleep Talk – Talking all things sleep.

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Audio Timeline / Chapters:

00:00 – 34:03 Theme – Lucid Dreaming
34:03 – 35:11 Clinical Tip
35:11 – 37:45 Pick of the Month
37:45 – 39:10 What’s Coming Up?

Next episode:

Perfectionism

Links mentioned in the podcast:

Presenters:

Guest interview:

Dr. Benjamin Baird is a research scientist specializing in the study of human cognition and consciousness. His work uses a range of behavioral and cognitive neuroscience methods, including theoretical and computational modeling of behavior, functional and structural magnetic resonance imaging (MRI), diffusion spectrum imaging (DSI), high-density electroencephalography (hdEEG), eye-tracking, sleep physiological recordings and transcranial magnetic stimulation (TMS). His areas of interest include internally generated thought and perception, such as mind-wandering and dreaming, the role of prefrontal and frontopolar cortical networks in high-level control functions such as metacognition, the neurophysiology and neurochemistry of cognition during sleep and the neurobiology of consciousness.

Regular hosts:

Dr Moira Junge is a health psychologist working in the sleep field, who has considerable experience working with people with sleeping difficulties in a multidisciplinary practice using a team-based approach. Moira is actively involved with the Australasian Sleep Association (ASA) and a board member of the Sleep Health Foundation. She has presented numerous workshops for psychologists and is involved with Monash University with teaching and supervision commitments. She is one of the founders and clinic directors at Yarraville Health Group which was established in 1998.

Connect with Moira on Twitter – @MoiraJunge

Dr David Cunnington is a sleep physician and director of Melbourne Sleep Disorders Centre, and co-founder and contributor to SleepHub. David trained in sleep medicine both in Australia and in the United States, at Harvard Medical School, and is an International Sleep Medicine Specialist, Diplomate Behavioral Sleep Medicine and Registered Polysomnographic Technologist. David’s clinical practice covers all areas of sleep medicine and he is actively involved in training health professionals in sleep.

Connect with David on Twitter – @DavidCunnington. David also regularly posts information on sleep to his Facebook page.

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Transcript:

Welcome to Sleep Talk, the podcast about all things sleep, brought to you by sleephub.com.au. Here are your hosts, Dr. David Cunnington and Dr. Moira Junge.

Dr. David Cunnington: So welcome to Episode 61 of Sleep Talk, the podcast talking all things sleep. And welcome again, Moira.

Dr. Moira Junge: Hi, Dave. Hi, everyone.

Dr. David Cunnington: So the theme for this podcast is Lucid Dreaming, and it’s something that’s really become into the popular realm with some movies around the concept of lucidity during dreaming, and on some of the Be a Better You life hacking sites. Its lucid dreaming will give you great insights. Is that something you’ve seen, Moira?

Dr. Moira Junge: Yeah, well, I must admit I don’t know, was I living under a rock? But I, until maybe 10 years ago, I don’t think I ever knew the term. Is it bad to admit? I’ve come across…

Dr. David Cunnington: Maybe just shows you didn’t take enough drugs when you were younger, Moira.

Dr. Moira Junge: Well, maybe it’s just more in my world as a sleep professional, it just didn’t come across my desk as talking. It’s more sort of people asking more outside of my work like about lucid dreaming. But I want… Is it the same with– I wonder if everyone else listening is the same? And as you know, the movies, it’s really… Inception, and it just becomes much more interesting to people, I think, and pop culture. But as we’re here, it’s certainly not pop culture with really high-level research I think at the moment.

Dr. David Cunnington: And that’s a really good point. So it’s not something that comes into our clinical practice. But this is really an area where, in some respects, the clinical and academic practices like medicine is almost disconnected from where the public is at around this. Because it’s something that’s quite interesting and quite at the forefront in the public realm, and people ask us in our social lives about dreaming and lucidity, but we don’t get asked in our practice.

So I’ve been trying to bridge this gap between the public realm of what is lucid dreaming and how to think about it, and some of the science. We spoke to Dr. Benjamin Baird, who’s a research scientist specializing in the study of human cognition and consciousness at the Center for Sleep and Consciousness at the University of Madison, Wisconsin

Thanks very much for joining us on the podcast, Ben.

Dr. Benjamin Baird: Great to be here.

Dr. David Cunnington: So how do you define lucid dreaming?

Dr. Benjamin Baird: Yeah, so lucid dreaming is… there have been different definitions that have been given. But overall, now, the consensus is that you are aware of the fact that you’re dreaming. So there’s broad consensus around that kind of minimalist definition, simply aware of the fact that you’re dreaming while you’re dreaming.

So if you’re aware that you’re dreaming, you’re lucid. Often, there are other aspects that come along with that awareness, such as the ability to control your actions in the dream, and interestingly, also episodic memory. So you seem to also regain your memory for your waking life, including intentions for things you wanted to do in the dream.

So there’s a kind of constellation of phenomenological features that seem to, generally, we found in our research come on together. But sometimes you can just have the awareness without those other features, and you would still be lucid according to what most people would say today.

Dr. David Cunnington: And like today, we think about it in a neuroscience sort of way, historically, has this been thought about in human civilization and cultures?

Dr. Benjamin Baird: Yeah, so that’s a big question. And there is a whole history of how lucid dreaming has been described in Western literature, and also in Eastern cultures has a very rich history really going all the way back to classical India. And you can trace it all the way back to several centuries before the Common Era.

In texts, it’s known as the Upanishads, in which lucid dreaming, the term itself wasn’t used. That came along much later. But there were descriptions of awareness and different kinds of experiences of sleep awareness already that early on. And that developed into a whole rich tradition in Tibetan Buddhism, which is often referred to as Dream Yoga, which is something of a misnomer today, and we think of yoga as the different postures that people do. But actually, it’s a whole set of meditative practices.

And lucid dreaming is kind of the platform, if you like, the first step, they called it apprehending the dream state. That was the terminology that came online. Oh, and you know, roughly the seventh century CE with writings from famous teachers such as Pablo and Sababa, and others. And so very clearly, very explicitly, they were talking about the same kind of thing that we mean today with lucid dreaming.

Of course, they didn’t use that exact term. That term didn’t really come on until the 18th, 19th century with writings from French and Dutch researchers, scientists, and writers, Saint Denys, and also Frederick van Eeden. And there’s some debate about exactly who came up with the term first. Actually, Saint Denys and his writings use the term, but he used it more to mean vivid dreams, and this was in the mid 1800s. And then it was a little bit later on, van Eeden really consolidated the term lucid dreaming to refer to what we mean today that explicit awareness of being in a dream while it’s happening.

And so you get these sprinklings of discussion of the topic here and there, but it’s fairly sparse. So there are a few writers in Europe around those around that time, here and there. You can trace it in the West, though all the way back to Aristotle, there’s interesting, in his treatise on dreams in which he mentions several times having some kind of knowledge that you’re dreaming while you’re dreaming.

So it’s fairly rudimentary, it’s not very well fleshed out, but he does at least mention it, traces really all the way back to the classical Greeks. And there’s a lot of work coming up in the last century where it’s really taken off, and then in the last, really, 40, 45 years or so with a scientific interest in the topic, really, I think, come more into the public imagination.

This is only very, very recently, so I think the situation was very different. We’re just, you know, you can think of it as some select communities, particularly monks, people doing intensive contemplative practice and Eastern cultures, but for really a select few. And in the West, just some sprinklings here and there among various writers and psychiatrists, and scientists, but not very well known at all.

And so it’s a very, very different situation today, where now we have films like Inception, and Waking Life, and it seems like everyone knows about the topic. You can read about it at the checkout stand and there’s lots of scientific publications. So it’s really kind of taken off, I’d say in the last 40 years or so.

Even at the beginning of the scientific study of lucid dreaming in the West, it was regarded with some skepticism. In the sleep science community, people weren’t sure what to make of it. It was quite novel. Philosophers were skeptical that you could be aware that you were dreaming while you’re dreaming, because how can you be aware and asleep at the same time? That seemed like very paradoxical.

The science really firmly objectively showed that this is possible in really interesting ways which we can get into. And I think that really shifted the dynamic around this topic.

Dr. Moira Junge: I was wanting to ask, have you personally become interested in lucid dreaming or this level of research into dreams?

Dr. Benjamin Baird: I wasn’t a natural lucid dreamer. So many people, now that we recruit for our studies, for example, they report that they’ve always had lucid dreams. Since they were very little, they, for one reason or another, are one of the things we’re researching, actually, they just have lucid dreams all the time. They’re aware of the fact that they’re dreaming routinely. Sometimes once a month or several times a week, but can be multiple times per night even.

There are some people that are just lucid all the time or have at least many of these experiences during childhood, and they become interested in that way. That wasn’t the case for me. I didn’t have my first lucid dream until university. And at that time, I was getting very interested in consciousness more generally.

And so I think that the general picture for me is I became very interested in consciousness. I got interested in studying consciousness, which I’m now doing from a scientific point of view. But during my years in university, I was up on the internet late one night reading about consciousness-related topics, and I stumbled across the Lucidity Institute website, which is the website of Dr. Steven Lubbers, who’s now a close collaborator and colleague.

Lucidity Institute is one of the major nonprofit organizations that have studied lucid dreaming long time. They had a whole FAQ about what lucid dreaming is and lots of information and resources. And it was the first time I’d ever heard of it. And again, kind of going back to what we were talking about earlier, even 20 years ago, I think the situation was very different. It wasn’t as talked about. We didn’t have these major blockbuster films, it wasn’t as much in the public imagination. So I’ve never heard of it at all, and it kind of frankly just blew my mind.

I had never considered that it could be possible that you could be aware in that way during dreaming sleep. And I was so shocked by that idea. And then I’d never thought about it that that night I had my very first one, my very first lucid dream after reading about it. And this is something that we do see now that it… people hear about it for the first time. It’s so salient in their mind that they have their first experience of lucid dreaming after hearing about it.

So, that is a common thing, relatively common. But after I had my first one, it was just off to the races because it was so interesting. It just felt like this whole other continent, this whole other domain that was ripe for exploration, and really wasn’t being talked about wasn’t really being studied very much, and so just really captured my imagination.

And I went off and tried to find a way to do research on this topic. At the time, there wasn’t anyone in the United States who was doing mainstream academic work on the topic within science. And so I studied topics that were closely related, I tried to build up a skill set in psychology and neuroscience so that I could work on this. I worked on topics that I was also interested in, such as mind-wandering, like kind of daydreaming, things like meditation, and metacognition, various aspects of human cognition that I think have interesting connections with this, and also my broad interest in consciousness.

I have finally found a way to study it. And I’m now, and over the last seven years, that’s really been my focus, focus of my research. I’m now at the University of Wisconsin, Madison. And it’s a fantastic institute here, which I’m very proud to be a part of, which is the Center For Sleep and Consciousness at UW Madison

Dr. David Cunnington: One of the things I was curious about is when you’re doing this research, how can you tell if someone’s actually lucid dreaming at the time? You know, if you’re taking some measures, what sleep versus lucid dreaming sleep, and how do you pick those?

Dr. Benjamin Baird: Yeah, it’s a great question. This is such a fascinating topic. Because as I mentioned, it really shifted the thinking around lucid dreaming 40 years ago, because, again, there were some… people who were skeptical. And sleep scientists and philosophers were going, “Hey, how can this be possible? How can you be aware, and that sleep doesn’t make any sense?”

And along comes a young researcher, Dr. Stephen LaBerge. He was at Stanford at the time working in one of the major sleep laboratories in the US, William Dement’s lab at Stanford, and they’ve been doing a lot of work on dreaming and eye movements. And so they found that quite often, there’s a very close correlation. They would wake people up and say, just now what were you dreaming about, and they would look at the pattern of eye movements that was happening before they woke people up.

And often, they found this really interesting connection. And so dramatic example was that they had a participant in the sleep lab, and you can see on the electrooculogram, the measurement of the eye movements that the participant looked left, right, left, right, left, right about 12 times in a row and back and forth like that. They woke the person up and said just now what were you dreaming about. And he said he was standing on the side of a ping-pong table, watching a long volley of the ping-pong ball going back and forth, back and forth.

And so from this and many other kinds of examples like this, that gave Stephen LaBerge the idea to say, hey, wait a minute. The physical rotations of the eyes are correlated with where the dreamer is looking in the dream and the gaze direction within the dream. And he thought to himself, “Huh! Well, if I’m lucid, I can look in a specific pattern, looking at a specific direction within the dream, which will result in a specific pattern of eye movements. And the experimenter and I, before I go to sleep, can agree upon whatever pattern that might be. So it can be, tonight, we want you to look left, right, left, right, up, down, left, right in a very distinct pattern like that.

And so, while the participant is being monitored with the EEG, electroencephalogram, measuring the brainwave activity, as well as what we call polysomnography, all the different physiological channels, which are used to determine that the participant is currently in a specific stage of sleep. So eye movements, the chin myelogram, which drops very flat. There’s this characteristic atonia in certain stages of sleep.

All of this is used to definitively show this person is asleep, and they’re in such a stage of sleep. What they found was that the participants were able to make these objective eye movement signals, which showed up on the polysomnography while they were objectively asleep, and they were making these objective markers. So we could see that they were fully asleep, no question about it. And we can see that they’re making these eye movement signals while they’re asleep. And so that provided objective evidence that people could be aware and able to communicate the fact that they were aware in real-time to an external observer.

And so this has really taken off, and it’s now the gold standard, which is being used in laboratories all over the world to not only scientifically, objectively validate that people become lucid in the dream. But this whole technique of the eye signaling can also be used to timestamp if you like the beginning and end of experimental tasks as well. So people can give an eye movement signal and say, “OK, I’m aware I’m in a dream now. This is me marking my onset of becoming lucid.”

And then they can also go on to make an eye movement signal to say, “I’m starting to ask you wanted me to try in the dream.” And one of the things that were done just as a quick example, was having people count to 10. So, you know, in Inception, for example, there’s this whole notion that, you know, you can live a whole lifetime within an hour of waking time, so to speak. And so is there some kind of psychological time dilation in dreams?

And so they address this question at Stanford, and they have people estimate 10 seconds. You can make an eye movement, count to 10, then make another eye movement. In fact, it lines up identically, if you have people do that same task while awake. So sorry, Inception, time deletion turns out to be wrong. But no one has yet looked at the dream within a dream. So that’s still an open question be like.

Dr. Moira Junge: So are there any characteristics of people who are able to be more prone to be able to do this better than others?

Dr. Benjamin Baird: There has been a lot of research to try to determine to look at different kinds of personality or psychological dimensions that may differ between so-called frequent lucid dreamers, people that had, seemed to have lucid dreams all the time versus people that have lucid dreams rarely or never. And overall, I think the findings are pretty mixed. So I don’t have really, something really solid to say that, yes, this kind of personality characteristic within the, one of the most well known measurements of personality.

For example, psychology is the big five. And one of those dimensions is openness to experience. That seems to be one that’s replicated quite a few times is that individuals who have frequent lucid dreams seem to be higher on trait openness. I’d like to see more replication and more research on that topic. It’s a very interesting one.

We’ve done some work looking at the physiology, and so the question is, it’s really an interesting question, of course, that arises, say, we know that there are these people that have lucid dreams, as I noted earlier, sometimes every night, and they’re not even training to have lucid dreams. They just have them all the time. And the question is, what’s different about these people?

And so in a recent study, we wanted to ask, are there any differences in the structure of the brain in these so-called frequent lucid dreamers? And we tested these very high frequent lucid dreamers, so people that were having them on the order of every other night, every night, and we didn’t actually find any differences in brain structure between the groups.

We did find some differences in brain connectivity between certain areas and particular areas of the prefrontal cortex with areas of the lateral parietal cortex. And so this prefrontal lateral parietal connection might be important. So there could be some intrinsic differences, in other words in the connectivity of the brains of frequent lucid dreamers that may give them a proclivity to have lucid dreams.

I think that’s plausibly part of the story. So there probably are personality differences there, there probably are some intrinsic differences in physiology particularly in the brain. There could be differences in brain chemistry, although no one’s looked at that quite yet. It’s plausible, there are also differences in characteristics during sleep.

One hypothesis is that there may be more arousal and more signs of physiological arousal in some individuals who have lucid dreams frequently. But I don’t think that’s true for all of them. If you look at the population as a whole, roughly 50% of people have never had a lucid dream in their entire lifetime. And then another significant chunk of that pie is people that have had lucid dreams just a few times. So maybe once or a couple of times.

And so, and then yet we have this group of people that are having them almost every night spontaneously. And so it’s a really interesting question for future research to try to understand the characteristics of those individuals.

Dr. David Cunnington: So how do you change somebody? Or can we change somebody from a maybe never or occasional lucid dreamer into a skilled lucid dreamer? Because we, in a clinical sense, think there’d be some really helpful applications for that. Can you change them?

Dr. Benjamin Baird: Yeah, absolutely. And I guess one thing I should emphasize here is that there are these two groups, there are two buckets. One is people who have lucid dreams naturally, which some people say or spontaneously without doing any kind of training, they have lucid dreams all the time. Another group is people who have lucid dreams more frequently because they’ve trained to have them.

And so the question is, how do you do that effectively? One of the first techniques that was developed was called the mnemonic induction of lucid dreams, or mild, which was again developed by Stephen LaBerge, in that early period of research on the topic. And what was found was that if you could set your prospective memory. That is your memory to do something in the future, this is the same kind of memory you use if say, when leaving work today, I want to remember to pick up milk on the way home.” I’d say to myself, “Well, on the drive home tonight, I want to remember to stop at the store to pick up milk.”

And he was able to do some training and found that by doing those kinds of exercises with setting your intentions, setting your prospective memory, people could increase the frequency of lucid dreams they had. But most people find that these kinds of purely cognitive techniques, they can increase the frequency of lucid dreams, but by themselves, some people have limited capacity to really boost it up to the level that they would like.

And so there are a whole lot of other techniques and technologies, which have been explored over the years. One of the kinds of cool ones are sleep gadgets and the sleep masks, which are essentially like a regular sleep mask, except it has LEDs, often three LEDs on each side, and a computer chip embedded in the mask.

So it detects when you’re in REM, rapid eye movement sleep or REM sleep, which is the stage of sleep in which most dreaming occurs. And if it detects you’re in REM sleep, it’ll then flash those LEDs over your closed eyes while you’re asleep. And we’re currently doing some more research on this. But we found, what we find often is that the flashing lights become incorporated into the ongoing dream. So you have a dream of flashing lights.

I was fortunate enough to try this at a retreat in Hawaii on lucid dreaming. You got to use this mask for a couple of nights during the testing phase of research. And just as an example, I had one during which I was stuck in traffic, and the two brake lights in front of me were flashing red.

Another example, I was in Las Vegas, and I was playing the slot machines and all the lights were flashing, flashing, flashing, and neither time did I recognize the cue. But this is the idea, it’s a consistent mnemonic cue or a memory cue. You can use those techniques for the prospect of memory to say, hey, next time I see those flashing lights, that’s my reminder.

And I trained with this. I use it just for a couple of nights. But if you can imagine if you’re, if you have a sleep mask like this, and you’re using it consistently for a period of months or even years, you can train yourself, and train your brain to get very good at recognizing that cue. After a while, it just becomes like just so easy. Like, “Oh, there’s the flashing lights, I’m dreaming.” And so you can use that technique.

There have been several studies trying to induce lucid dreaming which is basically just kind of flip a switch and make people lucid by altering what’s happening in the brain. And a couple of studies in the last five years or so have looked at different methods of non-invasive electrical stimulation of the brain. And unfortunately, it’s coming more and more clear that those techniques currently just aren’t very effective. But that doesn’t mean that they won’t be in the future. And I think it is an interesting direction for future research.

And yet another approach that’s been taken in our recent research is pharmacology. And so there are substances, which can alter the chemistry of the brain during, particularly, during REM sleep, which make lucid dreaming much more likely.

Another technique is called sleep interruption. It’s now called, wake back to bed. You wake up about an hour and a half before you normally would, stay awake for 30 minutes, and go back to sleep, and that also ramps up your chances of having a lucid dream in the second part of your sleep.

And so we combined the cognitive techniques with the wake back to bed with the pharmacological intervention in a double-blind placebo-controlled study with a large number of people, and we found a huge effect of the pharmacological agent, which is Galantamine. And it’s an acetylcholinesterase inhibitor, which means that it’s getting rid of the enzyme, which gets rid of acetylcholine.

And so it’s a double negative. It actually increases or the net effect is that it increases the amount of acetylcholine during REM sleep, which is the main neurotransmitter in REM sleep. And so it’s ramping up brain activation during REM sleep. The precise mechanisms about how it works and so on, or if the effect even is cholinergically mediated are a little uncertain. Right now, we need more work to understand really how it’s working. But we know it has a very large effect on lucid dreaming.

And so putting all those techniques together of the cognitive techniques with waking back to bed with Galantamine, we were able to get people to have a lucid dream approximately 40% of the time in that last segment of sleep after returning to sleep. And this was in a sample of people, some of which had never had lucid dreams in their entire lifetime before. And so 40% is a huge number.

Dr. David Cunnington: At a clinical level, we can really understand how lucid dreaming might help people we see with nightmares, recurring distressing dreams, the area we don’t work in is sort of consciousness and consciousness research. So what does lucid dreaming tell you about that area or insight into consciousness?

Dr. Benjamin Baird: Yeah, it’s a great question. So, I mean, I think this is one of the overlooked topics. People don’t quite understand how useful lucid dreaming is within this context. Because what lucid dreaming essentially gives us is experimental control over the dream state. In ordinary dreams, you’re just at the whim and mercy of whatever happens.

So if you want to study faces during sleep, you have to sit around and measure lots and lots, and lots of dreams. Of course, faces are fairly common. So that’s not a great example, most people, you’ll have a dream of a face. But for lots of research questions, you have to collect huge amounts of data and just hope that the content of interest appears by chance, spontaneously in whatever people are dreaming about.

Whereas with lucid dreaming, as I noted earlier, you can actually have participants conduct experimental tasks in the dream state. They can invoke specific types of perceptual content. It’s like you want to study faces, and face perception. You can have lucid dreamers specifically bring up a face and even timestamp, the start and end of seeing a face with those eye movement signals.

What it allows from the physiological perspective are these– using this eye signaling approach are these very precise markers in the physiological record with specific types of psychological content. And that’s been one of the major challenges of dream science.

Now, going back decades is this tricky task of you wake people up in a sleep laboratory, and you get a dream report about what they’re experiencing before they woke up. But then how do you line that up with the physiology beforehand? It’s actually very, very tricky. The eye signaling method with lucid dreaming is a very powerful approach for lining up the physiology with the psychology, and then also the ability to do experimental tasks.

Just to give you one example. A couple of years ago, we published a big paper in Nature Communications, in which we looked at smooth pursuit eye movements across waking imagination, and REM sleep dreaming. And this experiment was only possible to do with lucid dreamers. There’s no way to do the experiment any other way.

And this goes into this large philosophical question about the nature of the imagery that we experience in dreams. It’s been debated for millennia, really. Is the nature of the imagery of dreams more like imagination, or is it more like perception? And we were able to actually gather some objective data on this by having people trace the tip of their thumb.

So they kept their eyes locked on the tip of their thumb, again, during ordinary waking perception, and they traced a circle very slowly. Again, keep the eyes always locked on the thumb. They did the same thing during trying to imagine that movement while awake. And they did the same thing in a lucid dream.

Again, they’re tracing the tip of their dream thumb within the dream. And what we discovered was that the eyes move in a smooth, sustained pursuit. We call it smooth pursuit, in both dreaming and waking perception, but not in imagination. And so it really suggests that the nature of the imagery of dreams is much more like waking perception than it is imagination.

So this is just one example of the kinds of experimental tasks people can do, the kinds of questions you can pose within the neurosciences and psychology that are impossible any other way.

Dr. Moira Junge: So Ben, I’m just, I’m really curious about lucid dreaming and your thoughts on how it can help the kind of clients that we see this quite traumatic dreams. They’ve got very debilitating traumatic nightmares. And often we might talk to them about using a technique called imagery rehearsal therapy, in which we asked them to practice certain imagery while they’re awake to be able to change the ending of the dream during sleep. What are your thoughts on all your studies and all your noise? What are your thoughts on the actual case or clinical applications?

Dr. Benjamin Baird: I think we need a lot more research to understand what the potentials and impossible limitations are. But I think the largest clinical application is likely to be for the treatment of chronic idiopathic nightmares.

In the United States, for example, it’s a huge problem. I mean, it’s… I think over between somewhere between 5% and 10% of the American adult population suffers from nightmare disorder of one kind or another, and we’re not sure why. Lucid dreaming has been often discussed for treatment of nightmares. But I think the real potential is often overlooked.

So one of the things that you’ll hear often is that lucid dreams can be used to terminate the dream. So if you’re dreaming, if you’re having a scary or frightening dream, you can just, “Oh, I know it’s a dream. I’m out of here,” kind of thing. But I think the real potential of lucid dreaming comes in a therapeutic context where you can actually work with the psychological material in the context of working with a professional therapist.

You can actually work with the imagery like you were mentioning, you can work with the content in real time, and the experience of lucid dreaming is as if it’s really happening. Dreams are so vivid, it’s as if you’re really having that experience. And so it can be an extremely powerful platform for working through certain scenarios for working with content for addressing characters. People that may be representations of real people in the real world in your real life, possibly people that have done some psychological harm to you, a number of people who have worked with lucid dreaming and they’ve been able to cure themselves of having nightmares.

So this is purely anecdotal at this point. There have been several small controlled trials, though, that have shown some preliminary effectiveness. But we really do need a lot more rigorous large-scale research to see how effective this is going to be.

Dr. Moira Junge: Oh, Ben, thank you so much for joining us on the podcast today. It’s been fascinating. We could actually talk for another… long time, three. I’m sure you are just getting started. So yeah, I just wanted to say thanks very much for all that wonderful… Well, hopefully, we’d get you back one day to talk further.

Dr. Benjamin Baird: That’d be great. Thank you so much for having me. It’s great to be here.

Dr. David Cunnington: So that was really great, Moira. What were some of your reflections after interviewing Ben?

Dr. Moira Junge: Oh, it was great, wasn’t it? Yeah, I didn’t want to finish that. He had to keep it as brief as he could. My take out, my reflections were that the interesting area, very niche area and exciting, there’s certainly a lot more work that they’re going to be doing for sure across the coming years and decades.

In my clinical work, after so many years now talking to people that this sleep, like coming to see me as a clinician with their sleep problems, and I’ve realized that I’ve only ever seen people who are having problems with their dreams in a negative sense. But they’ve been distressed by and hyperarousal traumatizers. It was just, it’s really interesting to say this other body of work that may not… if not around necessarily, you know, clinical distressing syndromes. So that was sort of an eye-opener for me. What about you?

Dr. David Cunnington: It’s really reinforced for me how little we really know about dreaming, the function of dreaming, consciousness, what is awake, what is sleep, and what are these states that have some features of each in between? And so you’re really interesting to hear how Ben is looking at using lucid dreaming for example trying to tease out and answer some of those questions. So yeah, a really fascinating area of work.

So if you’re ever looking for some more information, I can highly recommend Ben’s paper, The Cognitive Neuroscience of Lucid Dreaming and that was in Neuroscience Bio Behavioral Reviews in 2019. It’s actually open access, so free to read and a really good and well-researched, well-referenced paper. I’ll come back to… You know, I’m a big fan of J. Allan Hobson and his work, and on dreaming and Consciousness. In one of his books. The Dream Drugstore really explores this as well, looking at the effect actually of drugs on consciousness and the dream state, and what we can learn from that.

Dr. Moira Junge: I think we talked about him before. Have we mentioned him, his book before?

Dr. David Cunnington: I have this more coming.

Dr. Moira Junge: What’s the clinical tip for this episode, Dave?

Dr. David Cunnington: So reflecting on what Ben said, I think one of the things we didn’t quite explore was the effect of state characteristics on dreaming, and potentially on the lucidity of dreaming. On a personal level, I know I’m a bit more lucid in dreams if I’m a bit more stressed, or if I’ve traveled across time zones when we used to travel if I had jetlag.

Dr. Moira Junge: It’s true.

Dr. David Cunnington: And so in our clinical practice, we’ll often see if people get a change in dreams. It means something to us. So dreams become more vivid, become more distressing. And you can often track that with background distress or background sort of sympathetic nervous system activation. And there is that relationship between where someone sitting at a stress level and how vivid or distressing dreams can be

Dr. Moira Junge: As in the… it’s all around the world at the moment, you know, the COVID, so-called COVID dreaming.

Dr. David Cunnington: Yeah, absolutely. So that’s at a clinical level. Think of it as someone describing a change in dreams. It kind of reflects a change in circumstances and a change in physiology. It’s often the clue if someone’s saying to me “My dreams have changed.” I’m going, OK, what else is going on?

So Moira, what’s your pick of the month?

Dr. Moira Junge: My pick of the month is a paper that’s just been published, just September of 2021 in the Annals of Physical and Rehabilitation Medicine, and it’s with Jennie Ponsford’s group and PhD student, Lucy Emer. CBT versus health education for sleep disturbance and fatigue, and people having, had a stroke or some kind of acquired brain injury.

So it’s really wonderful piece of work that’s been… I highly recommend it. We’ll put it in the show notes. But it’s an eight-week treatment program of CBT. And it’s not CBTI, it’s CBT for… we call it CBT for sleep disturbance and fatigue, so CBTSF, looked at how just basic health education intervention as well.

And of course, the CBT was just good to see. It’s over and above basic health education was far more beneficial, and it was really improved quality of life, quality, and self-efficacy, increased confidence, learning how to pace themselves better, and therefore just manage their fatigue, get better sleep quality.

So I think people be really interested in reading that. And for our listeners who may not really think about it, it’s something we need to think about greatly around the post head injury, that fatigue and sleep are very, very big problems, and that we do, we need to be mindful of. What’s your pick?

Dr. David Cunnington: So coming back to J. Allan actually. And the reason to talk about him is Allan actually died in July at the age of 88 and had an obituary in the New York Times, which really tells you about how influential he’s been in the research area. And I learned a lot from him during my time in Boston. It was really a privilege to be able to be in small groups and learn from him.

And one of the things I liked about him is he challenged dogma in the psychiatry world. He was one of the sorts of main people challenging Freud’s dogma about dreams, and really boiling dreams down into a much more neuroscientific way of thinking about them, rather than dreams having meaning in that Freudian sort of way.

I really liked his book. He wrote a book a bit about his own personal sort of research journey called, Dream Life amongst these many other books around dreams. So I can highly recommend any of the books by J. Allan Hobson, and a tribute, given that he’s recently passed away.

Dr. Moira Junge: What else is coming up? What should we be looking out for in future episodes?

Dr. David Cunnington: So one of the things I want to have another episode and talk about is fatigue. We’ve already talked about chronic fatigue syndrome. But I want to talk about some of the biological mechanisms underpinning fatigue and where the research is going in that area.

There’s been a really great workshop put together as a collaboration between the Sleep Research Society and the NIH Neuroscience Program with a two-day program focusing on the biology of fatigue and trying to set research agendas going forward. And I participated in that workshop and will really try and bring some of that together to discuss some of that.

Dr. Moira Junge: Oh, great! So thanks so much for listening. Please send us any suggestions at podcasts@sleephub.com.au. We love to feature early career researchers and help people hear about their work.

Dr. David Cunnington: And if you like the podcast, review us on iTunes, subscribe, and tell your friends and work colleagues about the podcast. Thanks a lot!

This podcast is not intended as a substitute for your own independent health professional’s advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider within your country or place of residency with any questions you may have regarding a medical condition.

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Dr David Cunnington

Dr. David Cunnington is a specialist sleep physician delivering quality healthcare to clients with complex sleep problems and promoting sleep health through education, research and advocacy.