michael schredl

RESEARCHING
DREAMS
The Fundamentals
Researching Dreams
 Michael Schredl

Researching Dreams
The Fundamentals
Michael Schredl
Central Institute of Mental Health
Mannheim, Germany

ISBN 978-3-319-95452-3    ISBN 978-3-319-95453-0 (eBook)

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 Preface

Dreams have always fascinated mankind, for example, Joseph interpreting

the Pharaoh’s dreams of the seven fat and seven gaunt cows (theme was
replicated with heads of grain) correctly and, thus, preventing a major
famine (Genesis 41), the Oneirocritica of Artemidorus of Daldis (the fore-
runner of dream symbol books) or the Tibetan Dream Yoga (one of the
first lucid dream induction techniques). Dreams have played a pivotal role
in many cultures, for example, Muhammad receiving the revelation of his
divine mission in a dream, the mother of the Buddha having a prognostic
dream about her son, and shamanic dreaming for healing purposes in
indigenous cultures.
In modern times, the influential book Die Traumdeutung (The
Interpretation of Dreams) of Sigmund Freud published in 1899 helped
shape the view about dreaming as Freud used dream interpretation as a
tool within the psychotherapeutic process. The next milestone was the
discovery of REM sleep by Eugene Aserinsky and Nathaniel Kleitman
published in 1953; awakenings from REM sleep carried out in the sleep
laboratory very often yielded a clear, detailed dream report. Another land-
mark was the book The Content Analysis of Dreams by Calvin S. Hall and
Robert L. Van de Castle published in 1966; this book included an impor-
tant method to analyze dream in a scientific fashion (dream content analy-
sis) and dream data of 200 “normal” students. Since then, dream research
has compiled an abundance of empirical data—even though many ques-
tions about dreaming, for example, the function(s) of dreaming, are still
unanswered.

v
vi PREFACE

The purpose of the book is twofold. First, the methods of how to study
dreams are presented. Even though dreams are very private and could only
be elicited after awakening the sleeper, systematic ways to analyze these
dream reports have been developed. Like any other scientific method
there are pros and cons of this approach but understanding possible short-
comings is helpful for carrying out meaningful research projects. The sec-
ond aim of the book is to present a comprehensive introduction into the
research findings obtained so far, for example, factors of dream recall, the
continuity hypothesis of dreaming, the relationship between physiology
and dream content, etiology and therapy of nightmares, and lucid dream-
ing. The results of these studies show that studying dreams is as fascinating
as dreams themselves. The main goal of the book is achieved if the reader
is fully motivated to do dream research understanding that by using the
proper methods it can be done.

Mannheim, Germany Michael Schredl

 Contents

1 Definitions   1
References   7

2 Dream Recall  11
2.1 Introduction 11
2.2 Models of Dream Recall 12
2.3 Measuring Dream Recall Frequency 14
2.4 Dream Recall Frequency: Age and Gender Effects 17
2.5 Trait Factors Affecting Dream Recall Frequency 19
2.6 State Factors Affecting Dream Recall Frequency 22
2.7 An Integrative Model of Dream Recall 26
References  28

3 Dream Content Analysis  35

3.1 Basics 35
3.2 Collecting Dream Reports 36
3.3 Basic Steps of Dream Content Analysis 40
3.4 Scales for Dream Content Analysis 42
3.5 Dream Manuals 46
3.6 Quality Criteria: Reliability and Validity 49
3.7 Statistical Analyses in Dream Content Analytic Studies 53
3.8 Interpreting the Findings of Dream Content Analytic
Studies 55
References  58

vii
viii Contents

4 Dream Behavior and Dream Content in Healthy Persons  65

4.1 Dream-Related Behaviors 65
4.2 General Features of Dreams 67
4.3 Waking Life and Dreaming: The Continuity Hypothesis 71
4.4 Paradigms for Studying the Continuity Between Waking
and Dreaming 73
4.5 Factors Related to the Continuity Between Waking
and Dreaming 78
4.5.1 Time Course 78
4.5.2 Emotional Valence and Intensity of the Waking-Life
Experience 79
4.5.3 Type of Waking-Life Experience 81
4.5.4 Types of Continuity and Implications for Possible
Functions of Dreaming 82
4.6 Effects of External Stimuli on Dream Content 85
4.7 Gender Differences in Dreaming 89
References  92

5 Dream Content and Physiology 105

5.1 Dream Time and REM Sleep Duration106
5.2 Dream Content and Eye Movements109
5.3 Dream Content and the Electromyogram (EMG)111
5.4 Dream Content and Autonomic Parameters113
5.5 Dream Content and Brain Activation115
References 118

6 Dreams and Mental Disorders 123

6.1 Introduction123
6.2 Methodological Considerations124
6.3 Depression126
6.4 Schizophrenia128
6.5 Eating Disorders129
6.6 Dreaming and Sleep Disorders131
6.6.1 Insomnia132
6.6.2 Sleep Apnea Syndrome133
6.6.3 Narcolepsy135
6.6.4 REM Sleep Behavior Disorder (RBD)137
References 139
 Contents 
   ix

7 Nightmares 147
7.1 Definitions147
7.2 Other Nocturnal Phenomena Associated with Negative
Emotions148
7.3 Nightmares and Sleep Quality149
7.4 Nightmare Frequency149
7.5 Nightmare Content151
7.6 Factors Affecting Nightmare Frequency152
7.7 Therapy154
References 157

8 Lucid Dreaming 163
8.1 Definitions163
8.2 Frequency of Lucid Dreaming and Its Correlates164
8.3 Lucid Dreaming Induction165
8.4 Content of Lucid Dreams167
8.5 Lucid Dreaming in the Laboratory167
8.6 Applications of Lucid Dreaming169
References 170

9 Functions of Dreaming 175
References 179

References 183

Index 223
 List of Tables

Table 2.1 Models of dream recall 12

Table 2.2 Rating scale measuring dream recall frequency (DRF) (Schredl
2004a)15
Table 2.3 Gender differences in dream recall—a meta-analysis: effect
sizes for different age groups (Schredl and Reinhard 2008b) 18
Table 2.4 Trait factors affecting DRF 19
Table 2.5 State factors affecting DRF 23
Table 3.1 Dream content analysis: basic steps 40
Table 3.2 Number of dream persons (Schredl 1998b) 43
Table 3.3 Global rating scale (Schredl 1991) 45
Table 3.4 Coding system of Hall and Van de Castle (1966) 47
Table 3.5 Dream manual by Schredl (1998b) 48
Table 3.6 Checklist for interpreting the findings of a dream content
analytic study 56
Table 4.1 Realism/fantasy of 500 laboratory dreams (Strauch and Meier
1996)67
Table 4.2 Dream emotions (global self-ratings and external judge-based
ratings)68
Table 4.3 Sensory perceptions in dreams 69
Table 4.4 Paradigms for studying the relationship between waking and
dreaming73
Table 4.5 Different types of continuity between waking and dreaming 82
Table 4.6 Effect of external stimuli on dream content 86
Table 4.7 Gender differences in dream content (Hall and Van de Castle
1966)90
Table 4.8 Human aggressors in dreams (Schredl and Pallmer 1998) 91

xi
xii List of Tables

Table 5.1 Comparisons of times for different activities carried out in

wakefulness or during a lucid dream (Erlacher et al. 2014) 108
Table 6.1 Prevalence of nightmare disorder in outpatients with mental
disorders (Swart et al. 2013) 124
Table 6.2 Dream recall, nightmare frequency/negative dream emotions,
and dream content in patients with sleep disorders 131
Table 7.1 Nightmare themes (Schredl and Göritz 2018) 151
Table 7.2 Factors affecting nightmare frequency 152
Table 7.3 Therapeutic principles of the Imagery Rehearsal Therapy
(IRT)155
Table 8.1 Lucid dream induction techniques 165
Table 8.2 Applications of lucid dreams (N = 357 lucid dreamers) 170
Table 9.1 Functions of dreaming 177
 CHAPTER 1

Definitions

The term “dreaming” or “dream” is widely used in everyday language

with different connotations, for example, “dreamer”, “dreamy”, “dream
holiday”, or “dreaming of being wealthy”, so it makes sense to start with
a clear definition of the term in the field of dream research—even though
the particulars of this definition are debated. These issues related to defin-
ing dreaming are discussed in this chapter.

Definition

A dream or a dream report is the recollection of subjective experiences that

occurred during sleep after waking up.

Following this definition, dreaming denotes the subjective experiences

occurring during sleep. Although this definition sounds very simple, a
closer look shows that the matter is more complicated. First, how can we
be sure that the remembered dream upon awakening is really a recollec-
tion of experiences during sleep? Second, does it make sense to define
dreams according to qualities of perception and action, for example, dif-
ferentiate between thought-like (sleep mentation), minimal dreaming (a
single image/scene), and action-packed dreams? Third, are there non-­
conscious cognitive processes during sleep that can never be remembered?
Fourth, how can nocturnal dreams be differentiated from daydreams, sub-
jective experiences while sleepwalking, and other phenomena?

© The Author(s) 2018 1

M. Schredl, Researching Dreams,
[Link]
2 M. SCHREDL

Before looking more deeply into the problem regarding an exact defini-
tion of dreaming, it should be made clear that it is important to differenti-
ate between the physiological level (sleep) and the psychological level
(dreaming); some authors used dream sleep and rapid eye movement
(REM) sleep interchangeably, for example, William Dement (1960) chose
the title “The effect of dream deprivation” for his study which aimed at
deprivation of REM sleep and not dream deprivation. Keeping these two
levels apart is crucial for theories about dream function(s) compared to
functions of REM sleep (see Chap. 9). It is also important regarding a
possible taxonomy of dreams as subjective experiences in contrast to the
classification of brain states with physiological measures like electroen-
cephalogram (EEG) or imaging (wakefulness, REM sleep, NREM sleep,
slow wave sleep, etc.). For example, are REM dreams qualitatively differ-
ent from non-rapid eye movement (NREM) dreams or is this idea of clas-
sification mixing up the criteria for REM sleep and NREM sleep (American
Academy of Sleep Medicine 2007) with a classification of subjective expe-
riences that might be affected by the underlying brain state but also show
a considerable overlap in phenomenological characteristics if obtained
from different brain states, for example, daydreaming and experiences
under the influence of hallucinogenic drugs, useful?
The phenomenology of dreaming—if recalled—has been described by
many authors (for a review see: Windt 2015). Typically the dream experi-
ences are perceived as real as waking-life experiences while dreaming (with
the exception of lucid dreaming; although even in these dreams the experi-
ences are real [sometimes more intense and detailed] despite the knowledge
that it is a dream) and several analogues have been suggested over the years,
for example, dreaming has similarities to viewing a film (Cook 2011), dream-
ing as a form of virtual reality (Hobson and Schredl 2011), dreaming as an
organic psychosis with hallucinations and delusions (Hobson and Voss 2011),
dreams as immersive spatiotemporal hallucinations (Windt 2015), or dreams
as a world simulation (Revonsuo et al. 2015). The question is whether these
descriptions are helpful in understanding dreaming. The analogy between
film viewing and dreaming seems difficult, for example, there is still a discus-
sion ongoing whether dreams can be black-and-white like films in the
black-and-white area (König et al. 2017). Hallucinations are defined in a
psychiatric context as perception-like experiences that occur without an
external stimulus (American Psychiatric Association 2013). The term halluci-
nation might be an analogue for the visual, auditory, and other sensory
impressions while dreaming but is not very adequate to describe the
 DEFINITIONS 3

experienced emotions and thoughts of the dreamer. The psychiatric defini-

tion also includes that hallucinations must occur in the context of a clear
sensorium, that is, the waking state (American Psychiatric Association 2013),
for example, hearing voices that are perceived as distinct from the individu-
al’s own thoughts. While dreaming, this differentiation between real percep-
tions and “hallucinations” does not make sense, so one might debate the
comparison of dreaming with hallucinations occurring in the waking state.
Similar delusions which are defined as fixed beliefs that are not amendable to
change in light of conflicting evidence (American Psychiatric Association
2013) seem not to be an adequate analogue for the dreaming state—experi-
encing a real world without the knowledge that the physical body is sound
asleep in the bed. Also, a comparison being in a virtual reality might be mis-
leading as this activity occurs during waking and does not share the criterion
that the brain is asleep. Nevertheless, even though the experiences might be
quite similar on a phenomenological level, it seems difficult to use these
analogues to define dreaming. Regarding the world simulation view, Tart
(1987) pointed out that dreaming and waking are based on the same world
simulation process; the only difference is that in waking consciousness has
constantly to adapt to the input via the senses and the primary sensory cor-
tices. In his view dreaming is richer and more varied because of the lack of
external constraints.
In addition to these philosophical considerations, the simple question
“How do we know that a dream or dream report is a recollection of
dreaming?” is of utmost importance to empirical dream research. As men-
tioned in the definition above, the subjective experience can only be
reported by the dreamer himself/herself if dream recall is successful. What
kind of evidence would support the assumption that subjective experienc-
ing is present during sleep? First, the event-related potential paradigm
provided data that the sleeping brain is processing incoming stimuli and is
also capable of simple cognitive operations like differentiating between
different stimuli, for example, odd-ball paradigm (Ibanez et al. 2009).
Furthermore, external stimuli can be incorporated into the dream (see
Sect. 4.6). Within these studies the stimuli is typically presented during
REM sleep with an intensity that does not awake the sleeping person,
then—after 30 or 60 seconds—the experimenter awakens the person who
did not know at this point whether a stimulus was presented or not (if an
appropriate control condition with no stimulus or a sham stimulation is
part of the study). That is, if the stimulus is incorporated and the dream
includes some action between the incorporation and the awakening, it is
4 M. SCHREDL

very likely that the dream reflects the experiences that occurred during
sleep. Similarly, the correlations between physiological parameters mea-
sured during sleep and the dream report obtained after awakening do not
support the idea that dream reports are generated during the awakening
process (see Chap. 5). If, for example, muscle twitches during sleep cor-
relate with dream actions or heart rate increases minutes before being
woken up by a nightmare, these reported experiences must have occurred
during sleep. Sleep talking has also been related to dream content (Arkin
et al. 1970) and patients with REM sleep behavior disorder act out their
dreams, observed movements are in sync with the remembered actions
after waking up (Valli et al. 2012). Similar, lucid dream research is provid-
ing evidence for the notion that dreaming is taking place during sleep,
proficient lucid dreamers can perform eye movements within the lucid
dream that can be measured via the electrooculogram and even communi-
cate with the experimenter via Morse code; the experimenter uses two
different tones and the lucid dreamer can react with different eye move-
ment patterns (Appel and Pipa 2017). Taking together these lines of
research, the evidence is clearly in favor of the assumption that dreams are
subjective experiences during sleep and that the dream report is a recollec-
tion of these experiences. Whether the dream report is an accurate account
of the dream experiences is an important topic discussed in Chap. 3 within
the context of dream content analysis. If the dreamer, for example, focuses
on reporting only the dream action but not the accompanying thoughts
and emotions, findings based on such reports might yield a biased picture
of what dreaming is like. Therefore, researchers (Kahan 2012; Nielsen
2000a) strongly recommend to train participants regarding their skills of
dream reporting.
The question whether all remembered sleep experiences reported upon
awakening should be considered as dreams had a strong impact on the
REM-NREM debate that started after the discovery of REM sleep in
1953 (Montangero 2018). In the first sleep laboratory studies (e.g.,
Aserinsky and Kleitman 1953) the participants were asked about dreams
after they were awakened, resulting in high recall rates after REM awaken-
ings and very low recall rates after NREM awakenings. Foulkes (1962)
changed the question to “What was going through your mind before I
woke you up?” and obtained much higher recall rates for NREM awaken-
ings because he obtained reports that are thought-like but did not include
images. So, some researchers (e.g., Nielsen 2000b) used the term “sleep
mentation” for describing all possible experiences that can be recalled
 DEFINITIONS 5

from sleep and “dream” only for reports including a temporal progression
with images, thoughts, emotions, and so on (i.e., a full story like a recall
of a waking-life experience). In one paper even the term “dreamless sleep
experiences” was introduced (Windt et al. 2016), but this notion seems to
complicate matters even more. In order to illustrate this topic of differen-
tiating between different types of sleep-related experiences, several dream
examples of the NREM awakening study of Schredl, Brennecke, and
Reinhard (2013) will be presented. Overall, 12 participants reported 52
dreams (dream report length ranged from 4 to 163 words); the recall rate
was about 60%.
The following report could be classified as thought-like: “I was think-
ing about the possibility that the experimenter will soon awaken me.” The
report “There was an animal.” might include some perceptual qualities,
whereas a report like “I was sitting with another person in a car. We were
talking. It was during the day.” clearly includes perceptions (visual, audi-
tory) and is a world simulation. Classifying all 52 reports, only 3 reports
were clearly thought-like, 5 reports were ambiguous, but the majority of
the reports (N = 45)—even though they were much shorter than REM
dream reports (e.g., Schredl et al. 2009)—clearly were “dream-like”.
Nielsen (2000a) suggested to use those brief dreams with one setting the
term “minimal dreaming” but the major question is whether these brief
dream reports might be short because it is more difficult for the dreamer
to remember more sequences after being woken up from NREM sleep
compared to be awakened from REM sleep. The reanalysis of the data of
Schredl, Brennecke, et al. (2013) indicates that the distinction “thought-­
like” versus “dream-like” does not help to differentiate between NREM
and REM dreams on a qualitative level (see also: Antrobus 1983). So, the
question arises whether it is helpful to classify sleep-related experiences in
qualitative distinctive categories. The suggestion put forward in this book
is to term all reports that reflect sleep-related experiences as “dreams”
(reflecting dreaming) and be aware of the range of experiences that can
occur, from thought-like reports to very intense nightmares. Waking-life
experiences show the similar range, for example, from “I was just thinking
about the talk I have to give tomorrow” to scenarios with strong emotions
like falling in love.
Another interesting question was addressed by Nielsen (2000a): Are
there cognitive activities during sleep that cannot be reported—despite all
possible introspective effort? This question is of special interest regarding
sleep-dependent memory consolidation which assumes that brain-­activation
6 M. SCHREDL

patterns that occurred during the learning phase are reactivated during
sleep (Zhang et al. 2017). As during wakefulness the brain is processing a
lot more information than reflected in the consciousness of the persons, it
seems plausible that the sleeping brain is also doing a lot more than “just”
dreaming. For example, long-term potentiation altering the coupling
between neurons which is involved in sleep-dependent memory consolida-
tion (Ribeiro and Nicolelis 2004) or pruning (reducing the number of
synapses during slow wave sleep) (Tononi and Cirelli 2001) is presumably
not accompanied by conscious perceptions or related subjective experi-
ences. Nevertheless, dreaming might also reflect—at least partly—these
memory consolidation processes during sleep (Wamsley 2014).
If waking thoughts were collected under similar conditions (dark room,
lying in a bed, “awakened” by an experimenter via intercom), the report of
these waking experiences can be dream-like, for example, include bizarre
elements (Foulkes and Fleisher 1975). That is, from a phenomenological
viewpoint there is considerable overlap between daydreaming, mind wan-
dering, and dreaming (Starker 1978). The major difference, of course, is
that the brain is in a different state (waking vs. sleeping). But even that
distinction might be arbitrary as mind wandering and dreaming might
share the same neuronal substrate, the default network (Fox et al. 2013),
that is, there is also a marked overlap regarding the involved brain net-
works. Also during other brain states dream-like experiences can occur, for
example, during anesthesia (Hellwagner et al. 2003) or taking drugs like
LSD (Kraehenmann et al. 2017). Whether it is helpful to name these expe-
riences as dreaming is doubtful. Even closer to dreaming—defined as sub-
jective experiences during sleep—are the subjective experiences while sleep
walking (Oudiette et al. 2009), but it should be kept in mind that sleep
walking is a NREM parasomnia also called disorder of arousal which is
characterized by a brain state that is neither fully asleep nor fully awake,
that is, simple tasks like walking with open eyes work but more complex
cognitive tasks like recognizing faces are impeded (American Academy of
Sleep Medicine 2014). If sticking to the exact definition of dreaming given
above, the subjective experiences of sleepwalkers should not be termed
“dreaming” as the brain state is not “sleep” but an intermediate state.
Another phenomenon that is not easy to differentiate from dreaming is the
experiencing of persons with sleep state misperception, or “paradoxical
insomnia” (American Academy of Sleep Medicine 2014). These patients
think that they are awake even though the standard polysomnographic
recording with EEG, electrooculogram (EOG), and electromyogram
(EMG) shows sleep—according to the international classification rules for
 DEFINITIONS 7

sleep staging (American Academy of Sleep Medicine 2007). The underly-

ing pathology is probably a hyperarousal regarding brain function and/or
the autonomic system that can also be detected in the microstructure of
sleep (more brief arousals during sleep in these patients), but these altera-
tions do not affect sleep staging (American Academy of Sleep Medicine
2014). Using the criteria above, these experiences might be called dream-
ing even though they are much more like waking thoughts. This clearly
indicated that even the simple definition given at the beginning of the
chapter cannot cover all phenomena.
To summarize, although there is a general understanding of what dreams
are (recollection of subjective experiences that occurred during sleep) the
exact definitions vary between different authors. It would be easier if
researchers use similar terminology, but it is much more important to define
the phenomenon that is topic of the empirical study as precisely as possible.
The dream experiences can range from thought-like reports to full-blown
dream, nightmares, and lucid dreams. In the future, imaging studies might
help to identify the brain networks associated with these subjective experi-
ences possibly independent from the “classical” classifications of the global
brain state (waking, NREM sleep, REM sleep, anesthesia, etc.).

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 CHAPTER 2

Dream Recall

2.1   Introduction
As pointed out in Chap. 1, the hypothesis that the mind never sleeps is
widely accepted, that is, some form of experiencing (emotions, thoughts,
mental images, etc.) is present during every single minute of sleep. Despite
this assumption that every person dreams every night, the variability of
dream recall in the home setting is considerably large. Some persons
almost never recall any dream, whereas others can relate a detailed descrip-
tion of their nightly experiences almost every morning. As successful
dream recall is a prerequisite for dream research (and for the clinical use of
dreams), this chapter focuses on this topic, starting with a simple defini-
tion, and reviews the dream recall models, the methods how to measure
dream recall frequency (DRF), and the factors (state and trait factors)
affecting DRF. An attempt to formulate a comprehensive model of dream
recall is the topic of the last section of this chapter.
Dream recall can be defined as follows (Schredl 2007):

Dream recall is successful if a person is able to recollect after waking up some

mental content which occurred during sleep.

The successful dream recall has to be differentiated from the so-called

white dreaming (DeGennaro and Violani 1990) or contentless reports
(Cohen 1972); these terms designate incidents in which the dreamer has
the impression of having dreamt but is not able to recall any content.

© The Author(s) 2018 11

M. Schredl, Researching Dreams,
[Link]
12 M. SCHREDL

A topic that has been addressed already in Chap. 1 is the question that
how does one know that the dream report remembered after awakening is
a recollection of experiences that occurred during sleep and not produced
in milliseconds during the awakening process. Research in lucid dreaming
(see Chap. 8) and application of external stimuli that affect dream content
(see Chap. 4) indicate that the assumption that dream reports reflect
dreaming (subjective experiences during sleep) is very, very plausible.

2.2   Models of Dream Recall

Six models which have been formulated in order to explain inter-­individual
differences and/or intra-individual fluctuations of dream are depicted
chronologically in Table 2.1.
A simplified description of Sigmund Freud’s model of dream genera-
tion (Freud 1900/1991) might be: A latent dream thought emerging
from the unconscious and often expressing unacceptable drives or wishes
has to be altered so it could pass censorship and be recalled after awaken-
ing (the manifest dream). If the unconscious wishes have not been con-
cealed sufficiently, Freud assumed that the dream as a whole will be
repressed (not recalled), in order to avoid that the waking consciousness
gets access to these topics. From a methodological viewpoint, it is impor-
tant to acknowledge that this hypothesis cannot be tested empirically since
repressed dreams are not accessible for the researcher and cannot be com-
pared to recalled dreams to look for possible differences in dream content.
Therefore, several studies have tried to test the repression hypothesis using
indirect approaches by investigating the relationship between DRF and
repression conceptualized as a personality dimension or coping style. The
repressors (persons avoiding confrontation, feelings of anxiety) should
recall their dreams less often than so-called sensitizers.

Table 2.1 Models of dream recall

Models

Repression hypothesis (Freud 1900/1991)

Life-style hypothesis (Schonbar 1965)
Interference hypothesis (Cohen and Wolfe 1973)
Salience hypothesis (Cohen and MacNeilage 1974)
Arousal-retrieval model (Koulack and Goodenough 1976)
State-shift model (Koukkou and Lehmann 1983)
 DREAM RECALL 13

The life-style hypothesis of Schonbar (1965) postulated that persons

who are open to inner experiences, more field-independent, more intro-
verted, more creative, and have an internal locus of control, divergent
thinking style, and imagination recall their dreams more often, that is,
high dream recall is seen as part of a lifestyle. On the other hand, persons
who recall their dreams rarely should be extraverted, have an external
locus of control, and not be very open to inner experiences. The hypoth-
esis focuses on the trait factors influencing dream recall but it can be imag-
ined that state factors may also be of importance, for example, a person
could dream more in creative periods than in non-creative periods.
The interference hypothesis (Cohen and Wolfe 1973) is based on clas-
sical memory theory. The hypothesis states that recall is more difficult or
even impossible if interferences between the dream experience and the
successful dream recall occur. These interferences might be external noises
like the alarm clock or internal distractions like thoughts about the upcom-
ing day. On the other hand, this theory would predict that mentally
rehearsing the dream during the awakenings process would increase the
chance of recalling the dream experience.
Similarly, the salience hypothesis (Cohen and MacNeilage 1974) was
derived from classical memory theory. The more salient (impressive, vivid,
etc.) the dream is the better the recall of the dream. This hypothesis is
somewhat contrary to the repression hypothesis which states that instinct-­
driven and presumably intense dreams tend to be repressed and are not
recalled. The problem is again how to test this hypothesis empirically as it
is not possible—in contrast to the experiments of classical memory the-
ory—to measure the salience of the original experience (dream experi-
ence) independently. The researcher (and the dreamer) has only access to
the recalled dream. Similar to the interference hypothesis, the salience
hypothesis mainly focuses on the effect of state factors.
The arousal-retrieval model of Koulack and Goodenough (1976)
hypothesized that two steps are necessary for a successful a dream recall.
First, a certain amount of cortical arousal is necessary in order to transfer
the dream experience from short-term memory into long-term memory.
Presenting sleeping persons information via speaker or headphones did
not work, that is, resulted in any recall in the morning unless there were
some periods with alpha waves in the EEG reflecting relaxed wakefulness
(Aarons 1976). In the case of dream recall, a period of wakefulness must
follow the dream experience so that the person can recall this experience.
Once the dream is stored in long-term memory, the second step of the
14 M. SCHREDL

model, the process of retrieval, is important. The more salient the dream
experience and the less interferences occur during the retrieval process,
the higher is the probability of recalling the dream. Even the repression
hypothesis was integrated into the model, that is, very intense emotions
might also result in a smaller chance of recalling the dream.
The functional state-shift model of dream recall was formulated by
Koukkou and Lehmann (1983). Within this model cognitive activation of
the brain is divided into different functional states with their associated
memory storages. Higher functional states cannot very easily access mem-
ory storage system of a lower functional state, whereas the information
flow in the other direction is good. This explains why waking-life elements
are reflected in dreams (REM sleep is a functional state which is lower in
activation than the waking state) but waking consciousness has limited
access to the contents of the REM sleep periods. In the dream recall pro-
cess the transfer of experiences occurring in the functional state of REM
or NREM sleep would be easier if the difference in terms of overall brain
activation between the sleep state and the waking state was closer. A sim-
ple prediction would be that dream recall is lower after awakening from
NREM sleep compared to REM sleep, or awakenings during the second
part of the night are more likely produce dream recall than awakenings at
the beginning of the night as the brain is more active. The concept of a
general brain activation seems a bit outdated as imaging studies have
shown that brain activation patterns during sleep are quite complex
(Hobson et al. 2000).
One should keep in mind that these six theories or models do not
exclude each other; it may be that each theory captures a specific impor-
tant aspect of recalling a dream.

2.3   Measuring Dream Recall Frequency

Three measurement methods are widely used in dream research:
Questionnaires, dream diaries, and awakenings in the sleep laboratory.
Typically a single scale within a questionnaire is presented to the par-
ticipants; the formats vary considerably, for example, “How many dreams
did you recall last month?”, “Did you recall a dream last night?” or “How
often have you recalled your dreams recently (several months)?”
The rating scale presented in Table 2.2 shows a high retest reliability for
an average retest interval of 54 days (r = 0.85; Schredl 2004a). Even for a
three-year interval, the retest reliability was high (r = 0.663; Schredl and
 DREAM RECALL 15

Table 2.2 Rating scale measuring dream recall frequency (DRF) (Schredl 2004a)
How often have you recalled your dreams recently (several months)?

Almost every morning

Several times a week
About once a week
Two or three times a month
About once a month
Less than once a month
Never

Göritz 2015). These high coefficients indicate that this scale measures
inter-individual differences reliably.
Within the dream diary approach two types of diaries were used: Either
the participants should simply state each morning whether they have
dreamt or not (checklist), or they should—for content analytic studies—
record the dream(s) of the previous night as completely as possible (narra-
tive dream diary). From a methodological viewpoint, checklists are better
than narrative diaries as the recording of dreams each morning yielded a
decrease in DRF after one week (Schredl 2004b; Zadra and Robert 2012).
For a checklist study there was no drop in dream recall even after 12 weeks
(Schredl and Fulda 2005b). In order to measure inter-individual differ-
ences reliably, a high internal consistency of the diary had to be obtained in
the sample (the analogy is a psychometric test; the internal consistency
increases with the number of items and, here, the “item” is a Yes or No
answer each morning regarding dream recall). Using a checklist in a sample
of 198 participants, the internal consistency (Cronbach’s alpha) increased
with duration: r = 0.677 (7 days), r = 0.818 (14 days), r = 0.876 (21 days),
and r = 0.904 (28 days) indicating that a two-week diary typically will yield
sufficient reliability (Schredl and Fulda 2005b). For a two-­week narrative
diary, the internal consistency was r = 0.743 (Schredl et al. 2003).
In general, the correlation coefficients between DRF measured via
questionnaire scale (retrospective measure) and DRF via dream diary
(prospective measure) are of moderate size: r = 0.69, N = 338 (Cohen
1979), r = 0.52, N = 336 (Hill et al. 1997), r = 0.557, N = 285 (Schredl
2002), and r = 0.562, N = 444 (Schredl et al. 2003). Whereas these cor-
relations are sufficiently large, the problem is a big discrepancy regarding
the amount of dream recall. Cohen (1969), for example, reported a three-
16 M. SCHREDL

fold increase in DRF and a recent study (Zunker et al. 2015) found an
increase of 3.75 ± 2.58 mornings per two weeks with dream recall (ques-
tionnaire) to 6.93 ± 2.80 mornings per two weeks (checklist diary), this
equals a large effect size of d = 1.07. The increase in dream recall was
much more pronounced for low dream recallers than for high dream
recallers (Schredl 2002). Even a simple encouragement (Halliday 1992;
Redfering and Keller 1974) or filling out a dream questionnaire (Schredl
et al. 2002) can increase DRF considerably.
Given the marked differences between retrospective and prospective
measures, the question arises as to how these differences can be explained.
Aspy, Delfabbro, and Proeve (2015) outlined two possible explanations:
underestimation of the retrospective measures and enhancement effects of
the diary measures. The fact that the retrospective measures—asking for
estimations about the last 12 months—yielded lower figures than estimates
for a one-month interval would support this idea that successful dream
recall might simply be forgotten. Another hypothesis is that retrospective
measures might be biased by personality dimensions (Beaulieu-­Prevost and
Zadra 2005; Bernstein and Roberts 1995) as personality measures, for
example, absorption, thin boundaries, showed higher correlations with ret-
rospectively measured dream recall when compared to figures obtained
from diary measures (Beaulieu-Prevost and Zadra 2005). In addition to
reliability issues (lower reliability of diary measures), the assumption is that
persons who are not interested in dreams (associated with low absorption,
thick boundaries) tend to underestimate their dream recall systematically.
The other line of thinking focuses on the recall-enhancing effects of
keeping a dream diary, that is, the intention to recall a dream might mini-
mize interferences during the awakening process (Aspy et al. 2015).
Interestingly, Zadra and Robert (2012) found a higher increase from ret-
rospective estimates of dream recall in the first five days of keeping a nar-
rative dream log (including recording the dreams which can take a lot of
time) compared to a checklist dream log (just filling in whether there was
a dream (or several dreams) or not). As the increase in dream recall by
keeping a diary is significantly related to a positive attitude toward dreams
(Zadra and Robert 2012), the idea that motivation might play a role in the
dream diary enhancement effect seems very plausible.
As a measure of “true” DRF is not available, one has to keep in mind
that retrospective measures might underestimate DRF whereas ­prospective
measures produce overestimations due to focusing the attention of the
participants on dream recall.
 DREAM RECALL 17

The awakening in a sleep laboratory is the most expensive method for

measuring dream recall. The average recall rate for young adults ranged
from 80% to 90% if the sleeper is awakened out of REM sleep and 40–50%
if the sleeper is awakened from NREM sleep (Nielsen 2000), that is, dream
recall is dramatically increased compared to the DRF in the home setting.
Home recall, however, is associated with lab recall rates, persons remem-
bering more than three dreams per week at home were able report a dream
after 93% of the REM awakenings whereas in only 46% of the REM awak-
enings a low dream recaller remembered a dream (Goodenough et al.
1959). The clear advantage of the lab technique is the opportunity of
measuring physiological parameters such as EEG, respiratory indices,
heart rate, and skin resistance, both during sleep and during the awaken-
ing process (e.g., Siclari et al. 2017).
To summarize, the different measurement methods show medium to
high intercorrelations and, thus, the selection of a specific measurement
method should not have too strong effects on the results of a particular
study correlating DRF with other measures. Whereas questionnaire scales
elicit typically the stable everyday DRF and, therefore, are suitable for
investigating the relationship with personality dimensions, the diary
method and the awakenings in the sleep laboratory are more appropriate
for measuring intra-individual fluctuations of dream recall over time and
factors underlying this variation.

2.4   Dream Recall Frequency: Age and Gender

Effects
In student samples, DRF is on average between one or two mornings per
week with successful dream recall in the home setting (Belicki 1986;
Schredl et al. 2003). In representative samples of the general population,
DRF is lower, about one morning with successful dream recall per week
(Schredl 2008a, 2009b).
Representative studies in adults have shown that DRF decreases with age
(Schredl 2008a, 2009b; Schredl and Piel 2003; Stepansky et al. 1998).
Interestingly, children did not recall their dreams as often as young adults did
(Schredl 2009a). Mangiaruga, Scarpelli, Bartolacci, and De Gennaro (2018)
speculated that brain maturation as well as age-related cognitive decline
might explain—at least partly—the changes in dream recall during the life
span. According to the study of Giambra, Jung, and Grodsky (1996), the
major decrease in dream recall occurred between the ages of 22 and 50 years
and thus physiological aging process (e.g., decreasing memory capacity) may
18 M. SCHREDL

not underlie the age-related decline in DRF. Using a retrospective design,

participants (55–93 years of age) were asked to estimate their current DRF
and their dream frequency during young adulthood (Schredl et al. 1996).
For 60% of the sample, DRF did not change over the life span, whereas 23%
reported higher DRF in young adulthood and 17% a higher DRF in old age.
The decrease in dream recall found in cross-sectional studies may be explained
by cohort effects (generation effects), for example, attitude toward dreams
today may differ from that of previous time periods. One might speculate
that pursuing a professional career or raising children might reduce the inter-
est in dreams, an explanation which fit the data of Giambra et al. (1996).
Unfortunately, longitudinal studies of dream recall are scarce. Over a time
interval of 6–8 years (longitudinal design), Giambra, Jung, and Grodsky
(1996) obtained very different patterns, a drastic decrease in young women,
increase in middle-age men and women, and a decrease in the oldest groups
of women and men. In a sample of N = 1.340 participants (780 women, 560
men, age mean: 45.34 ± 13.96 years, age range: 16–89 years) DRF slightly
decreased within three years; this decrease, however, was not related to age
and gender (Schredl and Göritz 2015). As a number of state factors affect
DRF (see below), longitudinal studies of dream recall should include mea-
sures of interest in dream, sleep duration, stress levels, and so on.
In Table 2.3 the results of a meta-analysis (Schredl and Reinhard
2008b) regarding the gender differences in DRF are depicted. For all age
groups the gender difference was significant but the difference was very
small for children and much more pronounced (medium effect size) for
adolescents and adults.

Table 2.3 Gender differences in dream recall—a meta-analysis: effect sizes for
different age groups (Schredl and Reinhard 2008b)
Age group Studies Females/ Estimated Confidence
Males effect size interval (95%)

Children (≤ 10 years) 15 2332/2502 0.097 0.035–0.159

Adolescents 18 3133/2592 0.364 0.272–0.456
(10< × < 18 years)
Young adults 81 9238/6543 0.242 0.194–0.289
(18≤ × < 30 years)
Middle-aged adults 36 9139/7111 0.270 0.206–0.334
(30≤ × < 60 years)
Older adults (≥ 60 years) 13 1028/767 0.243 0.125–0.362
 DREAM RECALL 19

Similar to age, the gender variable itself provides no explanation about

the factors underlying this gender difference. As the gender difference
increases dramatically from childhood to adolescents, Schredl, Buscher,
Haaß, Scheuermann, and Uhrig (2015) hypothesized that there is a
gender-­specific dream “socialization”. Their data showing that girls talk
much more often with their peers about dreams than boys support this
idea. In adults, the gender difference was explained by variables like inter-
est in dreams and the frequency of nocturnal awakenings (Schredl 2010)
and sex role orientation; expressivity/femininity was positively related to
DRF (Schredl et al. 2010, 2013). These studies indicate that studying the
factors underlying this stable gender difference in dream recall might help
to identify mechanisms that explain the variability in dream recall.

2.5   Trait Factors Affecting Dream Recall

Frequency
Trait factors can be differentiated from state factors as characteristics that
are quite stable over time, for example, personality traits or cognitive
abilities. Some factors, for example, sleep duration, can show stable
­
­inter-­individual differences (habitual sleep duration) but also fluctuate
from night to night, depending on the persons daily schedules, and then
it would be a state factor that might affect dream recall.
The most important trait factors that have been studied so far are listed
in Table 2.4.
Only two studies (Cohen 1973; Gedda and Brenci 1979) looked into
the DRF of monozygotic and dizygotic twins to determine a possible

Table 2.4 Trait factors affecting DRF

Factors

Genetic factors
Personality factors
 Repression, neuroticism, introversion, openness to experience, absorption, “thin”
boundaries
Cognitive factors
 Intelligence, memory, fantasy, creativity
Sleep behavior
Sleep and waking physiology
Attitude toward dreams
20 M. SCHREDL

genetic influence on dream recall. These findings with relatively small sam-
ple sizes did not support the presence of a genetic effect. Cohen (1973)
reported that the concordance rates in dream recall (similar high or low
DRF) were high for persons who live together independent of their shared
genetic background. Genome-wide association studies (GWAS) have not
yet been carried out.
Based on Freud’s repression hypothesis (see Table 2.1) researchers
investigated the relationship between the personality trait sensitizer versus
repressor (subscale of the Minnesota Multiphasic Personality Inventory;
MMPI) in relation to dream recall. Repressors are persons who avoid pos-
sibly threatening stimuli and/or deny their existences. Sensitizers, on the
other hand, are persons who focus on possibly threatening stimuli and pay
attention to them. Tart (1962) found—as expected—a negative correla-
tion between this dimension (high scores represent sensitization) and
DRF: r = −0.25 (p < 0.05, N = 45). Subsequent studies, however, did not
yield a homogeneous picture; the majority of research findings did not
reveal a substantial relationship between this or similar personality dimen-
sions and DRF (Schredl 2007).
More promising were dimensions like “thin boundaries” (Hartmann
1991), “hypnotic ability” (Belicki and Bowers 1982), and absorption
(Schredl et al. 1997; Spanos et al. 1980). These dimensions show high cor-
relations with the openness to experience factor of the Big Five Personality
model (McCrae 1994). In student samples, small correlations between
openness to experience and DRF were found (Blagrove et al. 2003; Hill
et al. 1997; Schredl et al. 2003; Watson 2003). These findings were con-
firmed in a large sample (N = 2,492 with a more diverse educational back-
ground and a large age range of 17–93 years) (Schredl and Göritz 2017).
The alexithymia construct (affective deficits, lack of introspection) seems to
reflect the other end of the openness dimension and was inversely related
to DRF in several studies (De Gennaro et al. 2003; Nielsen et al. 1997;
Parker et al. 2000). The other four factors of the Big Five model are not
strongly associated with dream recall, except a small—yet unexplained—
correlation to conscientiousness and a small correlation to neuroticism
which was no longer significant if nightmare frequency was statistically
controlled (Schredl and Göritz 2017), that is, nightmare frequency is
related to neuroticism (see Chap. 7) and this increases overall DRF.
General intelligence or verbal intelligence was not significantly related
to DRF (Schredl 2007), more promising are the findings regarding visual
memory—persons with high scores tend to recall their dreams more often,
 DREAM RECALL 21

especially in the elderly (Cory et al. 1975; Schredl et al. 1996; Waterman
1991). Other forms of memory such as verbal memory and short-term
memory in general were rarely connected to DRF (Blagrove and Akehurst
2000). Another interesting link was found between dream recall and auto-
biographical memory (Horton and Malinowski 2015). Visual imagina-
tion, pronounced fantasy life, creativity, and the frequency of daydreaming
correlated with DRF (Schredl 2007); this makes sense as these aspects are
likely to be associated with the openness to experience factor.
As long sleepers (8–10 hours’ sleep duration) have more REM sleep
than short sleepers (cf. Cartwright 1978) and recall rates are higher after
awakenings from REM sleep compared to NREM sleep (Hobson and
Stickgold 1994), it was hypothesized that habitual sleep duration was
related positively with dream recall. Interestingly, two diary studies
(Schredl and Fulda 2005a; Schredl and Reinhard 2008a) analyzing the
effect of the between-subject factor (habitual sleep duration) and the
with-subject factor (short-term changes in sleep duration) clearly indicate
that the sleep duration plays a minor role in explaining inter-individual
differences in dream recall but the short-term changes in sleep duration
had marked effects on dream recall, that is, if one night a person sleeps
considerably shorter than she/he usually sleeps, then dream recall is mark-
edly reduced. Poor sleep quality and frequent nocturnal awakenings are
associated with DRF, a finding that might simply be explained by an
increased chance to recall a dream after awakening if frequency of the
awakenings is higher (Schredl et al. 2003).
Using Positron Emission Tomography (PET) combined with EEG,
Eichenlaub et al. (2014) found that the 21 high dream recallers (more
than three dreams per week) showed higher regional cerebral blood flow
(rCBF) in temporoparietal junction (TPJ) during REM sleep, slow wave
sleep, and wakefulness, and also increased regional cerebral blood flow
(rCBF) in the medial prefrontal cortex (MPFC) during REM sleep and
wakefulness than low dream recallers (less than two per month). As these
brain areas are part of the resting state network which is associated with
mind wandering (daydreaming) during wakefulness and dreaming (Fox
et al. 2013), these results suggest that the ability to recall dreaming is
associated with a trait aspect of cerebral functional organization. The brain
activation after presenting auditory stimuli during sleep (event-related
potential paradigm) was also higher in habitual high dream recallers com-
pared to low dream recallers (Eichenlaub, Bertrand et al. 2014; Vallat
et al. 2017b). In order to differentiate between state and trait aspects, it
22 M. SCHREDL

would be very interesting to train low dream recallers to increase their

dream recall by keeping a diary, focusing their attention on dreams and
to repeat the study protocol.
The last factor which might be considered as a trait factor is the attitude
toward dreams or the interest in dreams. These variables are strongly
related to DRF (Schredl 2007); however Schredl et al. (2003c) have
pointed out that most of the scales measuring interest in dreams are con-
founded with DRF because the items, for example, the item “Have you
ever speculated about the possible meaning of one of your dreams?”
1 = Not that I remember, 2 = Once or twice, 3 = Occasionally, 4 = Often
(Robbins and Tanck 1988), also follow a format measuring frequency.
Using a scale without references to frequency, for example, statements like
“How strong is your interest in dreams?” could be answered 0 = Not at
all, 1 = Not that much, 2 = Partly, 3 = Somewhat, 4 = Totally, the correla-
tion coefficients between DRF and positive attitude toward dreams/inter-
est in dreams are much smaller, for example, r = 0.158, N = 444 (Schredl
et al. 2003c) compared to r = 0.41, N = 336 reported by Hill et al. (1997)
who used—among other items—the scales of Robbins and Tanck (1988).
The causality in this relationship is still an open question. One might spec-
ulate that high interest in dreams may affect DRF because the dreamer is
applying techniques to increase dream recall (e.g., keeping a dream diary)
but, on the other hand, interest in dreams might be increased due to the
person’s curiosity about the meaning of her/his dreams, that is, if a person
almost never recalls a dream she/he might not be very interested in that
topic.

2.6   State Factors Affecting Dream Recall

Frequency
The most important state factors are listed in Table 2.5. These findings
deal mainly with intra-individual fluctuations of DRF, that is, those factors
that affect DRF in course of time within a person. A lot of studies also
utilize comparisons between different samples, for example, depressed
patients versus healthy controls, to estimate the effect of a mental disor-
der—which can be conceptualized as state factor—on DRF.
Cohen (1974) found that negatively toned pre-sleep mood resulted
in heightened dream recall the following morning. The study was
based on the salience hypothesis of dream recall: negative waking-life
 DREAM RECALL 23

Table 2.5 State factors affecting DRF

Factors

Experiences of the previous day(s)

Meditation, psychotherapy
Sleep duration/nocturnal awakenings
Physiological or brain activation during sleep
Interferences during awakening
Mental disorders
Drugs
Brain lesions

experiences of the previous day would increase the intensity of negative

dream emotions (continuity hypothesis of dreaming; see Chap. 4) and
so the dreams are more easily recalled. A cumulative index of emotions
experienced in different areas (academic studies, partnership, family,
friends, personal issues) also correlated negatively with dream recall,
that is, the more negative the emotions experienced during the previ-
ous day, the higher dream recall. It would be interesting to study
whether this effect might be moderated by an increased number of
nocturnal awakenings (Schredl et al. 2003). Participants themselves
associate periods of heightened dream recall with high stress levels
(Cartwright 1979). However, the diary study of Armitage (1992)
showing that women tend to recall their dreams more often in stressful
periods whereas men reacted to stress with a reduction in dream recall
indicates that a lot of questions are still unanswered.
Participating in a dream study often leads to a marked increase in DRF
(Halliday 1992; Redfering and Keller 1974). Similar increases were
reported at the beginning of psychoanalytic or psychotherapeutic treat-
ments (Myers and Solomon 1989; Schredl et al. 2000). Meditation,
Autogenic Training, and mindfulness training were also found to stimu-
late dream recall (Reed 1978; Schredl and Doll 1997; Schredl et al. 2016).
In an experimental study (Taub 1970) in which the participants were
allowed to sleep for 8 hours as well as for 9½ or 11 hours, it was found
that long sleep duration was followed by heightened dream recall. Whereas
habitual sleep duration was not or only marginally correlated with dream
recall, the fluctuation in sleep duration within in a person was predictive
for dream recall, the shorter the sleep the lower the chance to recall a
24 M. SCHREDL

dream (Schredl and Fulda 2005a; Schredl and Reinhard 2008a), that is,
sleep duration tends to be a state factor regarding its effect on dream
recall not a trait factor. The frequency of nocturnal awakenings measured
on a day-to-day basis via a dream diary is associated with an enhanced
probability for recalling a dream the next morning (Schredl and Montasser
1996); this complements the studies reporting a relationship between
DRF and the frequency of nocturnal awakenings as a trait factor. The
results of Vallat, Lajnef, et al. (2017b) indicated that periods of wakefulness
should be two minutes or longer to facilitate dream recall.
The studies regarding the effect of EEG parameters during the REM
period prior to awakening on dream recall yielded contradictory results
(Schredl 2007). A recent study (Siclari et al. 2017) using high-density
EEG (256 electrodes) found local decreases of low-frequency activity
(reflecting more activity) in parieto-occipital areas prior to successful
dream recall after awakenings from REM sleep and NREM sleep. These
areas are active during REM sleep (Hobson et al. 2000) and dream recall
was absent if these areas were damaged (Solms 1997). The high spatial
resolution of the Siclari et al. (2017) study clearly indicates that specific
patterns of brain activity play a role in explaining successful dream
recall and not a general index of brain activation—a problem with the
original formulation of the state-shift model of dream recall (Koukkou
and Lehmann 1983). Why Siclari et al. (2017) confused successful dream
recall with the presence or absence of dreaming is not clear. Interestingly,
rhinal-hippocampal connectivity values (a parameter important for suc-
cessful memory formation) were higher in patients with good dream recall
versus those patients with poor dream recall, underpinning the notion that
dream recall is a memory process (Fell et al. 2006).
A clear relationship between physiological activity during REM sleep,
for example, heart rate, skin conductance (as a measure for emotional
salience), could not be demonstrated (Schredl and Montasser 1996); this
might be simply explained by the inhomogeneous findings regarding the
emotional intensity of the dream and autonomic parameters (Schredl
2008b).
Cohen and Wolfe (1973) tested whether interferences during or shortly
after the awakening process impair dream recall. One group of participants
were asked to call the weather forecast upon awakening (duration: two to
three minutes), whereas the other group lay quietly in their beds for the
same amount of time. As expected, the interference of calling the weather
forecast impaired dream recall (29% vs. 54%). However, a diary study
(Schredl and Montasser 1996) carried out in the home setting did not
 DREAM RECALL 25

reveal any effect of interferences, for example, talking to the bed partner,
on dream recall. As the intention to recall a dream can increase dream
recall (see above; effects of keeping a dream diary), it would be very inter-
esting to study possible effects of internal interferences, for example,
thoughts about the upcoming schedule or thinking about current con-
cerns, on dream recall. Vallat, Meunier, Nicolas, and Ruby (2017c) investi-
gate another factor that might impede dream recall: the so-called sleep
inertia. After waking up, the brain is not fully functional compared to alert
wakefulness, for example, memory capacity might be decreased (Trotti
2017). This sleep inertia effect seems to be less pronounced in high dream
recallers compared to low dream recallers (Vallat et al. 2017c). Whether
sleep inertia is a state factor affecting dream recall or a trait factor (or
both) is yet to be seen.
Patients with mental disorders that are accompanied with cognitive
impairment like severe depression or dementia are showing lower DRF
compared to healthy controls (Kramer et al. 1975; Riemann et al. 1990).
Brain lesions within the parietal-occipital junction which is often associ-
ated with loss of spatial perception results in a cessation of dream recall
(Solms 1997). Also, large lesions in the frontal areas can cause complete
inability to remember dreams indicating those areas are crucial for dream
recall (Solms 1997). Interestingly, most patients recovered over a period
of one year and began to remember dreams again (Murri et al. 1989)—an
indication of the brain’s plasticity.
The treatment with the tricyclic antidepressant trimipramine was
accompanied by a slight decrease in DRF in a large sample of outpa-
tients, most likely explained by a shift toward more positive dream emo-
tions and a decrease in nightmares (Schredl et al. 2009), that is, it may
not be a direct effect. Other studies also point in the direction of dream
recall reducing effect of tricyclic antidepressants (see review: Tribl et al.
2013) whereas serotonin-reuptake inhibitors or similar compounds did
not show a systematic effect on dream recall, only in healthy controls
dream recall was reduced by serotonin-reuptake inhibitors (Pace-Schott
et al. 2001). It seems plausible that the effects of these drugs on the
amount of REM sleep (most antidepressants suppress REM sleep, not so
trimipramine) may explain alterations in DRF, but the findings of
Armitage Schredl, Riemann, et al. (2009) indicate that other factors may
play a role as well.
26 M. SCHREDL

2.7   An Integrative Model of Dream Recall

The previous sections provided an overview regarding the factors that
might affect dream recall. The model depicted in Fig. 2.1 is an attempt to
integrate the existing theories and to visualize at which part of the process
of dream recall each factor might be relevant.
The basic process consists of three steps that are necessary for successful
dream recall: During awakening the dream experience has to be captured
by the short-term memory (or working memory), then the content present
in the short-term memory has to be transfered into the long-time memory,
and lastly the remembered dream has to be reported verbally or written
down. The factors affecting this process can be divided into physiological
factors and personality factors but keeping in mind that these factors are
not independent but may very well inter-related. The findings of Eichenlaub,
Nicolas, et al. (2014) indicate that inter-individual differences in brain acti-
vation patterns, for example, connectivity in the default network, might
affect the ability to recall a dream successfully. In particular, during the
awakening process the extent of sleep inertia might affect the functionality
of the memory systems (Vallat et al. 2017c). This could be a trait factor
reflecting inter-individual differences in sleep inertia but could also reflect

Sleep Awakening process Wakefulness

Brain activation pattern, e.g.,
Default network functionality

Duration
Sleep inertia

Short-term Long-term
Dreaming Dream report
memory memory

Interferences Salience
Salience
Focusing on dreams/Memorizing Report style (verbal/ written)

Personality/Interest in dreams
Daytime experiences

Fig. 2.1 Integrative model of dream recall

 DREAM RECALL 27

state factors, for example, the higher recall rates from REM sleep compared
to those after NREM sleep awakenings (Nielsen 2000) and the effect that
shorter sleep duration within an individual is associated with a lower prob-
ability to recall a dream, as sleep inertia is more pronounced if sleep duration
is markedly below the individual’s mean sleep duration (Trotti 2017). The
effect of the duration of the awakenings process is often reported by persons
who tried to recall their dream in the home setting; at the moment of awak-
ening the dream is remembered but if the person continues to sleep, the
dream is gone. A duration of at least two minutes wakefulness seems to be
crucial for successfully transferring the dream from short-term memory into
long-term memory (Vallat et al. 2017b). The importance of the last step
(long-term memory—dream report) is evident in the findings that cues can
improve recall are considered (Botman and Crovitz 1989). An object seen
during the day can trigger the recall of a dream including the same topic
(Domhoff 1969), that is, even if the dream is not remembered immediately
after awakening, it might lie dormant in the long-term memory system—
according to Koukkou and Lehmann (1983), in the memory system of the
functional state “Sleep” that is not easily accessible from the functional state
“Waking”. Observations that proficient lucid dreamers can remember previ-
ous lucid dreams (Tholey and Utecht 1987) would fit in this line of think-
ing. The arousal-retrieval model of Koulack and Goodenough (1976) and
the state-shift model of Koukkou and Lehmann (1983) capture at least part
of these effects of physiology on dream recall but many questions are still
unresolved, for example, the interaction between physiological and psycho-
logical variables (e.g., personality).
The most general psychological variables are trait factors like personality
dimensions (openness to experience, thin boundaries, etc.). The effects fit
with the life-style hypothesis of Schonbar (1965). However, the question
arises how these personality dimensions might affect the recall process dur-
ing awakening. Several pathways are possible (not excluding each other),
for example, creative persons experience more intense dreams (salience
hypothesis) that are easier to recall, and persons who are interested in
dream might focus during the time they wake up on recalling the dream
and thus minimizing interferences (interference hypothesis), or creative
persons might have a more functional default network (also related to day-
dreaming) and therefore are able to recall their dreams better. Testing these
hypotheses is the mission of future research. The effect of state factors
would also fit in this concept; stressful periods are accompanied with more
28 M. SCHREDL

salient dreams (and often also with more awakenings during sleep) that are
more easily remembered, but one might imagine that interferences during
the awakening process might also be stronger as stressful thoughts might
pop into mind immediately after awakening—see the differential effect of
stress on dream recall in men and women (Armitage 1992). The enhance-
ment effect of keeping a dream diary or participating in a dream study on
dream recall might be explained by focusing on the dream experiences dur-
ing awakening (reducing interferences) and even increase the transfer rate
by memorizing the dream in this period. An important factor of method-
ological relevance is the effect of salience on dream reporting within the
most recent dream approach. Even though the dream was remembered
successfully in the morning, days or weeks later mundane dreams might be
forgotten but bizarre, funny, or salient dreams are reported—representing
a selection bias regarding dream salience. Similarly, the report style (how
detailed a dream is reported or recounted) might be associated with per-
sonality, for example, creativity, and thus affect the findings obtained by the
dream content analysis method. As reported above, controlling for dream
length seems a crucial measure to counter such influences.
To summarize, despite the considerable number of studies investigating
successful dream recall (the prerequisite to do dream research), many
questions regarding the interaction of physiological and psychological fac-
tors are still unanswered.

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 CHAPTER 3

Dream Content Analysis

3.1   Basics
Dream content analysis is the most important tool in psychological dream
research as this method suffices the common criteria of science such as
possible replication by another research group, assessment of reliability
and validity, and minimizing experimenter bias (Domhoff 1996; Hall and
Van de Castle 1966). The aim of content analysis is to quantify particular
aspects of the verbal material (dream report) in order to carry out statisti-
cal analyses (Schredl 2010). For example, Hall and Van de Castle (1966)
analyzed the nature of aggressive interactions in dreams and found that
50% of the aggressive interactions were of a physical nature in men’s
dreams whereas for women’s dreams the amount was only 34%—a signifi-
cant gender difference. However, the method of content analysis also has
some shortcomings. By applying specific scales, information is lost as only
a few aspects of the dream report can be measured. The uniqueness of a
single dream cannot be captured. A problem which is very important for
interpreting empirical findings is that content analysis relies on dream
reports to measure dream experiences, that is, the question “How close is
the dream report to the original dream experience” is of utmost impor-
tance. If dreamers, for example, do not explicitly report their emotions or
thoughts that occurred in the dream, the content analytic findings are
biased. These issues will be discussed in the validity section.

© The Author(s) 2018 35

M. Schredl, Researching Dreams,
[Link]
36 M. SCHREDL

3.2   Collecting Dream Reports

Several approaches have been used to collect dream reports (Schredl
2008d): interviews, questionnaires, dream diaries, and awakenings in the
sleep laboratory.
The easiest way to elicit dream reports from a large number of partici-
pants is the so-called most recent dream approach (Domhoff 1996). The
participants are asked to write down (as completely as possible) the last
dream they remember. The advantage of this retrospective collecting
method is that dreaming is not affected by this method as the participant
when remembering the dream is not aware that she/he will participate in
a dream study. But, on the other hand, depending on how long ago the
dream was recalled in the first place, the participant might have problems
remembering all the details of the dream. Unpublished data of the author
clearly indicate that most recent dreams include more emotions compared
to diary dreams, that is, intense and bizarre dreams are more easy to re-­
remember at a later time point after recalling them directly after waking up
(Cipolli et al. 1993; Kemp et al. 2003).
For interviews which elicit the most recent dream, the same issues
regarding the question how accurate is the re-recalled dream in respect to
the dream experience apply and more intense dream are over-represented
as they “survive” longer within the dreamer’s memory. Additionally, fac-
tors of the interview situation such as gender constellation or closeness
between experimenter and participant are also of importance, for example,
the dreams reports were more personal if an unknown student conducted
the interview compared to a university teacher known to the dreamer
(Cartwright and Kaszniak 1991). A research area in which dream inter-
views are crucial is studying dreams in young children (Foulkes 1982).
Within this context, experimenter variables, for example, telling the dream
to an unknown experimenter versus one of the parents, might affect the
findings as children might have the tendency to please the experimenter
and confabulate a dream. Sándor, Szakadát, Kertész, and Bódizs (2015)
tried to minimize biases by training the parents to conduct the dream
interviews; in addition, the interviews were to be recorded and evaluated
by the researchers to assess whether the parent was suggesting something
or leading the child.
Therapy dreams, that is, dreams reported by the client to the therapist,
might also be affected by the therapeutic relationship. Whitman, Kramer,
and Baldridge (1963) have demonstrated that the dreamer reported
 DREAM CONTENT ANALYSIS 37

­ ifferent dreams to the therapist than to the experimenter the night

d
before, for example, a male patient has not reported dreams which may be
interpreted as hints for homosexual tendencies to the therapist. This find-
ing indicates that dreams reported in the therapeutic setting might not be
a representative selection of the total dream life of this person but a delib-
erate selection of dreams which are related (or not related) to the thera-
peutic process. Hopf (1989) also pointed out that the usual procedure is
that the therapist is recording the dreams after the session is also a source
of bias. In addition, the therapists in his study selected mainly emotionally
intense dreams to record them and did not bother with more mundane
dreams. This implicates that dream content studies that are based on
therapist-­recorded patient dreams should be viewed with caution and
often do not allow a generalization on dreaming in general.
To minimize recall bias, dream diaries completed in the home setting are
an appropriate tool (Schredl 2002). Another advantage is that keeping a
dream diary increases dream recall, especially in low dream recallers (Schredl
2002) and, thus, allows to collect dreams from a person who would not be
able to recall a recent dream if retrospectively asked. The disadvantage of
the diary approach is that the person is aware of the fact that she/he is
participating in a dream study; one might speculate that very personal
dream topics, for example, erotic dreams, might not be recorded at all or
not as detailed as the researcher would like it to be. The finding that the
retrospectively estimated percentage of erotic dreams are considerably
higher as the percentage of diary dreams including some form of erotic
content supports this idea (Schredl et al. 2009). Another issue scarcely
studied systematically is the effect of the instruction regarding how to keep
the diary and how elaborate the dream reports should be. Stern, Saayman,
and Touyz (1978) varied the instructions for the two samples they studied:
one group should focus on outdoor nature settings and describe them as
completely as possible whereas the other group should focus on urban set-
ting. The results were clear; the instruction resulted in an increase of the
respective topic in the diary dream reports. Another problem is that keep-
ing a dream diary—even for two weeks—is very time-consuming. In a
dream diary study including 425 participants (Schredl 2004) the mean
word count dropped from 162.3 ± 135.5 words per morning report (all
dreams of the previous night) in the first week to 143.5 ± 119.4 words in
the second week and the number of reported dreams also dropped from
1011 to 601 (unpublished analyses), reflecting a decrease in motivation
related to keeping the dream diary. Related to this expenditure of keeping
38 M. SCHREDL

a diary is the fact that most dream diary studies were carried out in student
samples—even the so-called norms of Hall and Van de Castle (1966) and
not in full-time working persons. Another option for obtaining diary dreams
is to ask for (or the researcher is offered the opportunity by the dreamer)
dream diaries the dreamer kept for personal reasons. G. W. Domhoff (2018)
collected a considerable number of long dream series which are also avail-
able on his website [Link], for example, the Barb Sanders series
encompasses 4254 dreams over a time period of about 26 years. Such a
diary study would not be possible with research participants but it has to be
taken into consideration that only persons with specific characteristics, for
example, interested in personal growth, are willing to put in the effort to
record dreams almost every morning over such a long period in time; sec-
ondly, the dreamer might have selected to record only specific dreams, for
example, those that are puzzling him or her, and mundane dreams are not
recorded. But the opportunity to study how life events affect dreams even
years afterward is compelling, for example, the occurrence of school
friends in dreams 20 years after graduation (Schredl 2012). Interestingly,
Casagrande and Cortini (2008) showed that voice-recording dreams in the
home setting (instead of writing the dream report down) yielded more elab-
orated dream reports that closer the actual dream experience than written
reports. This is an option that should be pursued in the future.
In order to optimize controllability of the experimental situation and
enhance the amount of dream material because of the high recall rates of
about 80% after REM awakenings and 40% after NREM awakenings
(Nielsen 2000) dream reports collected during laboratory awakenings are
considered to be the “gold standard” for obtaining dream material. The
major drawback of this paradigm, however, is the strong effect of the set-
ting on dream content; that is, on average about 20% of the dreams include
direct laboratory references like electrodes, experimenter, and sleep lab
and about 38% direct and indirect references, for example, participating in
an experiment (Schredl 2008b), that is, these dream reports are clearly not
representative of the dream life of the participants in his or her everyday
setting. Furthermore, aggressive and sexual elements occur in laboratory
dreams less often than in home dreams (Domhoff and Kamiya 1964;
Weisz and Foulkes 1970) and also the number of emotions, especially
negative emotions, are reduced in the lab setting (Sikka et al. 2018); find-
ings which are interpreted as an “inhibitory” effect of the lab setting
(including video taping of the sleeper, technical staff presence in the ­adjacent
room). For investigating sleep physiology in persons with nightmares,
 DREAM CONTENT ANALYSIS 39

some researchers have conducted ambulatory polysomnography in order

to circumvent the “inhibitory” lab effect (Germain et al. 2006; Paul et al.
2015) and to collect dreams and physiological parameters in the home
setting. Especially for dream content studies, an ambulatory unit that can
automatically detect REM sleep and deliver a sound to awaken the sleeper
after five or ten minutes would be ideal—because the high recall rated
obtained in the lab can be also obtained in the home setting. Okuma,
Fukuma, and Kobayashi (1975) developed such a “dream machine” and
obtained interesting results but this technique has not been widely used as
detecting eye movements automatically in a reliable fashion is not an easy
task. Another rather exotic option was studied by Lloyd and Cartwright
(1995): they trained participants in the sleep lab to press a mini-switch
attached to the hand if they experienced dream images; in the lab the recall
rate was about 93%, in the home setting with the “Automatic Dream
Detector” recall rates could be increased to values of 61% to 80%.
Systematic studies of how these devices might affect dream content have
not yet been carried out.
In most dream studies, verbal dream reports that are later transcribed
or written dream reports were subjected to subsequent content analysis
(Domhoff 2018; Schredl 2008d) but specific research question might call
for other collection methods. In order to measure the effect of sublimi-
nally presented visual stimuli on dream content, Leuschner, Hau, Brech,
and Volk (1994) asked the participants to draw the main dream scenes and
applied a rating system to measure the presence of geometric forms (e.g.,
triangles that were present in stimulus) or thematic content (e.g., beach-­
related topics, also a feature of one of the pictures) in these pictures. Using
this specific method, the Leuschner et al. study and a subsequent study
(Schredl et al. 1999) found small but detectable effect of the sublimi-
nal stimulation prior to sleep onset.
To summarize, every collection method has its advantages and disad-
vantages which have to be taken into consideration when interpreting the
results of the study (Kramer 2010). If, for example, the researcher is inter-
ested in the relationship between dream characteristics and physiological
parameters, for example, heart rate, a sleep lab study or an ambulatory
polysomnographic (PSG) study is necessary. On the other hand, if the
researcher is interested in the effect of everyday life on dreams, a diary
study might be much more appropriate. For studying large dream samples
from groups with different backgrounds, age groups, and so on, the most
recent dream approach (paper and pencil or online) seems the best option.
40 M. SCHREDL

3.3   Basic Steps of Dream Content Analysis

In Table 3.1, the steps of carrying out a dream content analytic study are
listed. Formulating specific hypotheses, for example, higher percentage of
physical aggression in men’s dreams compared to women’s dreams, is very
important in dream research as the application of a dream manual (Hall
and Van de Castle 1966) allows the coding of over 300 different subscales
(see Sect. 3.5) and thus yields to the problem of multiple testing, that is,
if the significance level is p < 0.05 and 300 statistical tests are carried out,
one obtains on average 15 significant differences, even in a complete ran-
dom data set. The other option to deal with that is to adjust the alpha-­
levels with respect to the number of test, in this case p = 0.05/300 which
is p = 0.00017—and the researcher would need a very large sample
(N > 1000) to obtain sufficient statistical power (Beta error) for his or her
study. In practice it is much simpler to use one to five hypotheses and add
exploratory analyses which are discussed—if significant—with caution,
mainly in the direction that a future study confirming the finding is neces-
sary, that is, the exploratory analysis can provide ideas for future research-
ers about what might be interesting to look for.
Depending on the study’s hypotheses the researcher can select existing
scales (see next sections), for example, scoring eight types of aggressive
interactions according to the coding rules of Hall and Van de Castle
(1966), or developing new scales, for example, scales for assessing the
occurrence of interpersonal problems and contact-seeking behavior in the
dream. In order to document the quality of the scale, it is necessary to
compute interrater reliability indices, that is, compare the ratings of two
different external judges coding the same dream material. If well-­
established scales were applied, it is not necessary for each new study to

Table 3.1 Dream content analysis: basic steps

Procedure

Formulating a hypothesis
Selecting an existing scale or developing a new one
Eliciting dream reports
Preparing dream reports
Blind rating by external judges
Computing interrater reliability
Statistics
Interpreting the findings
 DREAM CONTENT ANALYSIS 41

compute interrater reliabilities because the researcher can refer to the indi-
ces given by the author of the scales or to previous studies using this par-
ticular scale.
It should be very carefully documented how dream reports were elic-
ited (see: Winget and Kramer 1979) since the type of dream report (most
recent dream, diary dream, reports obtained in a sleep lab) might have—as
pointed out above—a strong effect on the findings. As each dream collec-
tion method has pros and cons, it depends on the study’s aims as to which
method is best suited to answer the research question.
After collecting the dream reports, they usually were typed in order to
facilitate blind rating. All information not reflecting the dream experience,
like “I dreamed of my uncle whom I have seen the day before” should be
removed so the judges are not distracted by irrelevant information. For
some research questions, for example, guessing the dreamer’s sex (Schredl
2008a; Schredl et al. 2004), it is necessary to edit the dream more thor-
oughly and remove all explicit references to the dreamer’s sex, for exam-
ple, “My wife has …” changed into “My wife/my husband has …”. The
next step is to bring the dreams into a randomized order, for example,
mixing the men’s dreams and the women’s dreams so the external judge
cannot guess to which group the particular dream belongs (“blind judg-
ing”). Typically the dreams are numbered according to the new order
(viewable for the reviewer) and the researcher keeps a file matching the
new numbers with the group variable (men vs. women) and the original
subject number.
Usually one rater coding all dream reports are sufficient; solely in the
case of scales newly developed for the study, a second rater should rate at
least a subsample (preferably 100 dreams or more) in order to compute
interrater reliability indices. Typical indices are exact agreement, Cohen’s
kappa (e.g., physical aggression present/not present), Spearman Rank
correlations for ordinal scales (e.g., dream bizarreness with four catego-
ries), or Pearson correlations for interval scales (e.g., number of dream
persons).
After coding and entering the coding results in a file, the dream reports
are sorted along the group(s) the dream belongs to in order to perform
statistical tests, for example, a chi-square test whether more men’s dreams
include at least one physical aggression compared to women’s dreams.
The statistics might get more complicated if more than one dream per
participant is included (repeated measurement) or a dream series of one
dreamer is analyzed (see below).
42 M. SCHREDL

For interpreting the results correctly, it is vital to pay attention to all

relevant methodological issues that might bias the results, for example,
sample selection (e.g., solely students), dream selection (most recent
dreams might be more “dramatic” that diary dreams), and the reliability
and validity of the applied scales. For dream emotions, it was shown that
dream content analysis might yield biased results, for example, a strong
preponderance of negative emotions that was not found if the dreamer
completed self-rating scales after recording the dream (Schredl and Doll
1998). Again, this is not a problem of the particular scale but an inherent
problem of analyzing written dream reports as we do not know if the
dreamer is able to record all the perceptions, thoughts, emotions, and so
on that occurred while dreaming.
To summarize, dream content analysis is a straightforward method that
can be easily applied even though it can be very time-consuming depend-
ing on the number of dream reports and number of scales. A much faster
procedure is the use of templates within a digital word search method
(Bulkeley 2009, 2014), for example, counting all emotion-related words.
However, a lot of information is lost, for example, who is experiencing the
emotion or is somebody talking about emotions and so on.

3.4   Scales for Dream Content Analysis

Winget and Kramer (1979) collected 132 scales and rating systems that
have been used in dream content analysis and have been published in
English. Given this high number of scales and the extensive rating system
of Hall and Van de Castle (1966), the question arises whether it is neces-
sary to develop new scales. Clark, Trinder, Kramer, Roth, and Day (1972),
for example, have shown that the masochism scale developed by Beck and
Hurvich (1959) can be derived by summing up several categories of the
Hall and Van de Castle (1966) rating system. On the other hand, Hauri
(1975), who carried out a factor analysis of 23 scales of different authors
for 100 dreams, pointed out that scales which measures quite similar char-
acteristics, for example, dreamlike quality, showed relatively low intercor-
relations (about r = 0.5), that is, 25% of the variance shared but 75% of the
variance is unexplained indicating that the different scales might indeed
measure different aspects.
If an existing scale for the specific research question exits, everything is
fine. The scale(s) are then selected for the study. Often it is advisable to train
an external judge if she/he has never analyzed dream reports by providing
 DREAM CONTENT ANALYSIS 43

a sample of reports from another study (typically 30–50 dream reports are
sufficient for practicing coding). But if not, the question arises how to
develop a new scale. A simple receipt of how to construct a valid dream
content scale seems not to exist. Hall and Van de Castle (1966) suggest
reading a great number of dream reports in order to obtain a picture how
the specific content one is aiming for is appearing in the dream. However, it
is very important not to include the material which should be analyzed since
this will produce a scale that measures exactly those aspects the developer
had put into the scale. The categories should be formulated as exact and
comprehensive as possible. The aim from a methodological viewpoint is to
obtain a high interrater agreement if two or more judges apply the same
scale to the same dream sample, that is, the more detailed the coding rules
are formulated the simpler are the decisions for the external judge. However,
one has to keep in mind that there are always “grey areas” and special cases
which cannot be grasped by the categories of a scale (Domhoff 1996). An
example is presented in Table 3.2. Whereas this specific scale measures the
number of persons in the dream comparable to a waking-life experience or
theater play, Hall and Van de Castle (1966) have chosen a broader defini-
tion: they include persons who are mentioned in a conversation or if objects
which belong to a specific person occur within the dream. This example
illustrates that even simple parameters like the number of dream persons
depend on the coding rules which should be as explicit as possible. This
example also illustrates the arbitrariness of the scale’s definition, for exam-
ple, one might argue whether counting groups as one person makes sense.

Table 3.2 Number of dream persons (Schredl 1998b)

Scale: number of dream persons

How many single persons occur in the dream? For example, father, child, friend, and so
on or unknown persons
Groups which are mentioned solely as group will be coded as single person, even if
the description include the group size, for example, eight persons. If members of the
group appear in the course of the dream as single persons, they were coded separately.
Similarly, a division into subgroups will be counted for each new subgroup
If a person underwent a metamorphosis, that is, an identity change is taking place, this
will be coded as one single person
Each person who appears in the dream will only be coded once
If persons seeking contact to persons or objects which belong to other persons (e. g. the
car of my uncle) are only mentioned in the dream, these references were not coded
The dreamer herself/himself will not be coded
44 M. SCHREDL

In this case this option was chosen to avoid totally screwed data distribution,
for example, “I saw a group of about hundred people” would yield a very
high value. As the external ratings depend on the definition of the catego-
ries, the findings of a dream content analytic study should be particularly
careful evaluated with respect to these specific scales’ definitions.
After developing the first draft of the scale, two or more judges should
rate independently a number of dream reports in order to compute inter-
rater reliability coefficients. If the coefficients are low, the researcher
should discuss the disagreements regarding the coding between the judges
with the judges and revise the scale according to this new information. In
order to determine whether the interrater reliability improved, one has to
keep in mind to select new judges for the same material or select another
sample of dreams for the coding. Specific guidelines or cut-off values
about what classifies as “good” and “poor” reliability coefficients do not
exist in the dream research literature.
Content analytic scales in the narrow sense are defined as nominal scale,
for example, occurrence of persons (mother, child, friend, etc.) or aggres-
sive interaction (physical, verbal, etc.) within the dream; the rating system
of Hall and Van de Castle (1966) is using this type of scales. After the
dream(s) are coded, sum indices can be obtained, for example, number of
dream characters, number of aggressive interactions, and so on.
Furthermore, Hall and Van de Castle (1966) differentiated between
empirical and theoretical scales. Empirical scales were derived by reading
through many dream reports to look for topics which occur often in
dreams or have been of special interest to them. The above-mentioned
scale for measuring the number of dream persons is an example for an
empirical scale. The fact that this scale is also not free from making assump-
tions becomes obvious if one compares the coding of persons who appear
in the dream versus coding persons who were only mentioned in the
dream. Hall and Van de Castle (1966) have derived theoretical scales from
the psychoanalytic theory by making a variety of prepositions: the scales
“penis envy”, “castration anxiety” and “castration wish”. Looking at the
coding rules and the examples of the castration anxiety scale, for example,
“My finger was cut off”, “I wasn’t able to get an erection”, “I couldn’t get
my key in the lock” illustrates the fact that a lot of assumptions went into
the construction of that scale (e.g., metaphorical analogies); the correct-
ness of these assumptions can be debated (Domhoff 1996). The finding
that men tend to more often have dreams including penis envy (N = 25)
 DREAM CONTENT ANALYSIS 45

than women (N = 13 dreams) is also not encouraging (Domhoff 1996)

and explains why these theoretical scales were not used in subsequent
studies or by other researchers.
In addition to these content analytic scales, global rating scales were
commonly applied (Schredl 2008d). The following scale is an example
(Table 3.3).
The main difference between global rating scales and classical content
analytic scales is the possibility to measure intensity. For bizarre ele-
ments, one might imagine that the number of bizarre elements (Domhoff
1996) might correlate quite nicely with the global rating scale presented
in Table 3.3. More difficulties are encountered if emotions were mea-
sured, it seems obvious that occurrences of mild negative emotions do
not add up to emotionally intense dream—regardless the number of
mild emotions. A global rating scale, for example, the intensity of nega-
tive emotions by using a four-point scale (none, mild, moderate, strong)
applied by an external judge might be more appropriate to measure
emotional intensity. Similarly, other attempts (Saul et al. 1954) to define
intensity levels of hostility (occurrences of hostility in the dream from
1 = minor discomfort to an object to 6 = death of a person) can yield to
bizarre results that a dream with six minor discomforts equals a dream
with one death of a ­person. Since such approaches are unsatisfactory,
Gaillard and Phelippeau (1977) have suggested that a global rating scale
should assess the most intense occurrence of a category, for example,
negative emotions, and that this scale has an ordinal measurement level.
In that way, dreams can be classified into more or less aggressive or into
more or less emotionally intense dreams. Very simple global rating scale

Table 3.3 Global rating scale (Schredl 1991)

Scale: realism/bizarreness

In four steps the closeness of the dream action to everyday reality should be estimated.
Are the dream events part of everyday life of a person of a Western culture or are they
uncommon or impossible?
 (1) Possible in waking life and dream events are part of the normal everyday life
 (2) Many elements of the waking life, but the dream action is uncommon and
impossible for the dreamer in real life
 (3) Occurrence of one or two fantasy objects, bizarre connections, or actions that are
not possible in the real world
 (4) Occurrence of several fantasy objects, bizarre connections, or actions that are not
possible in the real world
46 M. SCHREDL

assesses the presence or absence of a particular theme (e.g., health related

topics, respiratory-­related topics). Global rating scales and Yes/No scales
often show sufficient interrater reliability (see below).
As mentioned above, one of the major methodological problems of
dream content analysis is that the external judge can only code the tran-
scribed or written dream report. As dream research aims to assess the
dream experience itself, the use of global rating scales completed by the
dreamer himself/herself after recording the dream might yield more
appropriate results, for example, for measuring emotions experienced
within the dream (see Sect. 3.6). Another application of self-rating scales
is the measurement of the temporal reference of dream elements. In a
study carried out by Strauch and Meier (1996), the participants were
asked whether and when dream elements occurred within one’s waking
life or waking thoughts.

3.5   Dream Manuals

A dream manual is a collection or system of a number of content analytic
scales aiming at a comprehensive measurement of the total dream experi-
ences or at least the major dream characteristics. The most often applied
coding system are the Hall and Van de Castle scales (Domhoff 1996). A
less elaborated system intended to measure some key features of dreams is
the dream manual of Schredl (1999a) that included global rating scales
and is conceptualized within a modular-design principle, that is, allowing
the addition of scales especially designed for a specific research topic. In
addition to the comprehensive manuals, systems for measuring special
aspects of the dream, for example, anxiety and aggression (Gottschalk
et al. 1963), latent structures (Foulkes 1978), relationship patterns and
emotions (Enke et al. 1968) or systems for special population groups, for
example, children (Foulkes and Sheperd 1971) have been developed and
published.
The coding system of Hall and Van de Castle (1966) has been devel-
oped over a period of about 20 years and includes the authors’ experiences
with over 10,000 dream reports. Aside from the three theoretical scales
“penis envy”, “castration anxiety” and “castration wish”, the manual
assesses a large variety of dream aspects, for example, characters, interac-
tions, activities, settings, objects (see Table 3.4). The eight major topics
are divided into subscales with over 300 different coding options.
 DREAM CONTENT ANALYSIS 47

Table 3.4 Coding system of Hall and Van de Castle (1966)

Main categories

Physical surroundings: Settings and objects

 Indoor, outdoor, uncertain, distorted settings
 Objects such as architecture, body parts, household, clothing, food
Characters
 Persons (number (individual vs. group), sex, identity, age)
 Animal, creature, mythic creatures
Social interactions
 Aggressive (eight subclasses, e. g., causing a death, physical attack, verbal threat)
 Friendly (seven subclasses, e. g,. long-term close relationship, offering a gift)
 Sexual (five subclasses, e. g., sexual intercourse, petting, sexual overtures)
Activities
 Expressive communication, thinking, physical activities
Achievement outcomes
 Success, failure
Environmental press
 Misfortune, good fortune
Emotions
 Anger, apprehension, happiness, sadness, confusion
Descriptive elements
 Modifiers, for example, size, velocity, age, color
 Temporal scale, negative scale (e. g., no, never, not, unsure)
Theoretical scales
 Castration anxiety, castration wish, penis envy, oral incorporations, regression

For example, if a person occurs in the dream, her/his gender, age,

familiarity (stranger vs. familiar character), and identity (e.g., brother) will
be coded. For interactions, it will be coded whether the dream ego is ini-
tiating the interaction or if s/he is recipient or if it is a reciprocal interac-
tion (e. g., fight = mutual aggression) and also the type of the interaction,
for example, verbal aggression or murder. The exact coding rules which
are quite complex are outlined and illustrated with many examples in Hall
and Van de Castle (1966) and G. W. Domhoff (1996).
Schredl (1991, 1999a) has developed—based on the manual of Dippel
(1988) which comprised 206 items—a dream manual with a new concept.
The basic idea was a kind of modular-design principle, that is, the manual
includes scales measuring key features of the dreams and a few additional
scales which will be developed by the researcher for testing the specific
hypotheses of the study. The idea to extract the most relevant scales was
first pursued by Hauri, Sawyer, and Rechtschaffen (1967) who carried out
48 M. SCHREDL

a factor analysis of 20 ordinal scales and obtained six factors: “vivid fan-
tasy” (including realism/bizarreness), “active control”, “pleasantness”,
“verbal aggression”, “physical aggression” and “heterosexuality”. Based
on these findings and own experiences, the manual of Schredl (1991) and
the subsequent versions (Schredl 1998b; Schredl et al. 1996, 1998, 1999)
enclosed the basic scales which are depicted in Table 3.5.
The advantage of this rating system is the simple applicability of the
basic scales; it is much less time-consuming than coding dreams according
to the rating system of Hall and Van de Castle (1966). In addition, as
pointed out above, it does make sense to add only scales that are specifi-
cally aiming at the study’s hypotheses; even if they have to be newly devel-
oped for the study. For example, Schredl (1991) developed a three-point
scale for measuring the occurrence of problems within a dream (none,
minor, and major problems) in order to test the hypothesis whether
patients with insomnia tend to have more problematic dreams than healthy
controls. Another example was provided by Schredl and Montasser (1999)
who investigated the dreams of anorectic and bulimic patients; they con-
structed scales measuring the occurrence of food themes and food rejec-
tion in dreams. The global rating scales allow the assessment of emotional
intensity of the dream and can be easily applied to short dream reports.
The manual of Hall and Van de Castle (1966) recommends using the
­system for dream reports with 50–300 words. The interrater reliability
coefficients are mostly sufficient (see next section). The experiences of the
various studies applying the system, for example, dreaming in the elderly
(Schredl, Schröder, et al. 1996), dreaming and eating disorders (Schredl
and Montasser 1999), gender differences in dreams (Schredl et al. 1998),

Table 3.5 Dream manual by Schredl (1998b)

Basic scales

Dream length (three-point scale)

Realism/bizarreness (four-point scale; see Table 3.3)
Number of dream persons
Verbal interaction (present vs. not present)
Physical interaction (present vs. not present)
Aggression (four subscales, physical vs. verbal, directed to the dreamer vs. directed by the
dreamer to others; present vs. not present)
Positive dream emotions (four-point scale: none, mild, moderate, strong)
Negative dream emotions (four-point scale: none, mild, moderate, strong)
 DREAM CONTENT ANALYSIS 49

dreaming in psychiatric inpatients (Schredl and Engelhardt 2001), patients

with sleep disorders (Schredl 1998b; Schredl et al. 1998), and the rela-
tionship of dreaming and personality (Schredl et al. 1999), confirm the
usefulness of the scales since the major findings have been replicated and
extended as well.
A new approach is the usage of elaborate word search templates;
Bulkeley (2014) compiled 40 templates within 8 classes: perception, emo-
tion, characters, social interaction, movement, cognition, culture, and
natural elements. For example, for “family”, the program is searching for
mother, brother, father, sister, nephew, married, and so on or for “fear”
search terms are afraid, frightened, worried, upset, fear, anxious, and so
on. The advantage of such an approach is quite obvious—if you have digi-
talized dream reports, the classification will take minutes. The disadvan-
tages are that searching for words lose context information, for example,
who is worried, and so on. For a first impression, especially if the researcher
wants to analyze big data sets, this method is enticing.
The brief overview illustrates the efforts which have been undertaken in
the field of dream content analysis to assess dream content comprehen-
sively but also economically. It has to be mentioned that the standardiza-
tion of the scales is desirable in order to compare findings of different
studies directly. But the results should not depend on the kind of scale (if
sufficient reliability and validity of the scale is ensured) used in the study.
For example, one does not have to use the Hall and Van de Castle system
for the comparison of physical aggression in women’s dreams and in men’s
dreams, other ratings system should yield comparable findings (Schredl
et al. 1998). It might even be advisable to use different approaches to
minimize possible biases inherent to a specific coding system.

3.6   Quality Criteria: Reliability and Validity

Determining quality criteria like reliability and validity is of utmost impor-
tance for all measurement instruments used in scientific studies (Bandalos
2018). The instrument should be reliable, that is, produce exact results,
and show validity, that is, measure the characteristic the researcher wants
to measure. These criteria are crucial for fulfilling basic principles of sci-
ence, for example, replicability (another researcher doing the same study
should obtain similar results). Whereas the procedure to obtain reliability
coefficients in dream content analysis is very simple and straightforward,
the assessment of the scales’ validity is much more complex.
50 M. SCHREDL

The reliability coefficient for a dream content analytic scale is deter-

mined as a coefficient of correspondence between different judges rating
the same dream material. According to the scales’ measurement levels
coefficients of exact agreement, Cohen’s kappa, Spearman rank correla-
tions, or Pearson correlations can be computed. Exact agreement, for
example, is the proportion of concordant ratings to all ratings performed.
Low values implicate that the subjectivity of the judges might play a major
role in the judging process; this is likely for scales with very few and impre-
cise coding rules. High values indicate a sufficient intersubjective compa-
rability and also implicate a high replicability if another researcher is using
the same dream sample and the same scale. Hall and Van de Castle (1966)
reported the following reliability coefficients for their rating system, for
example, occurrence of a person (93% exact agreement) and all features of
a person (76% exact agreement). The coefficients for social interaction are
markedly smaller, for example, 54% for aggressive interactions, 61% for
friendliness, and 63% for emotions. These coefficients are derived by com-
paring the ratings of the authors themselves and thus indicate that even
extensive practice still does not yield perfect concordance.
Interestingly, in subsequent studies (e.g., which applied parts of the
Hall and Van de Castle system), the interrater reliabilities were higher: the
exact agreement for the rating of single aspects of dream characters
exceeded 90% (Kramer and Roth 1979) and the classification of emotions
corresponded in 93–98% of the cases (Schredl and Doll 1998). A draw-
back of the coefficient of exact agreement is the fact that high coefficients
will be obtained if the measured characteristic occurs only rarely within the
dream. The application of Cohen’s kappa is recommended (Cohen 1960);
a coefficient which is yet rarely used in dream research.
For ordinal scales’ reliability Spearman rank correlations can be com-
puted. The coefficients for 17 different scales which were studied by Hauri
et al. (1967) varied between r = 0.59 and r = 0.69. These values have been
improved by Gaillard and Phelippeau (1977) according to their account
by reducing the categories per scale from seven to five. However, they only
reported exact agreements ranging between 88% and 98% if the difference
of one point was allowed, but a direct comparison to the Hauri et al.
(1967) study was not carried out. The correlation coefficients for global
rating scales included in the manual of Schredl (1999a) commonly varied
between r = 0.70 and r = 0.90 (Schredl 1998b; Schredl et al. 1996). An
exception was the correlation of the realism/bizarreness scale in the study
of Schredl, Schröder, et al. (1996); interestingly, the subsequent discus-
 DREAM CONTENT ANALYSIS 51

sion revealed that one judge who grew up in another culture (Egypt) rated
the realism of dream events in a different way as the other judge who grew
up in Germany. The interrater agreement of the general nominal scales,
for example, aggression, verbal interaction, was satisfactory with values
ranging from 88% to 100% (Schredl et al. 1998).
One might speculate that training and experience with coding dreams
might increase interrater reliability. So far only one systematic study on
this topic has been carried out (Schredl, Burchert, and Grabatin 2004). In
this study two raters first coded the same 100 dreams, then they discussed
their discrepancies and coded another 100 dreams. Again the discrepan-
cies were discussed and the third set of 100 dreams was coded. For the
verbal interaction scale the exact agreement went up significantly from
87% to 95%, whereas for other scales like bizarreness, positive and negative
emotions, and number of dream persons the training did not increase the
reliability which was quite high in the beginning ranging from r = 0.642
to r = 0.926 (Schredl et al. 2004). More studies on the effect of training
the judges on the reliability of the scales are desirable.
As mentioned above, the problem of validity is more complicated as
validity means the extent to which the scale’s measurement value is related
to the dimension which one would like to measure. Many rating systems
(e.g., Hall and Van de Castle 1966) rely on the so-called face validity: if the
external judge looks for explicitly mentioned emotions such as guilt, anxi-
ety, fear, embarrassment as explications of “apprehension” scale, the scale
measures the occurrence of apprehension in the dream. This seems very
straightforward, you get what you see. However, this coding of explicitly
mentioned emotions has its shortcomings as the ultimate goal is not to
measure whether the dreamer explicitly mentioned an emotion that can be
classified as apprehension within the dream report but the question whether
the dreamer experienced the emotion while dreaming. The following fic-
tive dream report will illustrate this line of thinking: “I see a monster and
run away as fast as I can.” It can be hypothesized that the dream ego expe-
riences fear but did not mention it explicitly in her or his dream report. The
emotion score of zero—if only explicitly mentioned emotions are scored—
did not reflect the emotion which was present while dreaming. So the
validity problem is not due to badly constructed scales but arises mainly
because the analyzed dream reports are more or less detailed in reflecting
the actual dream experience. One possible approach to this issue is to com-
pare self-ratings of the dreamer obtained after she/he recorded the dreams.
The basic assumption is that the dream experience is “fresh”, that is, the
52 M. SCHREDL

dreamer has still direct access to the dream emotions she/he experienced
in the dream. For example, the total score of aggression (Gottschalk-Gleser
rating system) correlated with the global estimate of aggression made by
the dreamer to r = 0.53 (Stegie 1986). Using similar four-point scales for
measuring dream emotions, the correlations between external ratings and
self-ratings of the dreamer were satisfactory: negative emotions: r = 0.669
and positive emotions: r = 0.557 (Schredl and Doll 1998). Validity coeffi-
cients of r = 0.53 or r = 0.67 can be viewed as good since the scale’s exter-
nal validity coefficient cannot exceed its reliability coefficient.
For measuring dream emotions, validity issues will be illustrated. One
problem of earlier studies (Hauri et al. 1967) was that they used a bipolar
scale for measuring emotional tone (strongly negative to strongly positive)
because Gaillard and Phelippeau (1977) have shown that 13% of all dreams
included positive and negative emotions. In a sample of diary dreams, the
proportion (34%) of dreams including positive and negative emotions was
still higher (Schredl and Doll 1998). Even if the external judge subtracts
the positive and negative emotions, it seems quite obvious that a dream
with intense negative and positive emotions is different from a neutral
dream, that is, it seems better (more valid) to use two scales for measuring
positive and negative emotions separately. Another problem was the ques-
tion whether the dreamer experiences the same emotions in specific dream
situations which she/he also would experience if he faced the same situa-
tion in waking life, for example, seeing a horrible monster induces fear
(appropriateness of dream emotions). Foulkes, Sullivan, Kerr, and Brown
(1988) and Merritt, Stickgold, Pace-Schott, Williams, and Hobson (1994),
however, have shown that such validity errors due to inappropriateness of
the dream emotion occurred in less than 5% of the dreams, that is, the
experiencing within the dream is very similar to experiencing in waking life.
Schredl and Doll (1998) have investigated the relationship between three
types of scales, the emotion scales of Hall and Van de Castle, the two emo-
tion rating scales for external judges constructed by Schredl (1991), and
two self-rating scales for measuring positive and negative dream emotions.
Almost 60% of the 133 dream reports included no explicitly mentioned
emotion (Hall and Van de Castle rating system) whereas the self-ratings of
the dreamer indicated that only 0.8% of the dreams did not include a posi-
tive and/or negative emotion, that is, the findings of this study clearly
demonstrate an underestimation of dream emotions if the Hall and Van de
Castle emotion scales are applied (Schredl and Doll 1998). In addition, the
rating scales designed for judges with the similar format of the self-rating
scales (four-point: none, mild, moderate, strong) did show a marked
 DREAM CONTENT ANALYSIS 53

underestimation of dream emotions, especially for positive emotions

(Schredl and Doll 1998). These findings were replicated by Sikka, Feilhauer,
Valli, and Revonsuo (2017) and Röver and Schredl (2017). Dream length
was associated with the underestimation, that is, the shorter the dream the
more pronounced the underestimation (Röver and Schredl 2017). Another
study (Schredl and Erlacher 2003) found a systematic underestimation of
the number of bizarre elements per dream by external judges compared to
the estimates of the dreamer himself/herself even though the interrater
reliability of the scale was high (r = 0.910). This clearly indicates that the
dream report did not contain the complete information about all different
characteristics of the dream. Strauch and Meier (1996), for example, have
reported dreams in which the experience of touching, for example, touch-
ing a piece of cloth, was not explicitly mentioned by the dreamer in her
report but was revealed after intense questioning. Similar results were
obtained if colors in dreams were analyzed: in 25% of diary dream reports
colors were reported spontaneously (Schredl 2008c), whereas 100% of
diary dreams included colored objects when the dreamer was probed to
report all colored objects of the dream (Schredl et al. 2008).
To conclude, whereas dream researchers had handled the problems of
reliability adequately, the issue of validity has to be studied more exten-
sively. For some dream characteristics like emotions, bizarreness, colors,
and sensory perceptions, it seems to be crucial to use self-rating scales in
order to obtain valid findings.

3.7   Statistical Analyses in Dream Content

Analytic Studies
After the coding of the dream reports and adding group labels (which
have not been given to the external judge), the question arises what statis-
tical procedures are appropriate. One issue is the measurement level of the
content analytic scale, nominal (e.g., physical aggression present vs. not
present), ordinal (e.g., bizarreness, see Table 3.3), or interval (e.g., num-
ber of dream persons). Another important issue is the question whether
there are repeated measurements: typically it is quite simple to perform
the statistics if each participant contributes one dream, but more complex
are the procedures for data sets with different number of dream reports
per participant and for analyzing long dream series of a single participant.
Another relevant issue is the adequate handling of the report length.
54 M. SCHREDL

A basic preposition for most statistical tests (e.g., t-test, Mann-­

Whitney-­U test, regression analysis) is the statistical independence of the
observations. If repeated measurements were made (several dream reports
per participant), it is commonly assumed that these values are dependent.
In the study of Brink and Allen (1992), 139 dreams of 12 patients with
eating disorders and 136 dreams of 11 healthy controls were compared.
The degrees of freedom (df = N − 2) are considerably smaller if the con-
tent analytic findings were aggregated per participant (df = 21) compared
to using the dream reports (df = 175) as independent unit, that is, the
significant findings based on the number of dreams which were reported
by Brink and Allen (1992) can be questioned. A possible solution to this
problem which results in the above-mentioned reduction in the degrees of
freedom is the computation of means, medians, and so on per participant.
However, this will result in a drastic reduction of statistical power, espe-
cially in small samples. Another solution to the problem is the application
of analyses of variance for repeated measures (ANOVA); however, this
method can only be applied if participants contribute equal numbers of
dream reports (cf. Heather-Greener et al. 1996) as this is often not the
case; the researcher loses information if she/he has to discard dream
reports. The most appropriate solution for data sets with multiple dreams
per participants is the usage of mixed models that account for the with-­
subject variance and maximize the statistical power (Schredl 2006; Schredl
and Reinhard 2008). Depending on the measurement level of the content
analytic scales the statistical analysis might require specific expertise as
mixed models are quite often used for interval scales but not so often for
binary (Yes/No scales) and ordinal scales.
It seems obvious that report length correlates strongly with almost
every content analytic derived parameter; the longer the dream the more
objects, persons, interactions can occur in the dream (Schredl 1999b).
This affects the interpretation of the findings if the two groups that were
compared differ considerably in average dream length, for example,
patients with insomnia versus healthy controls in the study of Schredl,
Schäfer, et al. (1998). For example, a lower percentage of social interac-
tions per dream compared to controls might simply be an effect of the
shorter dream reports. One correction procedure might be to use ratios,
that is, computing scores per word count. Trinder, Kramer, Riechers,
Fishbein, and Roth (1970), however, have shown that the relationship
between, for example, number of dream persons and dream length is non-­
linear and, thus, the ratios per word count might be biased. On the other
hand, Schredl (1999b) who analyzed 537 dream reports had demon-
 DREAM CONTENT ANALYSIS 55

strated that the linear correlation coefficients exceed the coefficients of

quadratic and cubic correlations and, thus, the division by word count is a
good approximation. Urbina (1981) has suggested to control dream
length statistically using analyses of covariance or logistic regressions.
Domhoff (1996) has suggested using ratios (e.g., aggressive interaction
per dream characters or ratio between aggressive and friendly interactions)
instead of absolute values (e.g., aggressions per dream). This approach is
problematic if scores for single dreams have to be obtained, for example
male/female percentage cannot be computed for each dream and might
vary considerably (0–100%) depending on the number of male and female
dream characters (typically ranging between 0 and 3). Using the number
of male or female characters per dream and dream length as a covariate in
the statistical analysis would manage this problem.
Time series analysis is a complex statistical task (Schredl 2000). It is
even more complicated if dream series are analyzed because of the differ-
ing time interval between measurement points (most dreamers do not
recall a dream every morning or might recall several dreams a night) and
the usage of binary scales (e.g., a specific animal is present in the dream or
not). There is one algorithm published by Klingenberg (2008) that can
deal with this problem. Schredl (2013) analyzing a long dream series
could demonstrate a significant increase in dreams with dogs after the
romantic partner of the dreamer bought a dog.
To summarize, depending on the data set, statistical procedures might
get complicated and the researcher might need advice and help from a
statistician. As appropriate statistics are crucial in sound scientific work,
researchers are encouraged to think about the statistics very carefully.

3.8   Interpreting the Findings of Dream Content

Analytic Studies
In Table 3.6 methodological relevant issues for interpreting the findings of
a dream content analytic study are summarized.
The sample characteristics are very important regarding the generaliz-
ability of the study’s result. For example the “ubiquitous” gender differ-
ence that men dream more often about men than women whereas women
dream equally often about men and women (Hall 1984; Hall and Domhoff
1963) is mainly valid for young students. In a sample of 2894 most recent
dreams, the percent of male dream characters was comparable for the par-
56 M. SCHREDL

Table 3.6 Checklist for interpreting the findings of a dream content analytic
study
Issue

Sample characteristics
Number of dream reports per participant
Type of dream report
Reliability of the content analytic scales
Validity of the content analytic scales
Appropriate statistical procedure applied

ticipant younger than 25 years (60.3% men’s dreams vs. 46.6% women’s
dream), that is, showing the “ubiquitous” gender difference, but in the
total sample (mean age of about 34 years ranging from 14 to 86 years) the
ratios were different: 59.2% of the dream characters in women’s dreams
were male and only 42.4% in the men’s dreams (Schredl et al. 2010–2011),
reversed compared to the figures obtained in student samples clearly indi-
cating that findings based on student samples cannot be generalized. The
notion of “norms” assigned to the first big dream collection of 500 dreams
of 100 female students and 500 dreams of 100 male students (Hall and
Van de Castle 1966) should be viewed with caution. Similar consider-
ations of the representativeness of samples apply also to clinical samples,
for example, are the participants self-selected (regarding their interest in
dreams) and participated because it is a dream study. In studying dream
content, there is an additional challenged to be faced. Winget, Kramer,
and Whitman (1972) selected 300 persons roughly representative of the
city of Cincinnati, of those 300 participants only 182 (about 61%) reported
a dream. In another representative study (Schredl and Keller 2008–2009)
only 36.8% of the interviewed persons reported a dream; the not report-
ing a dream was associated with dream recall frequency and older age.
That means that the original sample was representative, but the sample of
dream reporters were not; this should be kept in mind as dream recall is
related to a number of personality variables, for example, openness to
experience (Schredl and Göritz 2017) and other variables (see Chap. 2).
For correlating dream content with trait factors, for example, personality
dimension, it is necessary to measure inter-individual differences in dream
content reliably. Kramer and Roth (1979) addressed the stability respec-
tively the variability of dream content empirically in 14 participants who
were awakened out of REM sleep over 20 consecutive nights. Their find-
ings showed that the sum scores (number of dream persons, physical activi-
ties, verbal activities) based on three to five REM dreams per night correlated
 DREAM CONTENT ANALYSIS 57

on average to r = 0.40 between subsequent nights. The mean correlation

coefficient of r = 0.40 indicates that about 16% of the total variance is
explained by stability but more than 80% of the variance is unexplained
and, thus, is error variance regarding the measurement of stable inter-indi-
vidual differences. Schredl (1998a) who has analyzed diary dreams of 98
participants (to a maximum of five dreams per participant) has found com-
parable coefficients for dream length (r = 0.48) and the number of dream
persons (r = 0.30) but much lower figures for the scales “realism/bizarre-
ness” (r = 0.08), “positive emotions” (r = 0.08), “negative emotions”
(r = 0.18), and “verbal interaction” (r = −0.01). That means that for single
dreams the variability of dream contents is very large, that is, one dream
might be mundane, the next dream a wonderful experience, and the dream
after that nightmarish. Low stability coefficients (r = 0.07—0.37) were also
reported by Bernstein and Belicki (1995) who correlated the scores of two
dream series of five dreams elicited at an interval of two to three months.
Samson and De Koninck (1986) correlated waking-life extraversion with
dream extraversion scores based on ratings of the dreamer’s behavior by
external judges. Given the variability of dream content it is not surprising—
as they only used one dream per participant—that the correlation was very
small: r = 0.14 (p < 0.10, one-­tailed, N = 100).
How can this problem be solved? The analogy to psychometric tests,
for example, personality questionnaires, is helpful. A questionnaire with
only one item is not very reliable but the reliability increases if the ques-
tionnaire included a sufficient number of items measuring the same dimen-
sion. Using the formula computing internal consistency, Schredl (1998a)
estimated that 20 dreams per participant are sufficient to obtain values of
about r = 0.80 which are considered as good internal consistency (Rost
1996). Practically speaking, the researcher needs quite a number of dreams
to measure the trait aspects of dream content reliably as these dream char-
acteristics are fluctuating considerably from dream to dream. König,
Mathes, and Schredl (2016) also correlated waking-life extraversion and
dream extraversion and obtained a larger correlation coefficient (r = 0.420)
than Samson and De Koninck (1986) by using on average more than
three dreams per participant and only dreams with sufficient information
to rate the extraversion of the dream ego. The effect of the stability respec-
tively the variability of dream content measures on the results of studies
investigating the relationship between dream content and personality
dimensions should receive more attention as low and non-significant cor-
relations might be explained by this reliability issue.
58 M. SCHREDL

As pointed out in the Sect. 3.2, it is important to take into account the
type of dream reports that have been analyzed, most recent dreams, diary
dreams, or laboratory dreams. Each of these dream types has its pro and
cons, for example, if the researcher is interested in dream emotions, one
might get biased results if only laboratory dreams were collected. The
issues of reliability and validity are also of importance for interpreting the
findings, especially the validity aspect. As mentioned above, dream con-
tent analysis done by external judges might underestimate the occurrence
of dream emotions, that is, for this topic self-rating scales completed by
the dreamer are more appropriate.
Lastly, using the adequate statistics is important for interpreting signifi-
cant results; the most common mistake is to inflate the degrees of freedom
by using the dream report as unit although participants contributed sev-
eral reports—a recent example is the study of Voss et al. (2014). The appli-
cation of more complex statistical procedures in dream research is
increasing.
To summarize, despite the various issues that have to be considered, the
dream content analysis method is a straightforward method that can be
used also by novices—if applied and interpreted properly. Several topics
like validity of dream content analytic scales or applying the appropriate
statistical procedures to the data set have to be studied more thoroughly
in the future.

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 CHAPTER 4

Dream Behavior and Dream Content

in Healthy Persons

4.1   Dream-Related Behaviors

In addition to dream recall frequency, there are other aspects such as
dream sharing, reading dream literature, stimulating effects of dreams,
daytime mood affected by dreams related to dreaming; these might be
called dream-related behavior.
Dream sharing is quite frequent: in a large sample of psychology stu-
dents, about 14.5% of the recalled dreams were shared (Schredl and
Schawinski 2010). In a representative sample, 27.5% of the participants
stated they share their dreams quite often (Schredl 2009b). Women share
their drams more often than men (Curci and Rime 2008); this gender dif-
ference can already be found at an early age of eight years (Georgi et al.
2012). Extraversion, feminine sex role orientation (expressivity), and the
frequency of sharing emotional experiences in general are positively related
to dream sharing (Schredl et al. 2015; Schredl and Schawinski 2010). A
significant, positive correlation was found between dream sharing frequency
in couples and perceived relationship intimacy (Olsen et al. 2013). An inter-
ventional study (Duffey et al. 2004) indicated that regular dream sharing
increased marital intimacy and satisfaction. Sharing nightmares is the
most often applied coping method; typically it is associated with the motive
of relief to share these distressing dreams (Schredl and Göritz 2014). These
findings indicate that dream sharing is a part of everyday social interaction,
even in children and adolescents (Schredl et al. 2015). Reading literature
(books and articles) about dreaming is associated with positive attitude

© The Author(s) 2018 65

M. Schredl, Researching Dreams,
[Link]
66 M. SCHREDL

toward dreams and the Big Five personality factor “openness to experience”
(Schredl 2011b). The finding that the benefit of reading books about
dreams is varying considerably (Schredl 2011b) is an interesting topic for
future research. Anecdotes about dream stimulating waking-life creativity
have been reported fairly often, for example, August Kekulé discovering the
ring structure of benzene (Barrett 2001). Schredl and Erlacher (2007) were
able to demonstrate that dream effects on creativity are not a privilege of
geniuses but also occur in about 8% in the dreams of “normal” people. The
most frequent effect of dreams is the carry-over effect of the dream mood
into waking life (Schredl 2000b), especially negatively toned dreams
(Schredl 2009a) and nightmares (Köthe and Pietrowsky 2001) can exhibit
a strong effect on daytime mood. Interestingly, dreams that are effected by
daytime experiences are more likely to affect the mood of the next day, indi-
cating that relevant and stressful experiences are processed by the mind day
and night (Schredl and Reinhard 2009–2010).
Over the years, questionnaires addressing dream-related behavior,
dream themes, general dream characteristics (like colors and sounds), and
specific dream elements (like aggression and friendliness) have been devel-
oped: the multidimensional dream inventory (Kallmeyer and Chang
1997), Dream Content Questionnaire (DCQ) (Bernstein et al. 1995),
Dream Content Questionnaire for Children (ChDCQ) (Bruni et al.
1999), Dream style questionnaire (Gruber 1988), the Van Dream Anxiety
Scale (VDAS) (Agargün et al. 1999), the KJP dream inventory (Kroth
et al. 1999), the Dream Property Scale (Takeuchi et al. 2001), Dream
motif scale (Yu 2012), and the Düsseldorf Dream Inventory (DDI)
(Aumann et al. 2012). Although most of these questionnaires showed
adequate reliability, for example, measured as internal consistency of com-
posite scores derived from factor analyses or in terms of retest reliability,
the question as to how valid these questionnaire measures of dream con-
tent are is still an open question, as especially in low dream recallers the
dream content analytic results do not match the questionnaire findings
(Schredl 2002). Bernstein and Belicki (1995) and Schredl (2002) pro-
vided data showing the correlations between questionnaire measures of
dream content and measures derived from dream content analysis of
dream reports are very low, especially for low dream recallers. Within this
area, more research is needed to evaluate the psychometric quality of ques-
tionnaires aimed at eliciting dream content. Another interesting approach
to measure specific aspects of dream content is the use of items that are
aiming at a percentage of a specific dream topic in relation to all remem-
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 67

bered dreams, for example, sports dreams, dreams about music, and so on.
It could be demonstrated that frequencies of sport dreams obtained by
this type of questionnaire measure matched the findings of a diary study;
both studies (Erlacher and Schredl 2004; Schredl and Erlacher 2008)
compared dreaming in psychology and sport students.
A recently developed questionnaire (MADRE) elicited in a comprehen-
sive manner the most relevant dream-related variables including dream
recall frequency, nightmare frequency, interest in dreams, creative effects,
dream sharing frequency, and so on (Schredl et al. 2014). This question-
naire showed for most items a sufficient retest reliability and is freely avail-
able in German and English (appendix to the publication).

4.2   General Features of Dreams

The first research group analyzing large dream samples from healthy per-
sons was the group around Calvin S. Hall (Hall and Van de Castle 1966).
Subsequent studies looking at general characteristics of dreams such as
realism/bizarreness, dream emotions, perceptual experiences, and colors
are presented within this section.
In more than 90% of all dreams dream ego is participating fully in the
dream action (Soper et al. 1994; Strauch and Meier 1996), that is, the
dream is experienced similar to waking life and not as a film which is
replayed before the inner eye. Additionally, it is striking that the dreamer
is very rarely conscious about the fact that she/he is dreaming (cf. Chap. 8
on lucid dreaming) even if bizarre elements turn up within the dream. In
Table 4.1, the distribution of the realism/fantasy features of 500 labora-
tory dreams are depicted (Strauch and Meier 1996).
This clearly indicates that only a small portion of the dreams are bizarre,
most of the dreams are totally realistic or realistic but with contents that

Table 4.1 Realism/fantasy of

Category Frequency (%)
500 laboratory dreams (Strauch (N = 500)
and Meier 1996)
Realistic 28.6
Realistic-fictional 53.4
Fictional 10.0
Partly fantastic 6.2
Purely fantastic 1.8
68 M. SCHREDL

are unusual for the dreamer, for example, talking to the German chancel-
lor in one of our dream studies. Although about 30% of diary dreams
include at least one element which is not possible in waking life (Schredl
et al. 1999), one has to keep in mind that dream content analytic studies
are likely to underestimate bizarre elements, mostly those not in the focal
point of the dream action (Schredl and Erlacher 2003), that is, the per-
centage of bizarre dreams might be higher.
However, if the criteria for bizarreness are defined in a broader way
(Hobson et al. 1987), for example, abrupt scene changes, or something
like being in the hometown where there is a building that is not there in
reality, up to 75% of the laboratory dreams include this kind of bizarre ele-
ments (Strauch and Meier 1996), that is, different definitions of bizarre-
ness yield different results.
Regarding dream emotions, Hall and Van de Castle (1966) obtained
only 20% positive emotions and 80% negative emotions. As pointed out in
Sect. 3.6, the validity of external ratings of dream emotions based solely
on the dream report is questionable. In Table 4.2 two studies using ratings
made by the dreamer are depicted showing that positive and negative
dreams are almost balanced. In contrast, the external ratings of the same
1207 dream reports yielded a 3:1 ratio of negative to positive dreams—
clearly supporting the aforementioned problems with measuring dream
emotions.
In their sample of 552 diary dreams, Sikka et al. (2017) found even
more positive dreams (55.8%) compared to 35.3% negative dreams by ana-
lyzing the self-ratings of the dreamers; the external ratings of the same

Table 4.2 Dream emotions (global self-ratings and external judge-based ratings)
Category Laboratory Diary dreams b Diary dreams b
dreams a (%) (Self-ratings) (%) (external raters) (%)
(N = 500) (N = 1207) (N = 1207)

Neutral 27.4 4.7 17.2

Balanced 12.8 16.2 10.6
Predominantly 28.7 44.4 53.9
negative
Predominantly 31.1 34.7 18.3
positive

Strauch and Meier (1996)

a

Röver and Schredl (2017)

b
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 69

dreams also yielded a preponderance of negative dreams (28.1% vs. 12.5%).

These findings indicate that the notion that dreams are predominantly
negative is the result of methodological issues.
In Table 4.3, the findings of three selected studies (McCarley and
Hoffman 1981; Snyder 1970; Zadra et al. 1997) regarding the frequen-
cies of sensory perceptions within dreams are depicted.
All dreams (REM dreams) include visual impressions; auditory percep-
tions are also very prominent. On the other hand, other sensory modali-
ties are quite rare. Again, if the dreamer is asked about sensory perceptions,
the percentages increase dramatically. The figures for 397 diary dreams
were: 8.1% of the dreams include olfactory perception, 12.3% of the
dreams with gustatory perception, 31.2% of the dreams with tactile-­
temperature-­ pain sensations, and 63.0% includes auditory perception
(Carskadon et al. 1989). Typical smells were associated with food, ani-
mals, perfume, and smoke. The bodily sensations comprised tactile sensa-
tions, temperature, pressure, and pain. The high percentage of body
sensations may be illustrated by a dream example given by Strauch and
Meier (1996): a dreamer reported that she straightened a dress in order to
put it into a big wardrobe. Only when the dreamer was interviewed in
detail, it became clear that she felt the smooth cotton material of the dress
against her hand. Vestibular sensations were coded in the study of
McCarley and Hoffman (1981) if topics like floating, falling, spinning,
and so on were present in the dream. In a long dream series (N = 10,535
dreams) about 0.7% of the dreams included explicitly mentioned tempera-

Table 4.3 Sensory perceptions in dreams

Modality Laboratory dreams a (%) Laboratory dreams b (%) Diary dreams c (%)
(N = 635) (N = 107) (N = 3372)

Visual 100 100 100

Auditory 76 65 53
Vestibular – 8 –
Tactile 1 1 –
Gustatory 1 1 <1
Olfactory <1 1 1
Pain – – 1

Snyder (1970)
a

b
McCarley and Hoffman (1981)
Zadra et al. (1997)
c
70 M. SCHREDL

ture sensations of the dreamer and about 1.0% of the dreams included pain
(Schredl 2016). Pain dreams were more prominent in patients with
chronic back pain (Schredl et al. 2017) but the percentage of 16% pain
dreams indicate that even if pain is very frequent in waking life it rarely
shows up in dreams. Due to the limitations of dream content analysis, the
percentages of “rare” sensory perceptions should be viewed with caution;
whereas visual and auditory perception, for example, talking to someone
is often mentioned explicitly in the dream report, the subtler perceptions
are not; more studies using self-ratings of the dreamer are needed.
As dreams are dominated by visual perceptions, very early the question
arose whether and how congenitally blind persons dream; Heermann
(1838) reported that these persons can remember dreams but without
visual images. In his data, persons who got blind after the age of seven
years still had visual images years later. Although visual impressions are
lacking completely, the number of dream persons, social interactions, and
so on are quite similar to dreams of seeing individuals (Kerr et al. 1982).
Often the dream reports cannot be differentiated at first sight, that is,
whether the dream report stems from a blind or seeing person since blind
persons can describe settings in a detailed way, spatial relations without
having explicit visual perception—even words like seeing are used (Kerr
and Domhoff 2004). These findings indicate that dreams are not visual
images played in the mind but actual experiences very similar to waking-­
life experiences (see Chap. 1).
Normally very few color impressions were explicitly reported in dreams,
about 25% (Kahn et al. 1962). However, if the participants are asked
directly upon awakening to name the colors of all major dream objects,
the percentage increased up to almost 100% (Rechtschaffen and Buchignani
1992; Schredl et al. 2008). These findings again indicate that dream con-
tent analysis relying on the dreamer’s skills to report everything she/he
experiences in the dream might have its shortcomings in several areas.
Interestingly, during the era of black-and-white mass media a considerable
percentage of persons thought their dreams were also black-and-white
(Schwitzgebel 2002). A more recent study (König et al. 2017) showed
that in our days most people think their dreams are in color—as the media
switched from black-and-white to color; a very small number (0.53%) of
the generation only exposed to color media think that all their dreams are
black-and-white. The simplest explanation of these changes is that most
persons do not recall the colors of the dreams—except they play a domi-
nant role in the dream, for example, a blue elephant—and adding the
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 71

common analogy between films and dreams the people only thought their
dreams were black-and-white. If, for example, the faces of all dream char-
acters would be gray, the dreamer might notice and remember this strange-
ness. In sum, dreams are—according to the continuity hypothesis of
dreaming (see Sect. 4.3)—as colorful as waking life, but it seems not quite
simple to remember normal colors like yellow bananas or skin colors.
Another topic that has received little attention is the occurrence of cog-
nitive activities (thinking) as this is not mentioned by many dreamers in
their dream reports. Meier (1993), for example, has demonstrated that
cognitive activities (thinking) occur in 21.2% of laboratory dreams.
Carefully conducted studies in trained participants yielded higher percent-
ages of cognitive activities (Kahan and Claudatos 2016).

4.3   Waking Life and Dreaming: The Continuity

Hypothesis
Currently there is a debate as to how to interpret the originally formulated
continuity hypothesis (Domhoff 2017; Erdelyi 2017; Schredl 2017). As
many dream content analytic studies are based on the continuity hypoth-
esis it seems appropriate to start at the beginning. Although the idea that
daytime experiences affect dream content dates back a long time—see lit-
erature review of Freud (1900/1991)—the specific term “continuity
hypothesis” was first used by Bell and Hall (1971): “If he dreams fre-
quently of his mother, as Norman did, it is inferred that the mother plays
an important role in his life. This may be called the continuity hypothesis
because it assumes there is continuity between dreams and waking life”
p. 117 and “The continuity hypothesis holds generally speaking because
dreams and waking behavior are both motivated by the same unfulfilled
impulses” (p. 123).
A more explicit definition is given by Hall and Nordby (1972):

These facts and many others obtained from the content analysis of many
dream series have led us to formulate what we call the continuity hypothesis.
This hypothesis states that dreams are continuous with waking life; the
world of dreaming and the world of waking are one. The dream world is
neither discontinuous nor inverse in its relationship to the conscious world.
We remain the same person, the same personality with the same characteris-
tics, and the same basic beliefs and convictions whether awake or asleep. The
wishes and fears that determine our actions and thoughts in everyday life
also determine what we will dream about p. 104.
72 M. SCHREDL

Further explanations like “A large number of dreams reflect rather

faithfully the daytime activities and preoccupations of the dreamer. Skiers
dream of skiing, … and good friends and lovers dream about each other”
p. 104 (Hall and Nordby 1972) indicate that the concept of the continuity
hypothesis is very broad and not restricted to particular aspects of waking
life. But why do we have bizarre dreams that are not related directly to
waking-life experiences. Hall and Nordby (1972) put forward the follow-
ing explanation:

How can we reconcile the continuity hypothesis with the obvious fact that a
person will do something in his dreams that he would not or could not do in
a waking state? He will, for example, torture someone to death, have sex with
his young daughter, betray his best friend, or fly through the air. The answer
to this dilemma is to be found in the distinction between overt behavior
(‘acting out’) and covert behavior (thoughts, feelings, and fantasies). The
continuity may be between dreams and covert behavior or it may be between
dreams and overt behavior. A person who has many sex or aggression dreams
may either have many fantasies of sex or aggression when he is awake, or he
may have many actual sexual or aggressive experiences. In either case he is
preoccupied with sex or aggression, awake or asleep. Although when asleep
these preoccupations have fewer limitations, allowing the dreamer to experi-
ence tremendous diversity in his sexual and aggressive fantasies p. 104.

These explanations expand the continuity hypothesis even further;

everything that occurs in waking-life-like experiences, thoughts, fantasies
can and will come up in dreams. Whether all dreams that are not continu-
ous with waking, for example, flying dreams can be explained by having
fantasies about that topic in waking, is still a point of debate (Schredl
2012); one might speculate that mirror neurons might play a part when
experiencing pain in dreams that one never has experienced before (Schredl
2011a) or the effect of media on dreams (Van den Bulck et al. 2016).
Another hypothesis regarding the relationship between waking and
dreaming is the complementary hypothesis based on the dream function
of compensation formulated by C. G. Jung (1979), that is, we dream
about topics that have not been adequately addressed during the day but
are important for the psychological balance of the individual. Sometimes
the idea can be found that dreams are random, neurons of the brainstem
activate more or less randomly the cortex so that pictures are produced—
see activation-synthesis hypothesis of Hobson and McCarley (1977). Even
though these authors assign no function to dreaming, they also state that
these pictures are from memory and the mind upon awakening is trying to
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 73

put these elements together into a story (Hobson 1988), that is, dream
content is related to waking life.
For empirical researchers studying the continuity hypothesis the ques-
tion arises whether there are factors that affect the probability of a specific
waking-life experience, preoccupation, or thought to be incorporated into
a subsequent dream. After an overview of paradigms used to study conti-
nuity between waking and dreaming some of those factors that might
affect the continuity are reviewed, for example, time interval between
waking-life experience and dream, emotional intensity of the waking-life
experience, type of the waking-life experience.

4.4   Paradigms for Studying the Continuity

Between Waking and Dreaming
Different approaches have been applied for studying the continuity
between waking and dreaming (see Table 4.4). As each paradigm has its
pros and cons, this section will briefly outline the basic ideas of these
approaches and present an exemplary study.
The first paradigm “Temporal references of dream elements” is carried
out the following way: the participant reports or records the dream and
afterward she/he is asked whether a dream element is known to the
dreamer from his or her waking life. This approach can be called retro-
spective as this matching with waking life is done after the element
occurred in the dream. A diary approach is typically prospective as the
waking-life event is recorded before the participant knows that it would
show up in the dream. Strauch and Meier (1996) asked five participants to
match the dream elements of their dreams (50 dreams obtained from

Table 4.4 Paradigms for studying the relationship between waking and
dreaming
Research paradigms

Temporal references of dream elements (retrospective approach)

Experimentally manipulate daytime experiences
Field studies
 Linking inter-individual differences in waking life to differences in dream content
 Longitudinal designs, typically dream diaries (two to four weeks) or long dream series
“Blind” analysis of dream series
Lucid dreaming
74 M. SCHREDL

REM awakenings) with their waking life. The ability of the dreamers to
relate dream elements to waking life varied considerably: 30.9% of the
dream objects had been seen in waking life and 76.3% key dream charac-
ters were known to the dreamers. For 80 key dream characters, for exam-
ple, the time distribution (including meeting/talking to the person but
also thinking about the person) was as follows: 67.6% pervious day, 19.7%
previous week, 7.0% previous year, 5.6% more than one year ago. Vallat,
Chatard, Blagrove, and Ruby (2017) carried out a field study providing a
questionnaire with questions about the occurrence of the dream element
in waking life. For example, the intensity of the dream element within the
dream was lower compared to the intensity of the corresponding waking-­
life experience. Furthermore, waking-life experiences dating back a longer
time interval were rated to be more important and emotionally more
intense than waking-life experience of the previous day (Vallat et al. 2017).
Even though this method seems straightforward, there are at least three
problematic issues: (1) Memory. If waking thoughts are included in addi-
tion to waking-life events, it might be very difficult to recall all the thoughts
of the previous day, let alone of the previous week and therefore an expo-
nential decrease of the incorporation rate with time might just reflect the
ability of the participants to remember the connections, (2) Multiple cor-
respondences. If the person dreams about his mother this might corre-
spond with a telephone conversation two days ago or is related to a
childhood experience. (3) Closeness of correspondences. It should be kept
in mind that dreaming only very rarely includes exact replays of episodic
memories of waking-life experiences (Fosse et al. 2003; Malinowski and
Horton 2014b), that is, there is always some transformation. In the study
of Vallat, Chatard, et al. (2017) participants had to tell whether they felt
that parts of their dream were obviously related to some features of their
waking lives, whereas Blagrove, Henley-Einion, Barnett, Edwards, and
Seage (2011) constructed a scale with a different level of matching between
the contents of the dream report and the waking-day events recorded in
the diary: 0 = no matches at all between dreams and events, 1 = general
matches but these may be recurring themes, 2 = some vague resonances, it
is possible that dream and day are related, 3 = weak relationships between
dreams and events, 4 = several matches or one strong match, and 5 = mul-
tiple strong matches between dreams and events. The participants should
match a diary record of one day and a dream report. It seems obvious that
matching might be done very differently due to the instruction but also
between persons. Due to these problems, the findings obtained by this
retrospective approach are limited in their interpretation regarding the
continuity between waking and dreaming.
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 75

The experimental manipulation of waking-life experiences is often

done by showing the participants a film before bedtime, for example, a
stress film (Circumcision), and before another night in the sleep lab a
control film (educational travelogue) (Goodenough et al. 1975) or some-
thing along these lines, for example, reading a story. Then the dreams of
the two nights (e.g., obtained by REM sleep awakenings) will be com-
pared using dream content analysis and should show differences that cor-
respond with the films’ content. De Koninck and Brunette (1991), for
example, exposed phobic participants to a snake (in a terrarium) and read
them different stories prior to sleep onset. Interestingly, the emotional
tone of the story affected the participants’ dream emotions but not the
dream content. Another experimental manipulation was chosen for a
study in the home setting (Kröner-Borowik et al. 2013): half of the par-
ticipants were instructed to suppress an unwanted thought five minutes
prior to sleep, whereas the other half were allowed to think of anything at
all. Suppressing a thought did increase the probability to dream about it
(Wegner et al. 2004).
Within this context, it should be mentioned that participating in a sleep
laboratory study (sleeping in a bed not accustomed to, the experimenter
in the adjacent room, multiple awakenings per night) clearly affects
dreams: about 20% in over 2000 dreams collected in 12 sleep lab studies
included lab references (Schredl 2008b).
Most field studies use diaries to assess waking-life events/experiences
and dreams but there are also lab-based studies like the study of Breger,
Hunter, and Lane (1971) eliciting dreams after and before real-life stress-
ors like awaiting major surgery or an intensive group therapy session.
A simple diary approach asks the participants to fill in daytime events
and their dreams into a booklet for two weeks (e.g., Blagrove et al. 2011).
This diary approach has the problem that recording daytime experiences
in the evening can also affect subsequent dreams and, therefore, can bias
the results. Schredl and Hofmann (2003) solved this problem by present-
ing the questionnaire regarding daily activities (e.g., average amount
of time spent with friends, with studying, driving a car) after the two
weeks of dream recording. On the downside, however, the participants
only can provide rough estimates regarding the activities of the last two
weeks. The amount of time spent with specific activities during the day
correlated with the frequency of these activities in the dreams of the two-
week period, for example, persons who drove more often in their waking
life also dreamed more often about driving (Schredl and Hofmann 2003).
76 M. SCHREDL

A different approach was applied by Blagrove, Henley-Einion, et al.

(2011): the participants kept a diary for two weeks, for each day and for
each night/morning a separate sheet was provided. The task of the par-
ticipant and the external judges was to match each dream sheet with every
daytime experience sheet (for 10 mornings with dream recall this would
encompass 140 matchings) along a scale defining different types of cor-
respondences (thematic, literal, metaphorical, etc.). Schredl (2006)
instructed the participants to record the five most significant events of the
day and state for each event the emotional intensity and the emotional
valence of two five-­point scales. After recording the dreams (two-week
diary) the participants were asked whether one of those previously
recorded events were present in the dream; the advantage is that the cod-
ing of the event was done before the dreamer knew it came up in a dream.
One might speculate that the occurrence of the event in the dream might
bias the person to think it is more important. This might be a shortcom-
ing of the above-mentioned study of Vallat, Chatard, et al. (2017). In the
study of Schredl and Reinhard (2009–2010) the participants were asked
to rate on two four-point scales (no effect, mild effect, moderate effect,
strong effect) the intensity of the positive respective negative effect of the
events of the previous day on the dream without explicitly recording cor-
respondences between dream and waking-life.
In a longitudinal design, a specific dream characteristic, for example,
emotional valence, is correlated with an emotional score of the previous
day; these types of analyses typically require the application of mixed
model for statistical analyses as there are between-subject effects and
within-subject effects (Schredl and Reinhard 2009–2010). Another
approach is to compare different time points of the period the diaries were
kept, for example, ten dreams recorded before a significant daytime event
and ten dreams recorded after this event (Hartmann and Basile 2003). A
very fascinating opportunity to carry out longitudinal studies is to analyze
diaries of long-term dream journalists, for example, “Barb Sanders” pro-
vided 4254 dream reports over a period of about 26 years (Domhoff
2018), Schredl (2018) even analyzed a series of 10,952 dreams. The
advantage of these data is the possibility to study long-term effects, for
example, dreams about the ex-husband 15–20 years after the divorce (still
high levels of aggression) in the “Barb Sanders” series (Domhoff 2018)
and study topics that are rare in dreams, for example, dreaming about
interpreting a dream (30 of 10,148 dreams) (Schredl 2015).
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 77

These examples indicate that diaries can be used effectively to obtain

information about both aspects—waking life and dreaming. As mentioned
above, recording daytime experience (and dreams) can affect subsequent
dreams and, therefore, might bias the results. One alternative mentioned
in Sect. 4.1 is to use retrospective estimates for measuring dream content,
for example, “What percentage of your dreams involve sports?” or “What
percentage of your dreams involve reading?” (Schredl and Erlacher 2008).
Interestingly this retrospective study yielded comparable results to a diary
study investigating sport dreams (Erlacher and Schredl 2004). Overall,
methodological issues that might be of importance for diary studies have
not studied systematically, for example, the effect of recording daytime
events in the evening on dream content. Just keeping a dream diary has a
small effect: only 0.8% of the 264 diary dreams included a reference to the
experiment (Hall 1967).
In addition to correlating waking-life parameters with dream character-
istics or matching daytime experiences with dream elements, inter-­individual
differences in dreams can also be studied by looking at specific populations,
for example, comparing the dreams of men and women, or dreams of
patients with mental disorders and dreams of healthy controls. The idea is
that the groups differ in some aspects of their waking life and, thus, should
also differ in their dreams. For example, men dream of physical aggression
more often than women (Hall and Van de Castle 1966), reflecting the find-
ings of more physical aggression in waking life (Eagly and Steffen 1986).
An approach called “blind” analysis was developed by Hall (1947)
and further pursued by G. W. Domhoff (2003) and Bulkeley and
Domhoff (2010). The researcher receives a series of dreams without any
further knowledge about the dreamer who provided the dreams and
codes these dreams along the Hall and Van de Castle (1966) rating sys-
tem. In more recent papers, a word search algorithm was used (Bulkeley
and Domhoff 2010). Based on the dream content findings predictions
are made as to what should be prominent in the dreamer’s waking life,
for example, the percentage of dreams with reading/writing was 24.0%
(compared to 6.7% dream in Hall and Van de Castle sample of male stu-
dents), so the ­prediction was: “He does a great deal of reading and writ-
ing” and the dreamer agreed: “Correct. I write for fun and for a living”
(Bulkeley and Domhoff 2010). As the predictions were only presented
to the dreamer, this approach lacks a control condition in order to avoid
chance findings, for example, presenting the predictions to another
dreamer who provided dream reports.
78 M. SCHREDL

Interestingly, the research on lucid dreaming has not been looked at

from the viewpoint of the continuity hypothesis, even though proficient
lucid dreamers can carry out pre-arranged tasks in their dreams (LaBerge
1985), that is, remember clearly the instructions received while awake—a
very direct correspondence between waking and dreaming (Stumbrys
et al. 2014).

4.5   Factors Related to the Continuity

Between Waking and Dreaming
4.5.1  Time Course
Based on his extensive literature review and his own observations Freud
(1900/1991) stated: “Dreams show a clear preference for the impressions of
the immediately preceding days” (p. 247), the so-called day-residue effect.
Retrospective studies (Botman and Crovitz 1989; Grenier et al. 2005;
Strauch and Meier 1996) asking the dreamer to assess the time references
after reporting the dream and diary studies (Blagrove et al. 2011; Marquardt
et al. 1996; Nielsen et al. 2004; Nielsen and Powell 1989, 1992; Powell et al.
1995; Vallat et al. 2017) found this day-residue effect, that is, the highest
incorporation rates were found for events of the previous day and events of
the previous week or longer ago occurred less often. Botman and Crovitz
(1989) hypothesized that length of the time interval has an exponential
effect on the probability to incorporate the waking-life event into the dream;
however, one has to keep in mind that within the retrospective assessing of
temporal references (starting from the dream report and search for matches
in waking life) the exponential decrease might simply reflect the increasing
difficulties to remember waking-life events (and waking-life thoughts) that
occurred in the past. Systematic studies with diaries kept over long time
intervals (weeks, months, and years) have not been carried out.
Several studies (Blagrove et al. 2011; Marquardt et al. 1996; Nielsen
et al. 2004; Nielsen and Powell 1989, 1992; Powell et al. 1995) looking
at the incorporation rate of waking-life topics into dreams found a “dream
lag” effect: after a drop of the incorporation rate in the period of two or
four days (subsequent to the day-residue effect), there is an increase of
incorporations of events that occurred five to seven days before the dream
only to drop again for time intervals longer than eight days. This has been
interpreted as reflection of memory consolidation processes, especially
within the framework of two-step models including slow-wave sleep and
REM sleep (van Rijn et al. 2015).
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 79

The dream-lag findings, however, should be viewed with caution since

diary studies most likely elicit REM dreams prior to awakening in the
morning and, thus, are not representative for all REM dreams. There is
some evidence that dreams of the first REM period are more often affected
by experimental manipulations applied directly prior to sleep (Lauer et al.
1987; Roffwarg et al. 1978) in contrast to REM dreams that occurred
later in the same night. Additionally, Verdone (1965) and Roussy,
Raymond, Gonthier, Grenier, and De Koninck (1998) have shown that
dream elements of late-night REM dreams have more remote references
to waking life than dream elements of early REM dreams.
In dreams obtained via awakenings in the sleep laboratory the dream-­
lag effect was not found for NREM dreams but only for REM dreams
(Blagrove et al. 2011). The mean time between sleep onset and the awak-
enings to obtain these REM dreams was 6.16 hours, that is, on average
these were dreams of the latter part of the night. It would be very interest-
ing to collect larger samples of REM dreams stemming from the first part
of the night and test them for dream-lag effects. Van Rijn et al. (2015)
reported that only personal significant events might follow a dream-lag
pattern but not daily activities or current concerns. Furthermore, Henley-­
Einion and Blagrove (2014) and van Rijn et al. (2015) observed large
inter-individual differences regarding the number of incorporations, this
implicates that trait aspects like personality dimensions might play a role.
To summarize, there is evidence that the time course of incorporating
daytime events might not follow a simple exponential function as factors
like emotional involvement and/or personality might modulate the incor-
poration of waking-life experiences into dreams.

4.5.2  Emotional Valence and Intensity of the Waking-Life

Experience
Empirical studies (Cartwright et al. 1969; de Jong and Visser 1983; De
Koninck and Koulack 1975; Foulkes et al. 1967; Foulkes and Rechtschaffen
1964; Lauer et al. 1987) that presented a film prior to sleep onset and col-
lected REM dreams via awakenings indicated that direct incorporations of
the film topics into dreams are very rare. Similarly, dream incubation (dat-
ing back to Ancient Greek traditions), that is, thinking about a topic one
would like to dream about before falling asleep was not effective in two
controlled studies (Foulkes and Griffin 1976; Griffin and Foulkes 1977).
Only if the participants were instructed to think about a current personal
80 M. SCHREDL

problem, the probability of dreaming about this problem was higher com-
pared to a control condition without incubation: an increase from 20% to
40% of the dreams that were related to the personal problem (Strauch and
Meier 1996). As field studies (e.g., Breger et al. 1971) showed much
stronger effects for “real” stressors, one might speculate that watching a
film in the lab does not have a high personal significance and thus the film
contents are not incorporated into dreams. In order to increase the per-
sonal involvement of the participants, Wegner et al. (2004) instructed his
participants not to think about the target person (a person of the dream-
er’s life) which is a quite demanding task and obtained more occurrences
of the target in subsequent dreams than after just thinking about the per-
son; supporting the ironic-process theory. Subsequent studies (Bryant
et al. 2011; Kröner-Borowik et al. 2013; Taylor and Bryant 2007) using
idiosyncratic intrusive thoughts as targets that should be suppressed (not
thought about) replicated the findings of the first study. In a sleep lab
study (Schmidt and Gendolla 2008), the same effect was found for sleep
onset dreams, this time using an image of three white bears and the pre-­
sleep instruction not to think about them.
As mentioned above, field studies using questionnaires clearly indicate
that there is an incorporation of waking-life events into dreams: about
50–70% of the participants, for example, stated that TV consumption or
reading books has affected their dreams (Lambrecht et al. 2013). Computer
games like Tetris or alpine racer and others have shown a strong effect on
subsequent dreams (Gackenbach et al. 2011; Stickgold et al. 2000, 2001).
Spending time with personally relevant everyday activities like sports
for sport students, music for music students, or politics for politics ­students
is related to the percentage of dreams that include these topics (Kern et al.
2014; Schredl and Erlacher 2008; Vogelsang et al. 2016). The romantic
partner also plays a major role in dreams (Schredl 2001; Schredl and
Reinhard 2012; Selterman et al. 2012). Interestingly, emotions related to
friends met during the day had the strongest correlations with dream
emotions—much more than emotions related to academic studies (Schredl
and Reinhard 2009–2010), indicating that social interactions during the
day have a considerable impact on dreaming.
Very stressful, traumatic events also affect subsequent dream content
most severely; recurrent nightmares of the trauma are a hallmark symptom
of posttraumatic stress disorder (PTSD) (Wittmann et al. 2007). The effects
of experiences related to the 9-11 terror attacks (Bulkeley and Kahan 2008),
sexual assault (Krakow et al. 1995), childhood sexual abuse (DeDonato
et al. 1996), kidnapping (Terr 1981, 1983), accidents (Mellman et al. 2001;
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 81

Wittmann et al. 2010), and war (Kramer et al. 1984; Sandman et al. 2013;
Schredl and Piel 2004) on dreams can be detected even decades after the
experiences in waking life.
In a diary study (Schredl 2006) the participants were instructed to keep
a diary over a two-week period and record the five most important events
of the day and rate their emotional intensity and valence (two five-point
scales). The participants also recorded their dreams and evaluated whether
one of the recorded events of the previous days showed up in the dream.
The emotional intensity and valence of the incorporated events was com-
pared with the other recorded events of the same day. The findings indi-
cated that emotional intensity was higher for incorporated events compared
to not incorporated events but the emotional valence of the waking-life
event had no effect (Schredl 2006). The study of Malinowski and Horton
(2014a) replicated this finding, emotional intensity but not stressfulness
was crucial for the incorporation of the waking-life event into subsequent
dreams. From a methodological viewpoint, it seems to be important to
use a design in which the emotional intensity of the waking-life event will
be rated before it shows up in the dream, that is, the approach of retro-
spectively rating the emotionality of events that resurfaced in the dream
(e.g., Vallat et al. 2017) might be biased by hindsight: I dreamed about
this, therefore it must be important.
Overall, the field studies and trauma studies indicate that emotional
intensity might be one of the most crucial factors affecting continuity
between waking and dreaming, that is, emotionally more intense
­waking-­life experiences are more likely to be incorporated into subsequent
dreams than less intense experiences.

4.5.3  Type of Waking-Life Experience

Meumann (1909) was the first researcher who observed that reading
and writing occurred very rarely in his dreams although he was engaged
in these activities for up to six hours per day. Hartmann (2000) com-
pared the frequencies of reading, writing, and typing with other wak-
ing activities like walking, talking with friends, and sexuality, and also
found that the three Rs (reading, writing, and arithmetics) are less
likely to be found in dreams compared to other activities. Based on his
findings that emotional intensity of the waking-life activity might not
explain these differences (e.g., comparing walking with reading),
Hartmann (2000) formulated the hypothesis that during the choliner-
gic-driven REM sleep focused thinking processes are more difficult for
82 M. SCHREDL

the brain to handle than in the waking state. However, it should be

noted that thinking in general, for example, about what other people
think, what to do next, is quite common in dreams (Meier 1993).
The findings of Hartmann (2000) were confirmed by several studies
(Schredl 2000a; Schredl and Erlacher 2008; Schredl and Hofmann 2003).
In a diary study (Schredl and Hofmann 2003) the so-called cognitive
activities (reading, writing, calculating, working with a computer)
accounted for 41.6% of the elicited waking-life activities (including talking
with friends, driving a car, watching TV, using the phone, and being in
nature) whereas only 18.6% of the dream activities fell into this category.
On the other hand, important examinations (highly salient for the
dreamer) did occur often in dreams just before the actual date (Arnulf
et al. 2014). The hypothesis of Schredl (2000a) that dreams more likely
reflect “archaic” themes like social interactions or being in nature was not
supported by Schredl and Hofmann (2003) as driving a car, for example,
was significantly overrepresented in dreams. Part of these findings might
point to a preference of dreams for social topics.

4.5.4  Types of Continuity and Implications for Possible

Functions of Dreaming
As pointed out in Sect. 4.3 the continuity hypothesis has originally been
defined as very broad; every aspect of waking life can affect dreams, maybe
in a different way. For conducting empirical studies it might be helpful to
differentiate between different types of continuity (see Table 4.5).
The most forward concept of continuity is the thematic continuity, for
example, a sport student does sports, learns about the theoretical aspects
of sports, and thinks about sports during the day and thus dreams quite
often about sports (Erlacher and Schredl 2004). The question of interest
for empirical science is what factors affect this type of continuity. As the

Table 4.5 Different types of continuity between waking and dreaming

Types

Thematic continuity
Emotional continuity
Metacognitive continuity
Continuity of formal characteristics, for example, bizarreness
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 83

previous sections indicate, time interval, emotional salience of the waking-­

life experience, and the type of the waking-life experience are of impor-
tance. Schredl (2003) proposed a mathematical model for the probability
that a specific waking-life event is incorporated into one or more subse-
quent dreams. The formula is: Incorporation rate = a(ES, TYPE,
PERS) × e−b(TN, TYPE) × time + Constant. First, there is an exponential decrease
with time (time interval between waking-life experience and dream), this
decrease might be modulated by the time of the night (TN; late-night
dreams with more remote temporal references) and by the type of the con-
tent (e.g., close person, object, setting, etc.). This exponential term is mul-
tiplied with a factor that depends on the emotional salience of the waking-life
experience (ES), the type of the waking-life experience (e.g., cognitive
activities vs. social activities), and personality (PERS). Interestingly, trait
factors that might affect the thematic continuity between waking and
dreaming have not been studied systematically. Pervious research indicated
that personality dimensions like field dependence (Baekeland et al. 1968)
or thin boundaries (Schredl et al. 1996) might modulate continuity, that is,
persons with thin boundaries might incorporate waking-life events more
easily into dream than persons with thick boundaries. The large inter-indi-
vidual variance found in studies matching waking-life experience and dream
content (Henley-Einion and Blagrove 2014; van Rijn et al. 2015) support
this line of thinking. The constant factor in the equation indicates that
some topics may show up in dreams regardless of the waking-life experi-
ences of the dreamer. The basic idea of formulating the model was not to
complicate things but to highlight the importance to conduct studies
including several or all factors of the model (or even new ones not yet iden-
tified) in order to explain the thematic continuity between waking and
dreaming more fully (Schredl 2003).
The emotional continuity between waking and dreaming was advocated
by Ernest Hartmann (2010). Hartmann studied contextualizing images of
dreams and their relationship to waking-life experiences, for example, a
tidal wave in the dream is the expression for the emotion of being over-
whelmed; this type of dreams is more frequent in persons suffering from
trauma (Hartmann 2010). Similarly, the stories read to the participants
before sleep onset in the study of De Koninck and Brunette (1991) did not
affect dream content, dreaming of a snake or squirrel (which were part of
the story), but the emotional tone of the story affected the dream emo-
tions. Interestingly, person who experienced flying dreams (which are often
accompanied by positive emotions) showed lower scores in neuroticism
which is associated with less negative and more positive emotions in waking
84 M. SCHREDL

(Schredl 2008c). These few examples highlight that thematic and emo-
tional continuity must be studied differently: on the one hand, dream con-
tent analysis is the method to work with if the researcher is looking for
thematic continuity, on the other hand, measuring dream emotions with
self-rating scales are more appropriate to study emotional continuity.
Whereas some researchers (Hobson and Voss 2011; Rechtschaffen
1978) highlighted the deficiency of higher cognitive processing in dream-
ing Purcell, Mullington, Moffit, Hoffmann, and Pigeau (1986) and
Kahan, LaBerge, Levitan, and Zimbardo (1997) were able to demonstrate
that self-reflectiveness and metacognitions (e.g., thinking about different
options to act, being concerned about the impression made, or thinking
about the own thoughts, feelings, attitudes, behavior) are present in
dreams, maybe not as often as in waking. The typical dream theme “being
inappropriately dressed” (Griffith et al. 1958) is illustrating that the think-
ing about what others think about oneself being not dressed appropriately
or being totally nude is the major concern of the dreamer. Based on
research showing that meditating, being mindful during waking is linked
to lucid dream frequency and lucid dream control (Reed 1978; Stumbrys
and Erlacher 2016; Stumbrys et al. 2015) Stumbrys (2011) proposed a
continuity in self-reflective awareness, that is, persons who are ­self-­reflective
during waking (e.g., by training mindfulness) are also more self-­reflective
in dreams.
The last type of continuity concerns formal aspects of dreaming, for
example, schizophrenic patients who often show a formal thought disor-
der (incoherent thinking) also report more bizarre dreams (Schredl and
Engelhardt 2001). The style of thinking might affect specific dream char-
acteristics. However, carrying out these types of studies is very tricky as the
person can only report the dream while being awake, for example, in the
case of the patient with schizophrenia it is difficult to differentiate whether
the reporting of the dream is incoherent or the dream experience itself.
Future research is necessary to investigate this type of continuity in a more
detailed way.
As the continuity hypothesis does not make any claims regarding pos-
sible functions of dreaming, it is nevertheless interesting to ask the ques-
tion whether research done in this area might be helpful in speculating
about possible function(s) of dreaming (see Chap. 9).
The research regarding the temporal references of dream elements (see
above) indicates that new information is mixed with experiences from the
distant past. In addition, dreams are creative, that is, they form new asso-
ciations instead of just replaying daytime experiences (Hartmann 2011).
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 85

This parallels processes typically involved in problem solving: first, com-

pare the new incident with already successfully handled experiences, and
second, if no strategy is already available, try something new (brainstorm-
ing). In view of this analogy, proposing problem solving and adaption as a
possible dream function (Stewart and Koulack 1993) seems plausible.
The findings that emotional intensity is a factor affecting the incorpora-
tion of waking-life events into dreams (Malinowski and Horton 2014a;
Schredl 2006) might hint at an emotion-regulating function of dreams
(Kramer 2007). The strong impression of negatively toned dreams and
nightmares on waking life (Schredl 2009a) lead to the formulation of the
threat simulation theory (Revonsuo 2000), that is, rehearsing in dreams
to avoid dangerous places might have increased survival chances of our
ancestors and thus dreaming might have (or had) an evolutionary func-
tion. Lastly, the importance of social interactions in dreams (compared to
academic activities) (Schredl and Hofmann 2003) might point to another
evolutionary aspect of dreaming: rehearsing social skills in dreams as being
an accepted member of the social network was crucial for survival in gath-
erer/hunter societies (Revonsuo et al. 2015).
The problems in studying possible functions of dreaming are addressed
in Chap. 9. Due to these problems, all hypotheses about dream function
remain highly speculative.
One very interesting area for future research is studying dreams that are
clearly not continuous with waking life (e.g., flying dreams). Why do we
dream about things, for example, pain we never experienced in our waking
life (Schredl 2011a), or how can the occurrence of walking dreams in
congenital paraplegics (Voss et al. 2011) be explained. This line of research
might also help to shed light on possible functions of dreaming.

4.6   Effects of External Stimuli on Dream

Content
Typically the sleeper does not react to normal stimuli (only to loud ones
that awaken her or him), so the question arose whether the dreaming mind
completely disconnected from the outer world (Hobson et al. 2000).
Simple forms of information processing during sleep can be studied with
the method of event-related potentials (Ibanez et al. 2009). Typically, audi-
tory stimuli are presented, the so-called mismatch negativity is understood
as the result of a perceptual process able to detect changes in a repetitive
sonorous sequence, based on processes of regularity detection: this can be
86 M. SCHREDL

found in N1 sleep and REM sleep (Ibanez et al. 2009). In the study of
Campbell and Muller-Gass (2011) auditory stimuli that are only slightly
above hearing threshold appear to be processed extensively during a
200–400 milliseconds interval in both NREM and REM sleep. From
everyday anecdotes it is known that external stimuli (buzzer, telephone
ringing, snoring) can also be incorporated into the dream, that is, a very
complex processing of external stimuli can occur. A very famous example is
the stimulus incorporation of a piece of his wooden bed top falling on the
neck of the sleeper, Alfred Maury (1861). He dreamed that he will be
beheaded by the blade of a guillotine; the external stimulus was trans-
formed in a way that it fit into the dream plot which was about the French
revolution.
In Table 4.6, selected dream studies applying different types of stimuli
are listed. The standard approach is as follows: the sleeper is monitored via
polysomnography, if she/he is in REM sleep for about 5–10 minutes, the
stimulation is applied. The continuous EEG recording is important to
ensure that the person is not awakened by the stimulus, but it must have
an effect on the organism—above the perception threshold (Koulack

Table 4.6 Effect of external stimuli on dream content

Study Stimulus Stimulus Rate of direct
applications incorporations (%)

Dement and Wolpert (1958) Sinus tone (1000 Hz) 35 9

Light flashes 30 23
Water spay (skin) 33 42
Berger (1963) Participant’s name 89 54
Koulack (1969) Electrical stimuli (thumb) 99 55
Hearne (1978) Water spay (face or hand) 10 60
Hoelscher et al. (1981) Salient or neutral words 59 34 (salient)
11 (neutral)
Trotter et al. (1988) Olfactory stimuli 79 19
Nielsen (1993) Pressure cuff stimulation 15 47
on the legs
Nielsen et al. (1993) Mild pain stimuli 42 31
Leslie and Ogilvie (1996) Rocking of the bed 45 25
Schredl et al. (2009a) Olfactory stimuli 28 0
Schredl et al. (2014b) Olfactory stimuli 31 3
Rahimi et al. (2015) Traffic noise 13 24
Paul et al. (2014) Light flashes 24 39
Vibration (hand or foot) 60 45
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 87

1969). After a pre-defined period of sleep, for example, 30 seconds, the

sleeper will be awakened and asked to report the dream experience.
A methodological issue is the measurement of the incorporation of the
stimulus into the dream. Typically, direct and indirect incorporations are
differentiated. For a direct incorporation the stimulus is perceived in the
dream the same way it was presented, for example:

Dream: I dreamed I was in Golden Gate Park. I was walking by some gar-
denias. They were just opening. All of a sudden, I could smell the gardenias,
but they smelled like lemons instead of gardenias. (Stimulus: freshly cut
lemon; Trotter et al. 1988, p. 95)

The following example for an indirect incorporation was reported by a

participant after awaking from a REM sleep period in which a tape with
human weeping was played.

Dream: Another women and I were inside a small self-service store, and we
were just about to get to the cashier. It was about whether I buy another
liquid to gargle with. And we kept walking around the store, and every time
I took a step with my right foot, it squeaked like an old door. It was like a
regular whistle sound, so that, with every step I took, it was as if I squeaked
like an old piece of furniture. And somehow I tried to fix that with the gargle
water. (Strauch and Meier 1996, p. 179)

The stimulus was incorporated into the dream but was not recognized
as weeping (Strauch and Meier 1996). For this dream the assumption that
the stimulus was incorporated and transformed seems quite plausible. The
question of what transformations of the stimulus are still acceptable is a
critical one: if the coding rules are too broad every dream might have
some form of reference to the stimulus. This methodological issue can be
dealt with by introducing a control condition, that is, comparing the
dreams after stimulation with dreams obtained from REM periods with-
out stimulation. It is necessary to elicit these control dreams within the
same study as, for example, participating in an olfactory study might also
show up in control dreams including some references to odors (Schredl
et al. 2009). Nielsen (1993) who coded direct and indirect incorporations
obtained 25% “incorporations” within the control dreams without prior
stimulation compared to 60% of the stimulated dreams. In addition, it
would be desirable that the dreamer did not know whether at all or what
88 M. SCHREDL

stimuli were presented, otherwise she/he might be biased. For olfactory

stimuli as used in the study of Trotter et al. (1988) this is difficult to real-
ize; the stimuli in the later studies (Schredl et al. 2009; Schredl et al. 2014)
were presented with an olfactometer producing a steady air flow via a tube
attached to the nose that clears the odor within the 30 seconds between
the end of the stimulation and the awakening.
The incorporation rates varied from 0% to 60% between the studies
using different stimuli (Table 4.6). Comparing the studies, there might be
three factors affecting the incorporation of external stimuli. First, tactile
stimuli, for example, spray of water, electrical and pressure stimuli have
shown the highest incorporation rates. It may be hypothesized that “close”
stimuli are more important and thus will be processed in a different way;
it seems plausible from a phylogenetic viewpoint that such stimuli are
more likely to indicate immediate danger for the sleeping organism, much
more than “distant” stimuli like a tone far away. Second, meaningful stim-
uli, for example, the person’s name (Berger 1963) or words which are
related to actual waking-life problems (Hoelscher et al. 1981) yielded
higher incorporation rates than neutral stimuli. Third, olfactory stimuli
did rarely show up in dreams compared to other sense modalities; this is
also plausible as purely olfactory stimuli are not processed via the thalamus
but by the olfactory bulb which has strong projections to the limbic sys-
tem whereas the thalamus is projecting into the neocortex (see: Schredl
et al. 2014).
A very extensive and tricky study was carried out by Rechtschaffen and
Foulkes (1965). Three participants slept with eyes taped open. A room
vaporizer was necessary to keep the cornea moist during the long periods
with open eyes. A slide showing an object was present in 30 experimental
tails. There was only one dream report after a slide stimulation which
shows a slight resemblance of the dream images to the presented picture.
This result is in contradiction with older dream theories that postulate that
the sense organs play a role in dream production (Pigman 2002).
One study (Bokert 1967) investigated the effect of thirst on dream
content. Persons who were deprived of food and fluids for one day and
given a salty meal prior to sleep dreamed more often about drinks and
water; however, drinking as explicit action and the direct experience of
thirst occurred very rarely. A problem of this study is that the incorpora-
tions might not be based on the thirst stimulus during sleep but reflect the
thoughts and experiences of the waking day—according to the continuity
hypothesis.
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 89

Overall, the research on external stimuli clearly indicates that the brain
is processing external stimuli during sleep and even though stimuli show
an effect on dreams in an experimental setting, the majority of the dreams
recalled in the home setting seems to be “stimulus-free”.

4.7   Gender Differences in Dreaming

Gender differences in dreaming have been studied quite extensively.
Women tend to recall their dreams more often than men (Schredl and
Reinhard 2008), are more interested in dreams (Schredl et al. 2014), and
share their dreams more often (Olsen et al. 2013). These gender differ-
ences can be found already in children, especially regarding dream sharing
and listening to dreams (Georgi et al. 2012); therefore Schredl, Buscher,
et al. (2015) theorized about a gender-specific dream socialization.
The first large-scale study looking at gender differences in dream con-
tent included five dreams of each of 100 male and 100 female students
(N = 1000) which had been collected in the years 1948–1952 (Hall and
Van de Castle 1966). Selected findings are depicted in Table 4.7.
Men dreamed more about outdoor settings, physical aggression, weap-
ons, and sexuality than women (Hall and Van de Castle 1966). In addi-
tion, a higher proportion of male dream characters were found in men’s
dreams whereas women dreamed equally often about men and women. In
women’s dreams, more explicitly mentioned dream emotions, household
objects, and clothing occurred.
Despite marked changes in society, for example, women’s liberation,
Hall, Domhoff, Blick, and Weesner (1982) replicated about 30 years after
their initial study (Hall and Van de Castle 1966) most of the gender dif-
ferences, for example, more physical aggression and higher proportion of
male dream characters in men’s dreams. Subsequent studies often con-
firmed the gender differences presented in Table 4.7, for example, regard-
ing male/female percentage (Tartz and Krippner 2017), physical
aggression (Schredl et al. 2003), and weapons and clothing (Mathes and
Schredl 2013).
For two gender-specific dream topics (work-related dreams and dreams
of deceased persons) gender differences also remained quite stable from
1956 to 2000 (four representative cross-sectional studies, overall
N = 5946): although there was an overall increase of work-related dream
topics in general over the years, the gender difference in which men
reported work-related dreams more often remained stable and women
90 M. SCHREDL

Table 4.7 Gender differences in dream content (Hall and Van de Castle 1966)
Variable Men Women
(N = 500) (N = 500)

Settings (“outdoor”)/(“indoor” + “outdoor”) 52% 39%

Proportion of male dream characters 67% 48%
Physical aggression/Total aggression 50% 34%
Sexuality 11.6% 3.6%
Objectsa
 Household objects 8.1% 10.5%
 Weapons 3.0% 0.8%
 Clothing 5.7% 10.2%
Explicitly mentioned emotions per dream 0.48 0.70

Total number of objects for men (N = 2422), for women (N = 2659)

a

reported dreams of deceased persons more often in all four studies (Schredl
and Piel 2005).
On the other hand, some findings have not been confirmed, for exam-
ple, the results concerning dream emotions; if self-ratings of the dreamers
were analyzed, no differences between men and women were observed
(Schredl et al. 1998). This might be explained by the limited validity of
measuring dream emotions via external judges (see Sect. 3.6). Although
Hall and Domhoff (1963) and Hall (1984) stated that the higher male/
female percentage of the dream characters is ubiquitous (similar findings
across different cultures), more recent studies (Domhoff et al. 2005–2006;
Schredl and Keller 2008–2009; Schredl et al. 2010–2011) were not able
to detect this specific gender difference for two reasons: the preponder-
ance of male dream characters in men’s dreams compared to the balanced
ration of the dream characters’ gender in women’s dreams was only found
in single men and women but not in students with a steady romantic rela-
tionship (Schredl 2001), and another factor was age as the “ubiquitous”
gender differences was only found in young adults but not in persons with
age over 25 years (Schredl and Keller 2008–2009; Schredl et al.
2010–2011). These findings indicate that it might be problematic to gen-
eralize the results stemming from student samples.
Another interesting method to study gender differences in dreaming is
a matching design: The external judges were presented with 200 dream
reports from 100 men and 100 women (the order is random) and asked to
 DREAM BEHAVIOR AND DREAM CONTENT IN HEALTHY PERSONS 91

guess whether the dreamer’s sex is male or female. All obvious references
to the dreamer’s gender were removed, for example, girlfriend was changed
into girlfriend/boyfriend. As a kind of pre-training the judge read several
empirical articles about gender differences in dreaming. In the study of
Schredl, Schwenger, et al. (2004) Judge 1 matched 64.0% of the dreams
correctly (equivalent to an effect size of d = 0.28) and Judge 2 matched
64.5% of the dreams correctly (d = 0.29). If it were complete random
guessing the result would be 50%, so the judges could guess the dreamer’s
gender based on the information of one dream report better than chance;
on the other hand a lot of guesses were not correct. Subsequent studies
(Schredl 2008a; Schredl et al. 2010) replicated this finding.
Another interesting gender difference relates to the gender of dream
aggressors in bad dreams of children and adolescents (see Table 4.8).
For girls and boys strange male characters are the dream aggressors that
occur most often whereas women comprise only about 20% of the aggres-
sors (Schredl and Pallmer 1998). The high percentage of male strangers as
human aggressors in children’s dreams seems also to support the continu-
ity hypothesis of dreaming as criminal rates including homicide are much
higher for men compared to women (Broidy and Agnew 1997), that is,
the gender distribution of violent criminals in waking is also reflected in
the dreams of children and adolescents.
Based on the consistent findings regarding several gender differences in
dream content, the question arises how these gender differences in dream
content can be explained—as gender itself does not explain anything.
According to the continuity hypothesis (see Sect. 4.3) gender differences
in dream content should reflect corresponding gender differences in wak-
ing life. Meta-analyses for gender differences in sexuality (Oliver and Hyde
1993) and physical aggression (Eagly 1987) clearly indicate gender differ-
ences similar to the reported differences in dreams do occur in waking life;
men, for example, more often reported about engaging in sexual fantasies

Table 4.8 Human aggressors in dreams (Schredl and Pallmer 1998)

Aggressors Total (%) Boys (%) Girls (%)
(N = 111) (N = 35) (N = 76)

Male stranger 49.7 51.4 48.7

Female stranger 3.6 0.0 5.3
Male (familiar) 27.8 31.4 26.2
Female (familiar) 18.9 17.2 19.8
92 M. SCHREDL

during waking and think more often about physical aggression. Schredl,
Desch, et al. (2009) were able to demonstrate that the frequency of sexual
fantasies in waking correlated with the frequency of erotic dreams.
Whereas Hall (1984) speculated about the Oedipus complex as one
possible explanation for the preponderance of male dream characters in
men’s dreams (in contrast to the equal amount of men and women in
women’s dreams), Paul and Schredl (2012) reported that male/female
percentage of the dream characters correlated with the male/female per-
centage of waking-life social interactions, that is, the findings are in line
with the continuity hypothesis. As persons with partnership dream often
about the partner (mostly of the opposite sex) the male/female ratio
decreased for men and increased for women and, thus, did not show this
specific gender difference anymore (Schredl 2001). Similar, Lortie-Lussier,
Simond, Rinfret, and De Koninck (1992) demonstrated that working
women’s dreams showed more similarities with the “male” dream pattern
than those of housewives.
To summarize, these studies clearly indicate that gender difference in
dream content are reflecting gender differences in waking life and thus pro-
vide further support for the continuity hypothesis of dreaming. As many
studies in this field are based on student samples, it would be necessary to
study samples with a larger age range. Especially interesting will be longitu-
dinal studies in larger samples of children to study the critical age when
gender differences in dream recall and dream content are developing.

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 CHAPTER 5

Dream Content and Physiology

In this section, studies which investigated the relationship between dream-

ing (psychological level) and physiological parameters of sleep (mostly REM
sleep) will be reviewed. The basic idea is to study how the body interacts
with the mind, for example, if the dreamer experiences extreme panic in
dream is his or her heart beat accelerated? The typical paradigm is as follows:
during REM sleep, different physiological parameters such as eye move-
ments, EEG, heart rate, respiratory activity, brain activity are recorded. Then
the sleeper is awakened and asked to report the dream experience. Dream
reports were analyzed using specific criteria, for example mean word count,
number of visual elements, emotional intensity, or were classified along dif-
ferent aspects, for example active versus passive dreams. These two data
pools (psychological level and physiological level) were related to each other
using appropriate statistical methods like correlations or classifications.
Additional evidence for the relationship between dream content and
physiology was provided by the research of Michel Jouvet (1999). Cats
with specific lesions in the brain stems that control muscle atonia during
REM sleep showed aggressive behavior, prey-catching behavior and so
on during REM sleep—behavior that is typical for their waking life. It
seems plausible to assume that they were acting out their “dreams” (unfor-
tunately cats cannot provide verbal dream reports). In a rare parasomnia,
the REM sleep behavior disorder, the same brain stem areas are malfunc-
tioning and the loss of REM atonia yields to dream-associated body move-
ments during REM sleep (see Sect. 6.6.4).

© The Author(s) 2018 105

M. Schredl, Researching Dreams,
[Link]
106 M. SCHREDL

5.1   Dream Time and REM Sleep Duration

Alfred Maury, a French sleep and dream researcher, raised the question
whether the recalled dream is really a recollection of experiences that
occurred during the sleep or—as he hypothesized—is generated in milli-
seconds during the process of awakening. Maury (1861) had a long and
intense dream about the French revolution; he saw the important politi-
cians, murderers, riots, and so on. In the very last sequence, he was led to
the guillotine and in the moment the blade was hitting his neck, he awak-
ened and noticed that a piece of his wooden bed top had fallen on his neck
(he had slept in the prone position). Because of the logic of dream action
(riots, being sentenced to death, brought to the guillotine) Maury (1861)
thought that the dream was generated backward by the arousing stimulus.
Accounts of near-death experiences like reviewing one’s whole life in a
brief period of time (Moody 1989) support this view.
The cardinal question is whether this hypothesis can be tested. And
indeed, modern sleep research offers tools to look more closely into the
relationship between “real” time and time experienced in the dream. The
first idea was to link dream length as a rough measure of the duration of
the dream experiences with the length of the REM sleep prior to awaken-
ing. Dement and Kleitman (1957) awakened their subjects in the sleep
laboratory after 5 minutes or after 15 minutes of REM sleep. The partici-
pants were asked to estimate the duration of the dream experiences (long
vs. short). About 83% of 111 judgments were correct and dream length
correlated to the REM sleep duration (r = 0.40–0.70 for N = 15–35
dreams per participant), that is, the participants had a relatively accurate
perception of the dream’s duration. Glaubman and Lewin (1977) repli-
cated this finding; however, Rosenlicht, Maloney, and Feinberg (1994)
did not find any differences in dream length after awakening the persons
from REM sleep with various durations: after 5 minutes of REM sleep the
mean dream length was 325 words, whereas after 10 minutes of REM
sleep the average dream report length was 413 words. It might be possible
that the authors have not taken into account that body movements during
REM sleep may interrupt dreams (Dement and Wolpert 1958) and that
ceiling effects were present as the dream reports in the 5-minute condition
were extremely long. Other confounding factors might also have played a
role, for example, gender—men reported much shorter dreams than
women (men: Ø 267 words and women: Ø 492 words). Rosenlicht et al.
 DREAM CONTENT AND PHYSIOLOGY 107

(1994) argued that their finding indicates that dreams are not limited to
REM periods (i.e., dreams obtained after REM awakenings might also
include NREM dream experiences) but the studies of Jovanovic (1967)
suggest that a new dream is starting at the onset of a REM period:
Participants who were awakened shortly (20 seconds) after the onset of
REM sleep reported the subjective experience of a new dream beginning.
In a similar way, dream reports stemming from awakenings directly after
gross body movements which occur regularly during sleep in general and
also in REM sleep included often an experience of a dream that just ended
(Dement and Wolpert 1958). Using the “Nightcap” device, Hobson and
Stickgold (1995) have demonstrated that dream report length after spon-
taneous awakenings in the home setting is related to the duration of REM
sleep prior to the awakening: REM durations of 0–15 minutes yielded a
mean report length of 220 words, for 15–30 minutes 330 words, and for
30–45 minutes 510 words. For the duration over 45 minutes the mean
word count decreased to 350 words, maybe a ceiling effect. It can also be
argued that the time estimates depend on the dream content. Indeed,
Moiseeva (1975) found time estimates of the dream experience strongly
related to REM sleep duration, but there was a marked overestimation if
the dreams were bizarre, intense, and vivid, that is, if the experience is
vivid, intense, and detailed, the estimated time intervals are longer.
Another approach to compare the subjectively experienced time during
dreaming and REM duration is to investigate the temporal patterns of the
incorporation of external stimuli into dreams. Dement and Wolpert
(1958) reported the following dream example:

The first part of the dream involved a rather complex description of acting
in a play. I was walking behind the leading lady, when she suddenly collapsed
and water was dripping on her. I ran over to her and felt water dripping on
my back and head. The roof was leaking. I was very puzzled why she fell
down and decided some plaster must have fallen on her. I looked up and
there was a hole in the roof. I dragged her over to the side of the stage and
began pulling the curtain. Just then I woke up. (p. 550)

In this example, cold water was sprayed on the back of the dreamer
10 minutes after the onset of the REM period. Exactly 30 seconds later he
was awakened. The duration of the action sequence between applying the
external stimuli and awaking (dragging the person to the side of the stage)
108 M. SCHREDL

is comparable to the duration that this action would take in waking life.
Relating the temporal pattern of eye movement to dream content
(Roffwarg et al. 1962) also supports a close connection between “dreamed”
time and “real” time (see Sect. 5.2).
Lucid dreaming also offers a very sophisticated tool to study the rela-
tionship between dreamed time and real time. LaBerge (1985) asked his
participants to perform a distinct eye movement pattern, then count to ten
and after that repeat the eye movement made in the beginning—in the
waking state and during a lucid dream. The measured durations amounted
to about 13 seconds whether the task carried out in waking life or in a
lucid dream. Erlacher, Schädlich, Stumbrys, and Schredl (2014) expanded
LaBerge’s study using different counting intervals, walking periods, and a
brief gymnastic routine including jumps, somersaults (see Table 5.1).
Overall, it took a little bit longer to perform the task in the lucid dream
compared to the waking state (Erlacher et al. 2014). Interestingly, the
ratios ([Link]) of the time spent with counting or walking is very sta-
ble—in waking and in a lucid dream.
The findings clearly indicate a relatively direct relationship between
subjectively experienced time within the dream and objectively measured
REM sleep duration. Considering the small number of studies in this field,
several questions are still unanswered, for example, the relationship
between dream content (full of action vs. mundane dreams) and time.

Table 5.1 Comparisons of times for different activities carried out in wakefulness
or during a lucid dream (Erlacher et al. 2014)
Time in Time in a lucid Difference in
wakefulness (s) dream (s) percentage (%)

Counting (N = 5)
 Counting to 10 8.9 ± 1.8 11.1 ± 3.0 +24.7
 Counting to 20 17.0 ± 4.2 22.4 ± 6.3 +31.8
 Counting to 30 24.4 ± 5.5 30.5 ± 8.0 +25.0
Walking (N = 7)
 Walking 10 steps 6.7 ± 0.3 10.6 ± 4.0 +58.2
 Walking 20 steps 12.5 ± 0.6 18.3 ± 6.0 +46.4
 Walking 30 steps 18.5 ± 0.9 28.6 ± 9.8 +54.6
Gymnastic routine 6.6 ± 0.1 8.1 ± 1.5 +23.2
(N = 8)
 DREAM CONTENT AND PHYSIOLOGY 109

5.2   Dream Content and Eye Movements

Most extensive research has been carried out to investigate the relation-
ship between eye movements which had given the REM sleep its name
and dream content. Early in 1892, Ladd formulated the so-called scan-
ning hypothesis stating that the eyes move during sleep according to the
performed movements within the dream—in a similar way they would do
if the activities had taken place in the waking state.
Although, eye movements during sleep were studied previously, for
example, Pietrusky (1922) has studied eye positions of 300 sleeping per-
sons, regularly occurring phases with rapid eye movements were first
detected by Aserinsky and Kleitman (1953). Aserinsky, Lynch, Mack,
Tzankoff, and Hurn (1985) found many similarities between REM sleep
eye movements and eye movement carried out in the waking state; solely,
large eye movements are somewhat slower during REM sleep than in wak-
ing. Unfortunately, the authors did not interpret their finding. Measuring
glucose metabolism in the brain by using positron emissions tomography
Hong, Gillin, Dow, Wu, and Buchsbaum (1995) found that the eye move-
ments during REM sleep activate similar brain areas which are active dur-
ing performing eye movement in waking and, thus, concluded that eye
movements in REM sleep are saccadic scans of targets in the dream scene.
How can the “scanning” hypothesis be tested empirically? First, global
measures of visual activity within the dream were correlated with the num-
ber of eye movements occurring during the REM sleep period prior to the
awakening. Second, attempts were made to relate the electro-oculogram
(EOG) patterns to the gaze shifts remembered and described in the dream
report.
Dement and Wolpert (1958) categorized 105 dream reports according
to whether the last sequence was visually active (e.g., looking around) or
visually passive (e.g., looking at a distant object) and classified the EOG
recordings of the REM period prior to the awakenings in a similar way.
These independently made classifications were significantly correlated
(exact agreement: 74%, p < 0.00001).
Subsequent studies, however, yielded a mixed picture (Berger and
Oswald 1962; Firth and Oswald 1975) and thus did not provide a clear
evidence for the “scanning” hypothesis. Despite the small sample size
(N = 11 dreams of one participant), Hong et al. (1997) obtained a signifi-
cant correlation between the number of “visual” words and the number
of eye movements of the last 6 minutes of REM sleep prior to the awaken-
ing. The technique of averaging eye movements over time periods has the
110 M. SCHREDL

disadvantage to possibly increase error variance—as temporal eye move-

ment patterns might vary considerably and might be masked by the aver-
aging procedure.
Roffwarg et al. (1962) aimed at comparing specific EOG recordings
with dreamed eye movements: After being awakened, the participants
were interrogated by an interviewer who had no access to the EOG
recordings for about the last 10–20 seconds of the dream experience. This
interviewer, who was experienced in relating particular actions to the cor-
responding eye movements, predicted the eye movements which he would
expect to occur in the EOG recording according to the dream report. The
following example gives an illustration of this approach.

Dream: … The last thing I remember is looking down at a small piece of

paper, held at about chest level, trying slowly and haltingly, dwelling on each
word, to translate something that looked like 3 lines of French poetry. It
took about 20 or 30 seconds to do it, probably. I don’t remember if I look
up at any time from the paper. As I remember, essentially, I kept my eyes on
the paper. Interviewer’s prediction: There should be relative REM quies-
cence with the exception of a few spaced leftward glances if the subject has
finished a line of reading and returns to the next line. (p. 240; Roffwarg
et al. 1962)

The fact that the interviewer did not predict relatively small eye move-
ments (reading word by word within the line) can be explained by the
problem to detect such eye movements or the position of the eyeballs by
the commonly used sleep recording machines. The corresponding EOG
pattern of the above-cited example showed three small but distinct eye
movements to the left (22 seconds, 8 seconds, and 0.5 seconds prior to
the awakening). Overall, 80% of the clearly recalled dream actions corre-
sponded with the EOG recording in this study (Roffwarg et al. 1962). In
patients with REM sleep behavior disorder (see Sect. 6.6.4), Leclair-
Visonneau, Oudiette, Gaymard, Leu-Semenescu, and Arnulf (2010)
showed that the recorded eye movements were very often in sync with the
movements, for example, grabbing an imagined object (these patients act
out their dreams due to a loss of muscle atonia in REM sleep).
Interestingly, a direct relationship between eye movements within the
dream and the EOG recording was reported by lucid dream researchers
(Hearne 1978; LaBerge 1980). The participants were instructed to carry
out three large eye movements from the left to the right and backwards if
 DREAM CONTENT AND PHYSIOLOGY 111

she/he is aware that she/he was dreaming. These eye movement patterns
were easily detectable out of the regularly occurring eye movements of the
REM period in almost 100% of the cases (N = 30 dreams; LaBerge et al.
1981).
To summarize, there seems to be a relationship between dream content
and eye movements (“scanning” hypothesis), however, it is not clear how
“tight” this relationship is, that is, whether all eye movements occurring in
REM sleep are related directly to dreamed gaze shifts. Hobson et al.
(2000) hypothesized that some of eye movements were caused by brain-
stem activity and Herman et al. (1984) have pointed out that predicting
eye movements based on a dream report can be a very difficult and error-
prone task, for example, eye movement while scanning non-moving
objects. In addition, other findings, for example, that congenitally blind
persons also have eye movements during REM sleep without having visual
dream imagery (Gross et al. 1965) or the occurrence of visual dreaming
during NREM sleep (e.g., Antrobus 1983), are not in line with the “scan-
ning hypothesis”. Thus, the relationship between dreamed eye move-
ments and real eye movements seems to be a complex one.

5.3   Dream Content and the Electromyogram

(EMG)
Although the general muscle tone during REM sleep is inhibited by nuclei
in the brain stem, small twitches in the limbs can occur (Siegel 2017). So
the question whether these muscle twitches are related to dream body
movements has been studied. An interesting approach was chosen by Max
(1935): He recorded electro-myogram (EMG) potentials of deaf persons
and awakened them if he detected muscle activity in the arms or fingers (as
expression of communication in dreams via sign language). Thirty out of
38 awakenings after muscle activity yielded a dream report including com-
munication, whereas dream reports obtained after awakenings without
muscle activity in arms or fingers were characterized by purely visual imag-
ery. A subsequent study (Stoyva 1965) that tried to replicate the earlier
findings reported that EMG activity of the fingers was more pronounced
during REM sleep compared to NREM sleep for both deaf persons and
hearing controls. The two groups, however, did not differ in respect to
their finger EMG activity. Thus, the findings of Max (1935) can be
explained in the following way; he awakened the deaf persons out of REM
112 M. SCHREDL

sleep (high EMG activity) obtaining a detailed dream report which often
includes communication and out of NREM sleep (low EMG activity) with
poor dream recall.
In the study of Wolpert (1960) dream reports were categorized into
active (many limb movements during the dream) and passive dreams. For
34 dream reports, the concordance between EMG activity (high vs. low)
and the dream action (active vs. passive) was high (74% of the cases;
p < 0.005). In two subsequent studies (Gardner et al. 1975; Grossman
et al. 1972), it was possible to differentiate between increased activity of
the arms during the dream (e. g. playing guitar) and leg activity (e. g.
walking). In a lucid dream hand clenching was related to muscle twitches
of the right respective left fist depending on the hand that was clenched in
the dream (LaBerge et al. 1981). These findings indicate that small muscle
twitches are related to the dream—supported by the findings in patients
with REM sleep behavior disorder (Valli et al. 2012) showing a relation
between dream content and actual movements during REM sleep.
Arkin et al. (1970) have investigated the relationship between sleep
talking and dream content. The following dream example was obtained by
awakening the sleeper after he had uttered audibly the sentence “Uh—
sniff—um—Argentina’s is a long way away—6000 miles”:

Dream example: I was dreaming about this girl I used to go out with last
summer and she’s from Argentina—and uh—I uh, I don’t know, see I—
can’t remember exactly what I was thinking but I uh—told her I’d go down
there to see her but, I don’t know, I can’t remember exactly what I was
thinking. So that seems to be in my mind. (p. 386; Arkin et al. 1970)

Overall, Arkin et al. (1970) found 79.2% concordances between the

words uttered by the sleeper (chronic sleep talkers were studied) and the
following dream report obtained by awakenings from REM sleep.
McGuigan and Tanner (1971) have measured chin and lip EMG activity
during REM sleep. After excluding ambiguous dream reports, they
obtained five dream reports including talking and eight mainly visual
dreams. Only for the dreams with talking an increased EMG activity in
chin and lips was detected but not in EMG of the neck which was used for
controlling the effects of a general increase in EMG activity. These find-
ings were confirmed by Shimizu and Inoue (1986): Talking in dreams was
highly significant correlated with EMG activity of the speech muscles.
During this experiment a crystal microphone was attached to the throat to
make that sleep talking has not occurred.
 DREAM CONTENT AND PHYSIOLOGY 113

Although the number of studies is still small, a clear relationship

between dreamed movements and EMG activity could be demonstrated.
This is in line with the finding that hand clenching within a lucid dream is
accompanied by activity in the motor cortex (Dresler et al. 2011).

5.4   Dream Content and Autonomic Parameters

Imaging studies (Maquet et al. 1996) have shown that the amygdala, a
brain area involved in the processing of emotions, is very active during
REM sleep—a finding that fits in nicely with the findings that dreams are
emotional—sometimes including very strong emotions (see Chap. 4). So
the question was whether these emotions experienced in the dream are
linked to autonomic parameters like heart rate, heart rate variability, respi-
ratory rate, electrodermal activity, cortisol, and so on.
Several correlational studies (Fahrion 1967; Hauri and Van de Castle
1973; Stegie et al. 1975) linking dream emotions to autonomic parameter
like heart rate or respiratory rate produced mixed results. Stegie et al.
(1975) pointed out that methodological issues render this type of research
quite difficult: First, the night-time effect can affect the results as physio-
logical arousal as well as dream intensity tends to increase during the
course of the night. Second, every individual has a specific autonomic
response pattern to emotional arousal, that is, averaging over the total
sample might cover up possible correlations. Stegie et al. (1975) elicited
14–28 dreams per participant and found that the correlation patterns
between emotional intensity and autonomic parameters differed consider-
ably between subjects. However, this was a small pilot study and only 4 of
the 74 correlation coefficients reached significance. Another problem of
these studies is the averaging of physiological activity over distinct periods
of time (e.g., 5 minutes prior to awakening) in order to correlate the mean
values of this activity with dream emotions. This averaging procedure
seems problematic as the intensity of emotions can vary considerably
within the course of a dream, that is, the small number of studies in this
area has not provided conclusive evidence for the interrelationship between
dream emotions and physiology. The hypothesis that strong negative
emotions activate the stress system (hypothalamic—pituitary—adrenal
axis) could not be confirmed. Saliva cortisol levels obtained 5 minutes post
awakening did not correlate with the intensity of negative dream emotions
and only the well-known increase of cortisol during the course of the
night could be replicated. This analysis included 133 dream reports of 38
114 M. SCHREDL

participants—a reanalysis of the data stemming from two REM awakening

studies (Schredl and Erlacher 2010; Schredl et al. 2012).
Even in nightmares, the autonomic arousal is relatively weak, only 3 of
20 REM nightmares showed marked changes in heart rate, respiration
rate, and eye movements in the last minutes before awakening (Fisher
et al. 1970) whereas 5 nightmares were accompanied by minor autonomic
arousal and 12 nightmares do not show an increase in autonomic param-
eters at all. In an ambulatory study of nightmare sufferers in the home
setting we compared the autonomic response of 11 nightmares to the
parameter of 11 non-nightmare dreams of the same participants (within-
subject design, matching for time of night). There was a significant increase
in heart rate, but the increase was relatively small (69.53 ± 7.41 bpm vs.
63.24 ± 6.32 bpm). Based on this finding one might speculate that the
autonomic response to dream emotions, even extreme panic often found
in nightmares, in REM sleep is rather weak—it might be that dreams
should not impede with the restorative function of sleep.
For another physiological parameter, penile erections which occur reg-
ularly during REM sleep in males (Siegel 2017), the relationship to dream
content was investigated. As erections occur in almost every REM sleep
period, C. Fisher, Gross, and Zuch (1965) hypothesized an interaction
between physiological and psychological factors, that is, there is an under-
lying psychological control system, and psychological factors (e.g., erotic
dream content or anxiety) can modulate the degree of the erection. The
following dream report of a young man illustrates this relationship:

Summary of a long dream: There was a party at a beautiful house where a

dam breaks and a deluge occurs; water started pouring onto the lawn and
into the driveway and it was dangerous. There was a rainstorm and a stream
ran right in-side the house, swelled up immensely, and started rolling down
the driveway. The water pushed a lot of people in rowboats out to the sea
and the dreamer was rowing out with his girl to rescue them. Then he
approached his girlfriend and was fondling her breasts and just as the buzzer
went off he moved his hands down between her legs. (pp. 545–546; Fisher
1966)

This REM period lasted about 18 minutes with a marked inhibition of

erection. However, at the end of the REM period the penile erection
increased considerably; evidently in relation to the sexual excitement expe-
rienced in the dream. Of 30 dream reports elicited after REM periods with
 DREAM CONTENT AND PHYSIOLOGY 115

marked erections, eight were characterized by erotic dreams, whereas

erotic themes were not present in any dream report elicited after a REM
period without erection (p < 0.05). On the other hand, strong negative
emotions were found in 10 out of 17 dream reports stemming from REM
periods without erection in contrast to 5 out of 30 dreams associated with
erection (p < 0.01; Fisher 1966).
In 12 lucid dreams the dreamer experienced an ejaculation but this
dreamed ejaculation was not accompanied by a real emission of semen
(LaBerge 1985). C. Fisher (1966) who recorded a man who experienced
an ejaculation during REM sleep in the sleep laboratory reported that the
dream of this man was mildly erotic (holding hands). It seems that the
phenomenon “wet dreams” (nocturnal emissions) is not related directly to
the dreamed sexual activity.

5.5   Dream Content and Brain Activation

For recording brain activation a variety of different techniques are avail-
able, from the classical EEG to modern techniques like functional mag-
netic resonance imaging (fMRI), positron emission tomography (PET),
and near-infrared spectroscopy (NIRS) (Kalat 2014). All these tech-
niques have their pros and cons, especially relevant for measuring brain
activation during sleep—which would be necessary to correlate specific
dream contents with brain activation patterns. Maquet et al. (1996) used
the PET technique with the advantage that the participant can sleep in a
bed while the radioactive tracer is injected and the brain scan is per-
formed after awakening in the scanner. Although they asked their par-
ticipants whether they remembered a dream (which all did) it is not
possible to use this technique to correlate distinct dream actions, for
example, moving an arm to brain activation of the motor cortex due to
low temporal resolution (in the range of minutes). The fMRI technology
allows a much better temporal resolution (in the range of seconds) but
the problem is that the dreamer has to sleep in the scanner which is dif-
ficult because of the scanner noise and the necessity to avoid head move-
ments by fixating the head with a holding device. The only fMRI-EEG
study so far linking dream actions to brain activation is the study of
Dresler et al. (2011). They were able to record two REM periods with
lucid dreams of one participant (an exceptional skilled lucid dreamer)
and demonstrated that dreamed hand m ­ ovements were associated with
activations in the motor cortex. Another option is the EEG method,
which is applied in sleep research from the beginning to determine sleep
116 M. SCHREDL

stages (Rechtschaffen and Kales 1968). Typically only two central EEG
sites (C3, C4) were recorded, but this was expanded to six electrodes
(F3, F4, C3, C4, O1, O2), that is, including occipital and frontal areas
(American Academy of Sleep Medicine 2007). However, this small num-
ber of electrodes does not allow any source location (brain mapping)
based on the surface EEG signals, therefore, more recent studies (e.g.,
Siclari et al. 2017) used high-density EEG systems with 256 elec-
trodes. But systematic studies using brain mapping based on high-den-
sity EEG in relation to dream content have not yet been carried out.
Several neuroimaging studies of REM sleep (overview: Desseilles et al.
2011) found, for example, a decrease of activation of the dorsolateral pre-
frontal cortex and an increased activity of the amygdala. These differences
were linked to dream characteristics like dream bizarreness as the dorsolat-
eral prefrontal cortex is associated with planning and self-reflection and
the presence of intense emotions in dreams because this would reflect the
activated emotional processing circuit of which the amygdala is a part
(Desseilles et al. 2011). However, it has to be emphasized that these plau-
sible correspondences between specific brain activation and dream features
have not yet been tested empirically using imaging techniques, that is, is
dream bizarreness correlated with the activation level of the dorsolateral
prefrontal cortex? So far, there is only a small number of EEG studies link-
ing dream content to brain activation.
In a general and solely qualitative way, Moiseeva (1975) stated that the
EEG pattern accompanying bizarre and emotional intense dreams is dif-
ferent from the pattern of neutral dreams. Zadra and Nielsen (1996) who
analyzed the EEG pattern of strong negatively toned dreams have found
differences in the central, parietal, and occipital brain areas (more alpha
activity) and suggested that this activation reflects intense visual imagery
(occipital area) and motor activity in the dream (central area). A similar
result was reported by Gottschalk et al. (1991) who related the anxiety
level of the dream to the brain activity measured by PET. High levels of
anxiety were associated with high activation in the occipital, central, and
frontal lobe (the area which is associated with self-reflective thinking).
Etevenon and Guillou (1986) reported that left central brain activity
(motor cortex) was increased in two REM periods when the dreams
included intense activity of the right hand. There was a similar finding for
hand clenching in a lucid dream—using alpha suppression in the corre-
sponding motor cortex area (C3 or C4) as an indicator of activation
(Erlacher et al. 2003). As mentioned above, this was supported by a fMRI-
EEG study (Dresler et al. 2011).
 DREAM CONTENT AND PHYSIOLOGY 117

LaBerge (1985) has investigated the EEG activation of two different

activities during lucid dreaming. As expected, he obtained a blockade of
alpha waves of the right hemisphere while the dreamer is singing and an
alpha blockade of the left hemisphere during counting. The blockade of
alpha waves is reflecting activity of this brain area since fast frequency pat-
terns must be present. Voss, Holzmann, Tuin, and Hobson (2009) com-
pared the EEG of REM periods prior to lucid dream onset and the EEG
recorded during the lucid dream and found increased power in the 40 Hz
band in the frontal areas. This activation of the brain area that is associated
with self-referencing and planning in the waking state perfectly fits the
phenomenological difference between dreaming and lucid dreaming—as
the major difference between the two experiences is that in lucid dreams
the additional component of knowing that the current experience is a
dream is added. This activation of the prefrontal cortex was replicated by
a fMRI-EEG study (Dresler et al. 2012); these authors also found other
brain areas, for example, bilateral precuneus, cuneus, more activated dur-
ing REM sleep with lucid dreaming compared to non-lucid REM periods.
Experimentally stimulating the prefrontal cortex with transcranial current
stimulation resulted in slight increases in self-rated lucidity confirming the
idea that increased activity in the prefrontal cortex is associated with lucid
dreaming (Stumbrys et al. 2013; Voss et al. 2014).
Hong et al. (1996) investigated the relationship between talking and
listening within the dream and the corresponding EEG pattern. The
advantage of using these activities is the relatively specific localization of
the corresponding brain areas (Broca’s area: talking; Wernicke’s area: lis-
tening). For 12 dream reports obtained from REM awakenings (second
REM period of the night), the number of words related to talking corre-
sponded indeed with a decrease of alpha power above the Broca’s area
whereas the number of listening words was associated with decrease of
alpha power above the Wernicke area (Hong et al. 1996). Again, the
decrease of alpha power can be interpreted as activation since alpha waves
are found in relaxed wakefulness but not in an active waking state.
A more indirect approach to correlate brain activation and dream con-
tent was adopted by De Gennaro et al. (2011). They carried out volumet-
ric magnetic resonance imaging and diffusion-tensor imagining (waking
state) in 34 participants (22 women, 12 men; mean age: 37.7 ± 15.7 years,
range: 19–74 years). The basic idea is that high mean diffusivity and a
small volume of a particular brain area (structural atrophy) is linked to a
dysfunction of this area. On the other hand, the participants were asked to
voice-record their dreams for 14 days. Means per participant regarding
118 M. SCHREDL

bizarreness, emotional intensity, vividness, and dream length (word count)

were computed (N = 28 participants, as 6 participants did not recall dreams
within the study period). The results indicated that a higher mean diffusiv-
ity of the left amygdala, reflecting a decreased microstructural integrity, was
associated with shorter dream reports and lower scores on emotional load.
Bizarreness of dream reports was negatively correlated with the left amyg-
dala volume and positively correlated with the right amygdala mean diffu-
sivity. That is, inter-individual differences in dream characteristics were
correlated with inter-individual differences in functionality of the amyg-
dala. The large age range of the sample (age affected the imaging parame-
ters) and the small sample size are arguments that further studies are
necessary to validate these findings. Even fMRI studies might be of inter-
est, for example, Levin and Nielsen (2007) suggested to investigate inter-
individual differences in emotion regulation processes during waking in the
scanner and relate these differences to nightmare frequency.
The most extensive experiment for “dream reading” was performed by
Horikawa, Tamaki, Miyawaki, and Kamitani (2013). Three participants
spent 7–10 sessions (about 4 hrs. in the afternoon) in the scanner and
were awakened from N1 sleep over 200 times. The recall rate was 75% and
only reports with clear stage N1 EEG pattern were included. The visual
elements of the dream reports were classified, for example, man, car, street.
The fMRI data of the higher visual cortex were used for predicting dream
elements, for example, activation pattern of dreams including a man were
compared to the activation patterns of dreams without that element. The
mean decoding accuracy was 60%; significantly different from the 50% that
would be expected by chance. That is, decoding models trained on stimu-
lus-induced brain activity in visual cortical areas showed above-chance
classification, detection, and identification of sleep onset dream contents
(Horikawa et al. 2013). These topics are also investigated by researchers
interested in sleep-dependent memory consolidation showing via fMRI
technology that consolidation relies on replay of previously acquired stim-
ulus-specific brain activity patterns during sleep.

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 CHAPTER 6

Dreams and Mental Disorders

6.1   Introduction
Three motives have stimulated the investigation of dreaming in mental
disorders. First, the dream state itself was conceptualized by several theo-
rists as a mental disorder, hallucinating something that is not there
(Hobson 1997), and, secondly, hallucinations of schizophrenic patients
have been conceptualized as breakthroughs of dreams into the waking
state (Noble 1950). Third, many clinicians since Sigmund Freud have
attempted to use dreams in the diagnosis and treatment of their patients
with various mental disorders (Pesant and Zadra 2004).
According to the continuity hypothesis different waking symptoms of
patients with different mental disorders should be reflected in the dream
reports of these patients. As mental disorders are often accompanied by
significant distress, the continuity hypothesis would predict more negative
dream emotions. In Table 6.1, the prevalence rates of the nightmare dis-
order for different patient groups are depicted—the comparison to the
figure of about 5% found in the general population (Levin and Nielsen
2007) indicates that patients with various mental disorders experience
more often negatively toned dreams.
Several extensive reviews about dreaming in patients with mental disor-
ders have been published (Kramer 2000, 2010; Kramer and Nuhic 2007;
Kramer and Roth 1978; Mellen et al. 1993; Skancke et al. 2014) showing
that the main focus has been on schizophrenia, depression, PTSD, and
eating disorders. PTSD will not be reviewed in this section, as dreams,

© The Author(s) 2018 123

M. Schredl, Researching Dreams,
[Link]
124 M. SCHREDL

Table 6.1 Prevalence of nightmare disorder in outpatients with mental disorders

(Swart et al. 2013)
Primary diagnosis Nightmare disorder (%)

Mood disorders (N = 83) 37.3

Anxiety disorders (N = 109) 15.6
Posttraumatic stress disorder (N = 30) 66.7
Personality disorders (N = 161) 31.1
Other disorders (N = 115) 27.0
Total (N = 498) 29.9

more specifically nightmares, are a key symptom of the disorder (Ross

et al. 1989) and not particularly reflecting the waking-life symptoms of
these patients. So, the next sections will focus on dream studies in schizo-
phrenia, depression, and eating disorders. The last section will deal with
the relationship between various sleep disorders and dreaming—a very
interesting topic as dreaming is obviously closely related to sleep, that is,
sleep disturbances might have a direct effect on dreams.

6.2   Methodological Considerations

As several reviews (Kramer 2000, 2010; Kramer and Nuhic 2007; Kramer
and Roth 1978; Mellen et al. 1993; Skancke et al. 2014) indicated that the
scientific quality of many studies in this field are not adequate, a few meth-
odological issues that are of special interest in studying dreams of patients
with mental disorders will be reviewed.
One very critical issue is the description of the sample. This starts with
the rejection rate, the ratio of patients who refused to participate in relation
to all eligible patients. In the study of Schredl and Engelhardt (2001) about
30% of the patients refused to participate, most often stating that they do
not remember dreaming, that is, high dream recallers are overrepresented—
similar to dream studies in healthy persons (Strauch and Meier 1996). The
use of valid and appropriate diagnostic procedures was a problem in older
studies; more recent studies typically applied the diagnostic criteria of the
DSM-5 or an earlier version (American Psychiatric Association 2013). A
very interesting approach is the so-called Dimensional approach; waking-life
symptoms are operationalized by standardized instruments like the Beck
Depression Inventory (BDI), Symptom-­Checklist-­90 R, and the Positive
and Negative Syndrome Scale (PANSS) in order to correlate symptom
severity with specific dream characteristics (Schredl and Engelhardt 2001).
 DREAMS AND MENTAL DISORDERS 125

The possible effect of medication on dream recall and dream content is

a major problem in dream research with patients with mental disorders,
especially patients with severe depression or with schizophrenia. Due to
ethical considerations patients cannot be kept drug-free for long time
intervals and, thus, dreaming will be affected by the psychoactive drug.
Antipsychotic medication can have mixed effects on dreaming (Giordano
and Spoto 1977; Ornstein et al. 1969; Poulin et al. 2004), whereas most
antidepressants seem to reduce dream recall (Tribl et al. 2013). However,
it is important to differentiate direct pharmacological effects from indirect
effects of the medication on dreaming. For example, treatment with tri-
mipramine increased positive emotional tone of dreams in outpatients
(Schredl et al. 2009b), but these changes in dreaming were closely corre-
lated with improvement of daytime symptomatology, that is, the effect on
dreaming was indirectly caused by the improvement of daytime mood.
Since several compounds can cause nightmares (Pagel and Helfter 2003),
it is necessary to elicit and report all current medications of the patient
group. For longitudinal studies it seems also of importance to monitor
non-pharmacological therapies, for example, cognitive-behavioral therapy,
social skills groups, trainings of cognitive abilities.
A considerable number of dream studies have been carried out with
inpatients (Kramer and Roth 1978). The control samples were most often
matched regarding gender, age, and—if possible—years of education but
still the setting and daily routines might be different—as the healthy con-
trols were not staying in a hospital. The following dream of a 13-year-old
patient with anorexia nervosa will illustrate this point:

When the big mid-day meal arrived upstairs it was not wrapped up separately
for each patient with anorexia but was in one large bowl. Each one has to
take one part so that everyone gets the same amount. Of course everyone
took less and I got the biggest part. This was so stupid because this part had
the most calories in it. The supervisors did not believe me when I said that
it is too much but then I did not eat it. (Schredl and Montasser 1999)

This dream is clearly affected by the hospital setting. Similarly, the find-
ing of more unknown persons or strangers in dreams of patients with
schizophrenia (Kramer and Roth 1973; Lusignan et al. 2009) might be
explained by being in a psychiatric ward where meeting unknown persons
(new patients, new nursing staff, visitors of other patients, etc.) each day is
common. In order to control the dream content analytic findings for such
confounders, the daily lives of each group have to be monitored and mea-
sured quite extensively.
126 M. SCHREDL

As pointed out in Sect. 3.2 the method of dream collection (interviews,

questionnaires, dream diaries, and laboratory awakenings) can affect the
findings of dream content analytic studies. Within a clinical context, spe-
cial caution is necessary if dream reports were obtained during psycho-
therapeutic sessions and recorded by the therapist because dreams might
be selected, for example, disturbing dreams might be told more often for
seeking relief (Whitman et al. 1963). It is desirable that studies in patients
with mental disorders apply standardized dream collection and explicitly
document which approach was used.
A specific topic was mentioned by Eigel (1965); he observed that
depressed patients with melancholia could not be interviewed about their
dreams in the morning because the symptoms were very severe, the suc-
cess rate to obtain dreams was much better in the afternoon. This raises
the question as to how dependent the dream report is on the waking-life
symptoms, that is, bizarre dreams in schizophrenic patients might be the
result of reporting a coherent dream as bizarre due to the thought disor-
der often found in these patients. Another factor might be the so-called
mood congruency effect—that is, recalling more negative events if the
current mood is more negative (Fiedler and Hütter 2014). If this factor
also applied to dream recall, the finding that depressed patients report
more negatively toned dreams (Skancke et al. 2014) might be an artifact.
So far, only one study (Schredl et al. 2009a) in a student sample adopted
an indirect approach to test this effect by correlating inter-individual dif-
ferences in mood congruency effects in a memory task carried out in wak-
ing with possible mood congruency effects in dream recall. The findings,
however, did not support such an effect of mood congruency on dream
recall. Systematic research in patients with mood disorders is necessary to
clarify possible effects of waking-life symptoms on the dream reporting.

6.3   Depression
The common feature of depressive disorders is the presence of sad, empty,
or irritable mood, accompanied by other symptoms like diminished inter-
est or pleasure in almost all activities or pessimistic thoughts and a signifi-
cant distress or impairment in social, occupational, or other important
areas of functioning (American Psychiatric Association 2013). In addition
to unipolar depressive disorders, the DSM-5 includes bipolar disorders,
that is, depressive and manic (or hypomanic) phases occur in these patients.
The manic episode is characterized by abnormally elevated and expansive
 DREAMS AND MENTAL DISORDERS 127

mood including symptoms like grandiosity, flight of ideas, doing things

with possible negative consequences like spending a lot of money or sexual
promiscuity (American Psychiatric Association 2013).
In severely depressed patients dream recall and dream length are mark-
edly reduced (Riemann et al. 1990), possibly due to the impairment in
cognitive functioning (American Psychiatric Association 2013). Beck and
Hurvich (1959) carried out one of the first systematic dream content ana-
lytic studies in depressed patients. Based on their psychoanalytic back-
ground they expected that the dreams of this patient group reflect their
“need to suffer”. Their “masochism” scale included topics like unpleasant
affects (sad, hurt, lonely, etc.), being rejected, being blamed, criticized, and
so on. About 54% of the 120 dreams of 6 depressed female outpatients
included at least one “masochistic” topic whereas the 120 dreams of non-
depressed female outpatients (anxiety disorders, psychosomatic disorders)
only included 12.5% of such topics—a significant difference. The interrater
agreement between the blind rater and the therapist of the patients was
high (95% of the dreams were coded similar). A subsequent study (Beck
and Ward 1961) in a larger sample confirmed this finding. Whether one
adheres to psychoanalytic theories (“masochism” in depression) or the
continuity hypothesis (dreams reflect daytime mood), the preponderance
of negative emotions and experiences in dreams was found frequently in
patients with depressive disorders (Skancke et al. 2014). In two studies
(Schredl and Engelhardt 2001; Schredl et al. 2009b) dream emotions were
directly correlated with the severity of depressive daytime symptoms. Other
findings, for example, increased number of family members in dream of
patients with depression (Kramer and Roth 1978), have to be viewed with
caution as they may not reflect depressive symptomatology per se but pos-
sible consequences of the mental illness, for example, social withdrawal.
Glucksman and Kramer (2017) reported that depressed patients with sui-
cidal ideation more often dream about death and dying (60% vs. 20% of
these topics in depressed patients without suicidal ideation). Similarly,
themes of death and aggression in dreams were associated with more severe
depressive symptoms (Schredl and Engelhardt 2001), that is, dreams might
help in evaluation of potential suicidal behavior.
Bipolar depressed patients have dreams with themes of death and injury
prior to shift to mania (Beauchemin and Hays 1996). The heightened inci-
dence of bizarre dreams in manic phases reported by Beauchemin and Hays
(1995) was not replicated by Limosani, D’Agostino, Manzone, and Scarone
(2011). Due to the small number of studies in this patient group, the effects
of bipolar symptomatology on dreams are not well understood.
128 M. SCHREDL

Kramer, Whitman, Baldridge, and Ornstein (1968) reported that clini-

cal improvement using antidepressants leads to decreased hostility in the
dreams of depressed patients while intimacy, motility, and heterosexuality
increases. During treatment with the antidepressant trimipramine dream
emotions became more positive (Schredl et al. 2009b). However,
Armitage, Rochlen, Fitch, Trivedi, and Rush (1995) found no effect of
serotonin reuptake inhibitors on dream content in the course of successful
depression treatment. A possible explanation to these divergent findings
might be that antidepressants can have negative effects on dreaming, that
is, inducing nightmares (Tribl et al. 2013). Moreover, Hauri (1976)
reported that even patients fully remitted from depression still have more
negatively toned dreams compared to healthy controls. Studies looking at
the effect of cognitive-behavioral therapy on dream content in patients
with depression are still lacking.

6.4   Schizophrenia
The key features of schizophrenia and other psychotic disorders are delu-
sions (fixed beliefs that are not changed by obvious counterfactual evi-
dence, for example, persecutory, religious, grandiose delusions),
hallucinations (most often auditory (voices)), disorganized thinking
(speech), and negative symptoms like diminished emotional expression or
anhedonia (American Psychiatric Association 2013).
Whereas dream recall frequency in schizophrenic patients seems not to
differ from healthy controls in a systematic way (Lusignan et al. 2009;
Michels et al. 2014), schizophrenic patients reported nightmares more
often (Lusignan et al. 2009; Michels et al. 2014; Okorome Mume 2009)
and the occurrence of nightmares were—in conjunction with insomnia—
related to an increased risk of suicide attempts (Li et al. 2016)—frequent
nightmares as an independent predictor of suicidal ideation has been
reported in non-clinical samples (e.g., Nadorff et al. 2013). Also patients
at high risk states for psychosis reported significantly more nightmares
than controls (Michels et al. 2014).
More bizarreness, and implausibility, in dreams of schizophrenics com-
pared to non-schizophrenics has been one of the most robust findings
(Kramer 2000). However, Scarone et al. (2008) and Lusignan et al.
(2009) did not find differences in dream bizarreness between schizo-
phrenics and controls, even though the waking mentation of schizophren-
ics was found to be more bizarre than that of controls. On the other hand,
 DREAMS AND MENTAL DISORDERS 129

Noreika, Valli, Markkula, Seppälä, and Revonsuo (2010) found that the
schizophrenics’ dreams were more bizarre than healthy controls. Studies
focusing on formal aspects of the dream reports using graph analysis
(Mota et al. 2014; Mota et al. 2012) or textual analysis processing tech-
niques (Zanasi et al. 2011) were able to demonstrate that the waking-life
symptom thought disorder also can be detected in dream reports. On a
methodological note, it has to be considered that the distinction between
dream bizarreness and disorganized thinking and speech in waking is not
easy as the dreams are reported by the patients in their waking state, that
is, the thought disorder might affect the process of dream reporting but
not the dreaming process itself. The correlation between the question-
naire indices “paranoid ideation” and “psychoticism” with dream bizarre-
ness in schizophrenic patients and also in non-schizophrenic patients
(Schredl and Engelhardt 2001) might indicate that severity of psychotic
symptoms might be associated with dreaming itself as the non-­
schizophrenic patient group did not suffer from a full-blown thought dis-
order. D’Agostino et al. (2013) reported that in two patients the topic of
their delusion (grandiosity, religious delusion) did show up in the dreams
of these patients, supporting the notion of continuity between waking and
dreaming.
Systematic studies of antipsychotic drugs (typical and atypical neurolep-
tics) on dream content are still lacking (Kramer and Nuhic 2007); the
reported correlation between severity of psychotic symptoms and dream
characteristics, like bizarreness (Schredl and Engelhardt 2001), would
indicate a normalization of dream content in the course of a successful
therapy.
Despite the very interesting topic of dreaming in schizophrenia (dream-
ing as a “normal” form of psychosis), many questions are still unanswered.

6.5   Eating Disorders

Eating disorders are characterized by disturbances of eating or eating-­
related behavior that significantly affects physical health and/or psychoso-
cial functioning (American Psychiatric Association 2013). The three
essential features of anorexia nervosa are: persistent energy intake restric-
tion (semi-starvation), intense fear of gaining weight, and a disturbance in
self-perceived weight or body image (American Psychiatric Association
2013). For bulimia nervosa the key features are recurrent episodes of
binge eating, compensatory behavior to prevent weight gain (self-induced
130 M. SCHREDL

vomiting, use of laxatives, diuretics, fasting, or excessive exercise), and

strong relationship between self-esteem and body shape and weight
(American Psychiatric Association 2013).
Laboratory studies (Dippel et al. 1987) indicated that dream recall is
not reduced in patients with eating disorders. A questionnaire and diary
study (Schredl and Montasser 1999), however, found a slightly decreased
dream recall frequency in patients with anorexia or bulimia, possibly
related to depressive symptoms.
Weizsäcker (1937) was the first to report on the dream content in
anorexic patients. The dream themes prior to “craving days” were nega-
tive like death or body distortion whereas themes of well-being and
religious figures occurred in the dreams prior to “non-appetite” days—
reflecting the patients’ negative attitude towards food intake. A reanaly-
sis of these data (Jackson et al. 1993) showed that death imagery were
overall very frequent and might be related to the high mortality rates of
patients with anorexia nervosa.
Subsequent studies (Anelli et al. 2007; Brink and Allan 1992; Dippel
et al. 1987; Frayn 1991; Schredl and Montasser 1999) found an increased
occurrence of food dreams in anorectic and bulimic patients. The specific
topic of rejecting food was only found in dreams of patients with anorexia
nervosa (Schredl and Montasser 1999). These findings are in line with the
continuity hypothesis as these patients are intensely preoccupied with food
and eating in their waking life. Body distortion in dreams as reflecting the
typical symptom of anorexia was found by Frayn (1991) and Brink and
Allan (1992), for example, dreaming of an enlarged belly. The preponder-
ance of negative dream emotions and negative dream themes (Brink et al.
1995; Brink and Allan 1992; Dippel et al. 1987) was interpreted by Brink
and Allan (1992) as an expression of self-hate, rage, and an inherent
inability to develop a self-nourishing/nurturing attitude. An interesting
finding is the reduced number of male dream characters in female anorec-
tic patients; a finding that might reflect the problems with the transition
into womanhood (Schredl and Montasser 1999).
To summarize the research carried out so far, most findings fit in the
continuity hypothesis framework, that is, dream content does indeed
reflect the waking-life symptomatology observed in this patient group.
However, sample sizes of the dream studies are generally very small and
the interesting topic of whether dreams change during successful treat-
ment of the eating disorder, for example, reduction in food-related dream
themes, has not been studied systematically.
 DREAMS AND MENTAL DISORDERS 131

6.6   Dreaming and Sleep Disorders

Sleep disorders are very common; the prevalence rates for insomnia dis-
order are about 20%, for restless legs syndrome between 5% and 15%, and
sleep-related breathing disorders in persons older than 40 years about
10–19% (Amara and Maddox 2017). For dream researchers and clini-
cians, two questions are of interest: (1) is dreaming process affected by
the presence of a sleep disorder, for example, oxygen desaturations or
micro-­arousals? and (2) are factors that are playing a role in the etiology of
the sleep disorder, for example, stress in insomnia, influencing dream
content?
In Table 6.2, an overview of the studies investigating dreaming in
patients with sleep disorders is depicted. Overall, it can be stated that the
number of studies in this field is small (Schredl 2010), for example, sys-
tematic investigations of dream content in patients with primary hyper-
somnia and NREM parasomnias (night terror/sleepwalking) are lacking.
Dreaming in restless legs patients has been studied in two pilot studies
(Schredl 2001; Schredl et al. 2012) not yielding any significant differ-
ences. The findings regarding dreaming in insomnia, in patients with sleep
apnea, and dreaming in narcolepsy will be presented in the next sections.

Table 6.2 Dream recall, nightmare frequency/negative dream emotions, and

dream content in patients with sleep disorders
Sleep disorder Dream Nightmares/negative Dream content
recall dream emotions

Primary insomnia ↑ ↑ More problems

Restless legs = = No increase in dreams with
syndrome leg movements
Sleep apnea = = No increase in breathing-­
syndrome related dreams
Narcolepsy ↑ ↑ More bizarre and longer
dreams
Primary = --- ---
hypersomnia
Night terrors/ = ↑ ---
sleepwalking
Nightmare disorder ↑ ↑ Being chased, falling etc.
REM sleep behavior --- --- Aggressive dreams, Dreams
disorder (RBD) with gross body movements

↑ heightened in patients compared to healthy controls, = comparable to healthy controls, --- not studied
132 M. SCHREDL

The REM-sleep associated parasomnias (nightmares and REM-sleep

behavior disorder (RBD)) have been studied most extensively because
dreams and dream-related behaviors are at the core of these disorders. As
nightmares are discussed in Chap. 7, the RBD will be briefly reviewed in
this chapter.

6.6.1  Insomnia
The essential feature of chronic insomnia disorder is a frequent and persis-
tent difficulty in initiating or maintaining sleep that results in a clinically
significant distress and impairment in important areas of functioning
(American Academy of Sleep Medicine 2014). The prevalence of chronic
insomnia disorder in the general population is quite high (about 10%) and
associated risk factors are stressors, personality factors like neuroticism,
and medical illnesses (American Academy of Sleep Medicine 2014).
Using REM awakenings in the sleep laboratory patients with insomnia
was comparable to healthy controls regarding dream recall (Ermann 1995;
Pérusse et al. 2016). However, home dream recall was elevated in insom-
nia patients compared to healthy controls (Schredl et al. 1998) with the
statistical analysis indicating the idea that this dream recall frequency dif-
ference is explained by heightened frequency of nocturnal awakenings in
patients with insomnia. This is in line with the positive correlation between
frequency of nocturnal awakenings and dream recall frequency in healthy
persons (Schredl et al. 2003).
Several studies (Ohayon et al. 1997; Pagel and Shocknesse 2007;
Schredl 2009) found that persons with insomnia complained about night-
mares more often than patients without insomnia or healthy controls.
Nightmare frequency was directly related to insomnia severity (Schredl
2009). As stress and negative life-events can trigger insomnia, the increase
in nightmare frequency and the more negatively toned dreams in patients
with insomnia are in line with the continuity hypothesis of dreaming, that
is, dreams reflects the waking-life stressors that had affected sleep nega-
tively. The negative dream emotions correlated directly with the number
of waking-life problems (Schredl et al. 1998). In a group of 37 patients
with insomnia, negative dream themes correlated with the severity of
early-life maltreatment experiences, that is, even years after the stressful
experience the dreams are affected, and one might speculate whether these
negative life-events did also play a role in insomnia etiology in this patient
group (Schäfer and Bader 2009).
 DREAMS AND MENTAL DISORDERS 133

The dreams of insomnia patients more often contained negatives in

self-description, for example, low self-esteem, and negatives in dream
descriptions, for example words like no, never, or references to something
being missing (Ermann 1995; Schredl et al. 1998). Negative dream topics
like aggression, failure, and misfortunes were also more often found in
dreams of insomnia patients (Pérusse et al. 2016; Schredl et al. 1998).
Moreover, the occurrence of waking-life problems was significantly related
to the occurrence of problems in their dreams; if the patients reported
health problems, they dreamt also about health-related issues more often
(Schredl et al. 1998).
Overall, the findings indicate that sleep physiology alterations (frequent
awakenings) associated with insomnia might affect dream recall and that
dream content reflects factors (stressors) that are playing a role in insom-
nia etiology. It would be very interesting to study how successful treat-
ment with cognitive-behavioral therapy affects dream content.

6.6.2  Sleep Apnea Syndrome

The most common sleep-related breathing disorder is the obstructive
sleep apnea syndrome which is characterized by episodes of complete or
partial upper airway obstructions during sleep (American Academy of
Sleep Medicine 2014). These events, often resulting in blood oxygen
desaturations, are usually terminated by brief arousal resulting in non-­
restorative sleep and excessive daytime sleepiness, especially in severe sleep
apnea patients (American Academy of Sleep Medicine 2014).
Retrospectively measured dream frequency in the home setting seems
not different from healthy controls as the findings are mixed (Schredl
et al. 1999, 2006, 2012). This is in line with REM awakening studies
[49–51] that report similar recall rates for patients and age-matched
healthy controls (Carrasco et al. 2006; Gross and Lavie 1994) Furthermore,
two studies (Schredl and Schmitt 2009; Schredl et al. 2006) did not find
any relationship between dream recall frequency and sleep apnea parame-
ters such as respiratory disturbance index or oxygen saturation nadir.
In the nineteenth century, several researchers (e.g., Boerner 1855)
hypothesized that nightmares are caused by a shortage of oxygen. De Groen
et al. (1993), indeed, reported a relationship between snoring, breathing
pauses reported by the spouse, and nightmares in a sample of Dutch World
War II veterans. However, systematic studies in large samples of sleep apnea
patients did not find elevated nightmare frequency levels in patients
134 M. SCHREDL

compared to controls (Schredl et al. 2006, 2012; Schredl and Schmitt

2009; Valipour et al. 2007). Moreover, nightmare frequency was not
related to a respiratory disturbance index or the oxygen saturation nadir
(Schredl and Schmitt 2009; Schredl et al. 2006). Solely the presence of a
psychiatric comorbidity like depression or anxiety disorder was associated
with heightened nightmare frequency in this patient group (Schredl and
Schmitt 2009; Schredl et al. 2006). Similarly, Fisher et al. (2011)
reported that nightmare frequency is associated with daytime anxiety and
depression but not with apnea severity, that is, the findings contradict the
idea that oxygen desaturation during sleep cause nightmares.
Regarding negative dream emotions, M. Gross and Lavie (1994)
reported that dreams were more negatively toned on nights with sleep
apneas compared with nights with continuous positive airway pressure
(CPAP) treatment; however, the crossover design of the study was prob-
lematic as already successfully treated sleep apnea patients slept one night
without their CPAP machine (this might have stimulated anxieties in the
patients because they knew what was coming—a night with a lot of apneas).
Carrasco et al. (2006) reported a significantly increased number of violent
and highly anxious dreams in 20 never-treated severe sleep apnea patients
as compared to healthy controls and speculated as to whether this can be
attributed to a hyperactivation of the limbic system due to the arousals that
a necessary to terminate the breathing pauses. More negatively toned
dreams were also reported by sleep apnea patients that rated dreams recalled
in the morning after a diagnostic night in the sleep laboratory (Schredl
1998b). These negatively toned dreams ware also found in diary
dreams recorded in a home setting (Fisher et al. 2011). As intensity of
negative emotions was not related to severity of the sleep apnea symptoms
but to daytime anxiety and depression (Fisher et al. 2011), one might spec-
ulate that the more negatively toned dreams are explained by the continu-
ity hypothesis, that is, the dreams reflect patients’ daytime problems, like
daytime sleepiness which is a key symptom of obstructive sleep apnea.
As external stimuli can be incorporated into dreams (see Sect. 4.6), the
question whether internal stimuli like shortage of breath can affect dream con-
tent was investiged. Some very illustrative dream examples have been reported:

During the dream I felt tied up or chained. I saw thick ropes around my
arms and was not able to move. I experienced the fear of suffocation without
being able to cope with the situation. Powerlessness and also resignation
came up. (Patient with sleep apnea, male, 39 years, respiratory disturbance
index (RDI): 68.1 apneas per hour, maximal drop of blood oxygen satura-
tion: 43%; Schredl 1998b, p. 295)
 DREAMS AND MENTAL DISORDERS 135

I was diving without oxygen tanks and was gasping for breath. The way
to the surface was far and I managed it just in time. After waking up I really
gasped for breath. (male, 39 years, REM-sleep associated sleep apneas, RDI:
71.8, oxygen saturation nadir: 68%; Schredl et al. 2006, p. 207)

However, references to respiratory events in dreams of sleep apnea

patients were not significantly increased compared to controls (Carrasco
et al. 2006; Gross and Lavie 1994; Schredl et al. 1999, 2012). One plau-
sible explanation might be that the mind adapts to the apnea stimulus as
the disorder typically slowly progresses over years. It would be interesting
to conduct an experimental study where participants wear a device (a full-­
face mask) which allows breathing to be blocked for a very brief period of
time without knowledge of the sleeper in order to investigate the effects
of newly experienced respiratory pauses on dream content.
Schredl et al. (1999) found a strong relationship between dream bizarre-
ness and sleep apnea severity (r = −0.51, p < 0.005, N = 33), that is, a high
respiratory disturbance index was associated with more realistic and less
bizarre dreams. This finding might indicate that the frequent micro-arous-
als terminating apneas might interfere with the dreaming process.
The treatment of sleep apnea syndrome with CPAP results in a dramatic
change in sleep physiology with a slow-wave sleep rebound and REM
rebound in the first nights and less fragmented sleep (Freedman 2017).
Carrasco et al. (2006) found a decrease in dream recall on the first CPAP
night but an increase in dream length and positively toned dreams. These
results can be interpreted as an effect of slow-wave sleep rebound which
might be associated with reduced dream recall and less fragmented sleep.
The positively toned dreams, especially those found after three months
and after two years of CPAP treatment, might be explained by the positive
effect of CPAP treatment on daytime functioning.

6.6.3  Narcolepsy
Narcolepsy is characterized by excessive sleepiness (irrepressible need to
sleep or lapses into sleep) and diagnosed by carrying out a multiple sleep
latency test with five short sleep periods during the day in which the
patient falls asleep quickly (mean latency below 8 minutes) and shows two
or more sleep onset REM periods (onset of REM sleep within 15 minutes)
(American Academy of Sleep Medicine 2014). In many narcolepsy patients
cataplexies (sudden loss of muscle tone with retained consciousness often
triggered by strong emotions, e.g., laughing) and other REM-sleep asso-
136 M. SCHREDL

ciated symptoms like sleep paralysis (inability to move voluntary muscles

at sleep wake-transitions, mostly after waking up) and hypnogogic or hyp-
nopomic hallucinations (vivid dream-like experiences occurring at sleep
onset or while awakening from sleep) can be found (American Academy of
Sleep Medicine 2014). The pathophysiology of this disorder shows an
overactive REM sleep system, therefore REM sleep can occur directly after
sleep onset (in healthy persons the REM latency is about 90–100 min-
utes), the atonia phenomena (cataplexy, sleep paralysis) as a malfunction-
ing of the REM sleep regulation (Mignot 2017). The basis for this is often
a loss of hypocretin/orexin cells in the hypothalamus due to autoimmu-
nological processes (Mignot 2017).
REM awakening studies (Mazzetti et al. 2010; Nixon et al. 1964) indi-
cated that the percentage of recall after REM awakenings in patients with
narcolepsy is very high (about 90%) and comparable to the figures obtained
from matched controls. Home dream recall is typically elevated in narco-
lepsy patients (Rak et al. 2015; Schredl et al. 2012; Wamsley et al. 2014)
and these patients describe their dreams as more vivid and more emotional
than healthy controls (Roth and Bruhova 1969; Wamsley et al. 2014),
which might be the reason why narcolepsy patients more often mistake a
dream experience for a true memory (Wamsley et al. 2014). Patients with
narcolepsy also have elevated levels of nightmare frequency (Dodet et al.
2015; MacFarlane and Wilson 2006; Rak et al. 2015; Schredl et al. 2012);
about 30% of these patients suffer from a comorbid nightmare disorder
(Mayer et al. 2002; Pisko et al. 2014). Interestingly, narcolepsy patients
also experience more lucid dreams (Dodet et al. 2015; Rak et al. 2015)
and some patients stated that they use these techniques to reduce night-
mares (Dodet et al. 2015). But systematic studies of whether lucid dream-
ing or imagery rehearsal therapy (Krakow and Zadra 2010) can reduce
nightmare frequency in narcolepsy patients in the long run have not been
carried out.
The following bizarre dream reported by one female narcoleptic patient
(age: 20 years) illustrated the more bizarre dreams in these patients com-
pared to healthy controls (Schredl 1998a):

I dreamt that I stepped out of the bright light of the lamp and slipped into
another time period. I met my grandfather who I had never seen in my wak-
ing life and saw other persons from my hometown, much younger than
today. With the help of friends I managed to travel back to the present time.
I even brought some stuff from the past with me which my mother identi-
fied as her former belongings. (p. 106)
 DREAMS AND MENTAL DISORDERS 137

To summarize, the dysregulation of the REM sleep system underlying

narcolepsy also manifests in changes in dreaming such as higher home
dream recall frequency and more negatively toned and bizarre dreams.

6.6.4  REM Sleep Behavior Disorder (RBD)

RBD is a rare parasomnia and is characterized by abnormal behaviors
emerging during REM sleep usually manifesting an attempted enactment
of unpleasant, action-filled, and violent dreams (American Academy of
Sleep Medicine 2014). This disorder should not be confused with sleep-
walking as in sleepwalking the person’s brain is half awake and half asleep,
with this hybrid mode occurring out of NREM sleep. From a clinical view-
point, RBD affecting most often men older than 50 years is very severe
because it is a precursor of a neurodegenerative disorder like Parkinson’s
or Lewy body dementia (Silber et al. 2017). The underlying psychopa-
thology is that brain stem areas that are responsible for muscle atonia in
REM sleep are partially damaged, so the signals (especially strong signals
from intensive dreams) can break through and activate the musculature
even though the person is in REM sleep (Silber et al. 2017).
Jouvet (1999) studied oneiric behavior in cats by lesioning these brain
stem areas responsible for muscle atonia in REM sleep; the cats walked
around (in the large Plexiglas cage), pursued imaginary prey, licked the
floor as if they were drinking, and displayed aggressive behavior (ears flat-
tened backward and mouth open ready to bite). All these behaviors are
typical for an awake cat but these cats’ EEG recording clearly indicated the
presence of REM sleep.
Dream content—as mentioned above—in these patients is often
described as violent and action-packed (Fantini et al. 2005; Silber et al.
2017; Uguccioni et al. 2013). They also experience more nightmares
(Godin et al. 2015) and more nightmare distress (Godin et al. 2013).
However, these findings have to be viewed with caution. The study of
Fantini et al. (2005), for example, elicited most recent dreams and it is
very plausible that patients report those dreams that have been accompa-
nied by body movements and thus woke them up. These dreams are very
likely more intense than normal dreams as they were intense enough to
break through the muscle atonia and thus reflect the tip of the iceberg,
that is, healthy controls may experience similar dreams but did not awaken
from these dreams as their muscle atonia in REM sleep was intact. A diary
study in 12 patients with RBD recording 77 dreams did not show increased
138 M. SCHREDL

violence and aggression in these dreams compared to healthy controls

(D’Agostino et al. 2012). However, Fantini and Ferini-Strambi (2012)
pointed out that most of these patients were on clonazepam (the most
effective drug for treating RBD) and that might have affected the find-
ings—indeed, in insomnia patients the intake of benzodiazepines are asso-
ciated with more positively toned dreams compared to drug-free insomnia
patients (Schredl et al. 1998). It would be very interesting to carry out
laboratory studies with awakenings from REM periods with marked body
movements and REM periods with very little or no body movements and
compare these two dream samples; one might expect that the “body
movement” dreams might be more aggressive and action-packed than
those without movements.
Schenck, Scott, Ettinger, and Mahowald (1986) were the first to
describe this REM parasomnia and provided very illustrative examples.
The following dream was reported by a 67-year-old male:

I was a halfback playing football, and after the quarterback received the ball
from the center he lateraled it sideways to me and I’m supposed to go around
end und cut back over tackle and—this is very vivid—as I cut back over tackle
there is this big 280-pound tackle waiting, so I, according to football rules,
was to give him my shoulder and bounce him out of the way, supposedly, and
when I came to I was standing in front of our dresser and I had knocked
lamps, mirrors, and everything of the dresser, hit my head against the wall
and my knee against the dresser (p. 294; Schenck et al. 1986).

The action in the dream matched the performed body movements.

In a systematic study (Valli et al. 2012) comparing video clips of the
REM-sleep associated movements and the elicited dream reports (17
episodes) the external judges were able to match about 40% of the epi-
sodes correctly (significantly above chance as the judges were presented
with four dream reports per video clip with a chance level of 25% cor-
rect answers). One episode with the most movements was correctly
matched by all raters, that is, the main problem of the mismatches was
the paucity of body movements (Valli et al. 2012). This study illustrates
the opportunity to study dreams in action without having to refer to the
verbal dream report after waking up from REM sleep. Herlin, Leu-
Semenescu, Chaumereuil, and Arnulf (2015) identified 8 RBD patients with
no dream recall (4 never recalled a dream, 4 with the last dream recalled
more than 10 years ago) out of a pool of 289 patients as most of these patients
remembered their dreams. The motor behavior of these 8 patients during
REM sleep was as complex as the motor behavior of RBD patients with
 DREAMS AND MENTAL DISORDERS 139

dream recall, suggesting that they also experienced dreams but had prob-
lems to remember them upon awakening (Herlin et al. 2015). In 19
sequences with motor behavior in REM sleep most of the parallel recorded
eye movements (82%) were related to the actual movement, for example,
grabbing a fictive object, climbing a ladder (Leclair-Visonneau et al.
2010), also indicating that studying dreaming of patients with RBD in
detail offers a new approach to study the relationship between physiology
and dream content.

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 CHAPTER 7

Nightmares

7.1   Definitions
According to the International Classification of Sleep Disorders ICSD-3
(American Academy of Sleep Medicine 2014), nightmares are defined as
disturbing mental experiences that generally occur during REM sleep and
that often result in awakening. Most often the dream emotion is anxiety
but also other emotions like sadness, anger, guilt, and disgust can be the
prominent emotion of a nightmare (Robert and Zadra 2014). The most
common nightmare themes are being chased, falling, being paralyzed,
death of close persons, and being late (Schredl 2010a). Disturbing dreams
without causing an awakening are called “bad dreams”. As REM sleep is
more often found in the second half of the night, nightmares are also
reported to occur in the later part of the night. Upon awakening, the per-
son is fully awake, oriented about the surroundings, and able to give a full
account of the nightmare.
As most people have experienced nightmares at least occasionally in
their life span (Schredl et al. 2014), it is important to differentiate between
the general term nightmares and the nightmare disorder. In order to diag-
nose a nightmare disorder (ICD 10: F51.5), the person should report
clinically significant distress or impairment in social, occupational, or other
important areas of functioning due to the nightmares (American Academy
of Sleep Medicine 2014). In clinical practice, a cut-off of about one night-
mare per week or more often can be used as indication for the nightmare
disorder (Schredl 2013a). In children, the fear at sleep onset that

© The Author(s) 2018 147

M. Schredl, Researching Dreams,
[Link]
148 M. SCHREDL

­ ightmares might occur during the night is another indicator for the dis-
n
tressing effect of nightmares (American Academy of Sleep Medicine
2014). The diagnostic criteria exclude patients with disorders which might
be causal for the nightmares like PTSD, major depression, or anxiety dis-
orders. It is, however, still unclear whether nightmares should be consid-
ered as symptom of these disorders or considered as co-morbid condition
(Schredl 2013a).

7.2   Other Nocturnal Phenomena Associated

with Negative Emotions

Nightmares are not the only phenomena occurring during the night that
are associated with anxiety; there are night terrors, post-traumatic re-­
enactments, and nocturnal panic attacks. Night terrors occur most often
about one hour after sleep onset out of NREM sleep and are accompanied
with a massive autonomic arousal (loud vocalizations, dramatic increase in
heart rate) (American Academy of Sleep Medicine 2014). Usually, the
person is not fully awake and sleepwalking can occur after the night terror
attack. Night terrors can be differentiated from nightmares because the
sleeper often does not recall the night terror attack or at maximum a brief
scene or image like fire or a wall crushing down whereas nightmares are
easily recalled in detail. Post-traumatic re-enactments are replays of a trau-
matic event the person experienced in his/her waking life (Wittmann et al.
2007). These can occur during REM sleep but also during NREM sleep
and even in the waking state: then they are called “flashbacks”. Patients
suffering from PTSD often suffer from nightmares (American Psychiatric
Association 2013); about 50% of these nightmares are trauma-related
(more or less exact replay of the traumatic situation) whereas other night-
mares contain other distressing or terrifying topics (Wittmann et al. 2007).
Nocturnal panic attacks have their peak of experiencing anxiety and
panic after awakening, usually accompanied by death anxiety and somatic
symptoms like hyperventilation, paresthesias (numbness or tingling sensa-
tions), sweating and so on (American Psychiatric Association 2013),
whereas in the case of nightmares the anxiety decreases if the person is
fully alert (American Academy of Sleep Medicine 2014). It should be
noted, however, that nightmares can trigger nocturnal panic attacks in
patients with panic disorder (Schredl et al. 2001). Differentiating between
these four phenomena is very important from the clinical standpoint, as
effective therapeutic approaches are different.
 NIGHTMARES 149

7.3   Nightmares and Sleep Quality

Nightmares are classified as a parasomnia, that is, they are seen as phenom-
ena that occur during the sleep period but do not affect sleep itself like
insomnia or hypersomnia (American Academy of Sleep Medicine 2014).
However, subjective sleep quality in patients with nightmare disorder is
drastically reduced (Paul et al. 2015), presumably as direct effect of the
nightmare itself—most often falling asleep after the nightmare awakening
is prolonged—and indirect effects due to worries that nightmares may
occur after falling asleep. Interestingly, sleep laboratory studies and an
ambulatory study in the home setting did not find much difference regard-
ing typical sleep parameters like sleep efficiency obtained by polysomnog-
raphy in patients with nightmares compared to healthy controls, even
though subjective estimates of sleep quality are much lower (cf. Paul et al.
2015).

7.4   Nightmare Frequency

Large-scale representative studies in the general population indicate that
about 5% of the adult population suffers from nightmares (Bixler et al.
1979; Janson et al. 1995; Stepansky et al. 1998). Nightmare prevalence is
much higher, about 30%, in patients with mental disorders like depression,
anxiety disorders (Swart et al. 2013). In these studies the participants are
typically asked questions like “Do you suffer from nightmares?” aiming at
estimates for the prevalence of the nightmare disorder. Other studies mea-
sured nightmare frequency, for example, “During the past 30 days, have
you had nightmares?” “Often; sometimes; never” (Sandman et al. 2013).
As categories like “often” and “sometimes” are not very precise and might
be different for different participants, the following eight-point scale—
“How often have you experienced nightmares recently (in the past several
months)? (Several times a week, about once a week, two to three times a
month, about once a month, about two to four times a year, about once a
year, less than once a year, and never)”—was developed by Schredl, Berres,
et al. (2014). As nightmares might be confused with other nocturnal phe-
nomena associated with anxiety (see Sect. 7.2) a definition “Nightmares
are dreams with strong negative emotions that result in awakening from
the dreams. The dream plot can be recalled very vividly upon awakening”
was included in the item presentation. The retest reliability of this scale
was high: r = 0.75 (Schredl et al. 2014; Stumbrys et al. 2013). Another
150 M. SCHREDL

possibility to measure nightmare frequency is asking the participants to

keep a dream diary (with instruction to write down the remembered
dreams) or to keep a daily log (checklist regarding nightmare occurrence).
Wood and Bootzin (1990) reported a much higher nightmare frequency
obtained by the diary measure compared to the retrospective estimates,
assuming that the retrospective measures might underestimate nightmare
frequency, possibly because most of the persons try to forget their night-
mare as quickly as possible—an often used but ineffective coping strategy
(Schredl and Göritz 2014). This is supported by the findings that night-
mare frequency is higher if the question is about the nightmare occurrences
in the past month compared to the nightmare occurrences during the past
year (Robert and Zadra 2008; Wood and Bootzin 1990; Zadra and Donderi
2000). Subsequent studies (Robert and Zadra 2008; Zunker et al. 2015)
confirmed the previous difference between questionnaire and diary mea-
sures but the differences were much smaller, for example, nightmares per
two weeks increased from 0.20 ± 0.55 (questionnaire) to 0.27 ± 0.59 (daily
log)—an increase of 135.00% corresponding to an effect size of d = 0.101
(Zunker et al. 2015). The second explanation for the disparity might be
that keeping a diary or log might increase dream and nightmare recall
because the person is focusing on the topic (see Chap. 2).
The prevalence of persons with frequent nightmares (once a week or
more often) varied in large-scales surveys from 1.75% to 5.1% (Li et al.
2010; Sandman et al. 2013; Schredl 2010a, 2013b) and, thus, are roughly
comparable with the prevalence rates of persons suffering from
nightmares.
An extensive meta-analysis (Schredl and Reinhard 2011) indicated that
there is a gender difference in nightmare frequency with women tending
to report more nightmares than men; this difference is most pronounced
for adolescents, young, and middle-aged adults and almost non-existent
for children younger than 10 years and in the elderly (older than 60 years).
Regarding the age effect the findings are inhomogeneous: Whereas most
studies (Li et al. 2010; Schredl 2010a, 2013b) found a decrease in night-
mare frequency with age in adults, the Finnish study of Sandman et al.
(2013) reported an increase—even after removing war veterans from the
sample. As these studies are cross-sectional, longitudinal studies are
­necessary in order to study intra-individual changes of nightmare fre-
quency over time. Within a three-year interval, nightmare frequency was
decreasing slightly (Schredl and Göritz 2015), supporting the cross-sec-
tional findings of a nightmare frequency decrease with age.
 NIGHTMARES 151

7.5   Nightmare Content

Although nightmares have been studied quite extensively—mainly regard-
ing frequency, distress, and associated factors—content analytic studies of
nightmares are quite scarce (for the content analysis method see Chap. 3).
In Table 7.1, the findings of two studies (Robert and Zadra 2014; Schredl
and Göritz 2018) are depicted. The exact agreement for classifying night-
mare topics between the two raters was 76.5% (Cohen’s kappa = 0.53) in
the second study. Whereas Schredl and Göritz (2018) conducted an online
study in a large community-based sample (age mean: 42 years and age
range: 18–83 years) collecting a report of the most recent nightmare,
Robert and Zadra (2014) analyzed diary dreams from a younger sample
(age mean: 32 years) including about 50% students. This might explain
some of the differences, for example, more dramatic topics in the most
recent nightmares, like being chased or accidents (including the topic fall-
ing) as compared to the nightmares recorded in a diary, for example, the
frequent occurrence of not life-threating topics like interpersonal conflicts
involving hostility, opposition, insults, humiliation, rejection, infidelity,

Table 7.1 Nightmare themes (Schredl and Göritz 2018)

Themes Total sample Participants with Robert and Zadra
(%) frequent a nightmares (2014) Total (%)
(N = 1216) (%) (N = 684)
(N = 192)

Failure or helplessness 18.17 23.96 17.0

Physical aggression 17.85 17.51 31.5
Accidents 15.21 9.90 6.3
Being chased 13.98 11.24 7.6
Health-related concerns 11.60 14.58 12.2
and death
Interpersonal conflicts 9.62 15.10 29.5
Apprehension/worry 6.83 4.69 11.4
Disaster/calamity 4.52 5.21 5.4
Evil presence 4.36 3.65 7.0
Insects/vermin 1.97 1.04 5.3
Environmental abnormality 1.40 1.56 4.5
(bizarre things happening)
Others (e.g., being naked, 6.25 7.29 9.1
unable to find a toilet)

a
Frequent is defined as reporting one or more nightmares per week
152 M. SCHREDL

lying, and so on. The distribution depicted in Table 7.1 indicates that
there is a large variety of nightmare topics; this distribution is roughly
comparable between the total sample (including many persons with infre-
quent nightmares) and the persons with frequent nightmares.
Unfortunately, content analytic studies in patients with a diagnosed night-
mare disorder are still lacking.

7.6   Factors Affecting Nightmare Frequency

In former times the origin of nightmares was attributed to hairy beasts
sitting on the chest of the dreamer (Hartmann 1984), oxygen shortage
during sleep caused by externally impaired breathing, for example, bed-
spread over the face (Boerner 1855), or heavy and spicy meals eaten late
in the evening (Nielsen and Powell 2015). Today a diathesis-stress model
is widely used (Schredl 2013a)—comparable with models formulated for
other mental disorders (American Psychiatric Association 2013). Levin
and Nielsen (2007) adapted the diathesis-stress model for nightmares:
They conceptualized affect load as a state factor reflecting the combined
influence of stressful and emotionally negative events on an individual’s
capacity to effectively regulate emotions (stress factor) and affect distress
as a trait factor reflecting a long-standing disposition to experience height-
ened distress and negative affect and to react with extreme behavioral
expressions.
The factors that might have an effect on nightmare frequency are
depicted in Table 7.2.
A large-scale Finnish twin study (Hublin et al. 1999) showed that the
concordance rate for frequent nightmares is considerably higher in mono-
zygotic twins as compared to dizygotic twins, supporting a genetic factor
in nightmare etiology. Specific gene loci, however, have not yet been

Table 7.2 Factors affecting nightmare frequency

Factors
Genetics
Trait factors (neuroticism, “thin boundaries”)
Early adverse events
Psychopathology
Stress
Trauma
Side effects of medication
 NIGHTMARES 153

found. Ernest Hartmann found that creative, sensible persons (a personal-

ity dimension he termed “thin boundaries”) suffer more often from night-
mares (Hartmann 1991). This personality dimension is closely linked to
the Big Five personality factor “Openness to experience”; however, a care-
ful examination of the original boundary questionnaire indicated that
many of the items are also related to neuroticism (the long-standing dis-
position to experience heightened distress and negative affect in the model
of Levin and Nielsen 2007); however a “neuroticism-free” boundary
questionnaire was still related to nightmare frequency (Schredl et al.
2009)—possibly pointing to the dimension how a person reacts to stress
(Levin and Nielsen 2007). Within this context, several authors (Levin and
Fireman 2002; Levin et al. 2011) reported stronger associations between
psychopathology and nightmare distress compared to the correlation
between nightmare occurrence or frequency and psychopathology.
However, Schredl, Landgraf, and Zeiler (2003) pointed out that the com-
monly used distress scale of Belicki (1992a) is clearly confounded with
nightmare frequency as the severity of distress measured by five answering
categories (“always”, “often”, “sometimes”, “rarely”, and “never”) is
closely linked to nightmare frequency (e.g., r = 0.52; van Schagen et al.
2017) and the distress intensity for a single nightmare was not related to
neuroticism. The basic assumption had been that persons with high neu-
roticism experience their nightmares as more distressing (Belicki 1992a),
but the findings of Schredl, Landgraf, et al. (2003) did not support this
idea. Furthermore, one has to take into consideration that nightmare fre-
quency is typically measured by one item whereas the Belicki scale consists
of 13 items (Belicki 1992b) and, thus, is more reliable that a single item
and can produce higher correlations to other variables as the measurement
error variance is reduced. A relatively new approach was proposed by
Nielsen (2017) suggesting that early adverse experiences during sensitive
windows in the emotional maturation process might have a long-lasting
effect on nightmare frequency, that is, a trait variable maybe associated
with sensory processing sensitivity, a trait marker encompassing increased
emotional reactivity, greater depth of processing, and subtle awareness of
environment stimuli (Carr and Nielsen 2017). As reported above, mea-
sures of psychopathology correlate with nightmare frequency (Li et al.
2010; Sandman et al. 2013; van Schagen et al. 2017) and patients with
mental disorders experience nightmares more often than healthy persons
(Michels et al. 2014; Swart et al. 2013). Similar, measures of daily stress
was linked to nightmare frequency (Lancee and Schrijnemaekers 2013).
154 M. SCHREDL

This is in line with the continuity hypothesis of dreaming (Schredl 2003a)

showing that the negative experiences of the day are reflected in the per-
son’s dreams. Interestingly, Schredl (2003b) reported that the correlation
between the trait factor neuroticism and nightmare frequency was medi-
ated by the intensity of current stressors, that is, persons with high neu-
roticism experience more stress and this was the reason for their heightened
nightmare frequency. Experiencing traumatic events like war, sexual abuse,
rape, natural disaster, severe accidents can result in a full-blown PTSD
(American Psychiatric Association 2013); about 50–70% of PTSD patients
suffer from recurrent nightmares as one of their major symptoms.
Nightmare frequency after trauma, however, is also often increased even if
the criteria of PTSD were not fulfilled, for example, in women who were
abused as children (Cuddy and Belicki 1992; Steine et al. 2012). Similarly,
war experiences are still associated with heightened nightmare frequency,
even 50 years after World War II (Sandman et al. 2013; Schredl and Piel
2006). Current medication should be elicited as several compounds, espe-
cially antidepressants, can trigger nightmares (Pagel and Helfter 2003;
Tribl et al. 2013).
In short, the occurrence of nightmares is explained by a combination of
vulnerability and current stressors. In addition to these two factors, it has
to be taken into account that nightmares are (most often) an anxiety phe-
nomenon and that avoidance behavior—like in other anxiety disorders, for
example, specific phobias, agoraphobia, and panic disorder—leads to a
chronic condition (American Psychiatric Association 2013). A recent rep-
resentative study (Schredl and Göritz 2014) supported this notion as most
of the participants (75%) stated that they try to forget their nightmares as
quickly as they could; this could be seen as cognitive avoidance. This
would implicate that nightmares can still be afflicting, even though the
circumstances that originally triggered the nightmares (e.g., a major life
event) have long gone.

7.7   Therapy
Nightmares, more specific, the nightmare disorder, are underdiagnosed
and undertreated (Nadorff et al. 2015; Schredl 2010b). There are several
plausible reasons for that. First, even in sleep centers the physician often
does not ask explicitly about nightmares as most of the patients are seeking
help for symptoms of insomnia, restless legs syndrome, or sleep apnea; if
specifically asked the prevalence rate of nightmare disorder was 16.3%
 NIGHTMARES 155

(Krakow 2006). Similar, in a German sample of sleep-disordered patients

13.4% reported having a nightmare once a week or more often but only
1.6% were diagnosed with nightmare disorder (Schredl et al. 2012). On
the other hand, only one-third of persons with frequent nightmares have
sought professional help for their condition (Nadorff et al. 2015; Schredl
2013c; Thünker et al. 2014) once in their life. And if they sought profes-
sional help, more often than not that help was not beneficial (Schredl and
Göritz 2014; Thünker et al. 2014). In a sample of 744 students only 33%
believed that there is a cure for nightmares (Nadorff et al. 2015). This
leads to another possible reason for the low percentage of adequately
treated patients with nightmare disorder. The medication typically effec-
tive in mood and anxiety disorder like antidepressants, for example, sero-
tonin reuptake inhibitors, are not effective in treating nightmares; solely
prazosin, an alpha-adrenergic blocker, reduces post-traumatic nightmares
(Seda et al. 2015) but not nightmares that are not associated with trauma
(Krakow and Zadra 2006). As typical medical training includes the knowl-
edge of pharmacological and psychopharmacological treatment strategies
and only glimpses of cognitive-behavioral therapy, the lack of effective
drugs might also be part of the undertreated condition of nightmares.
The most powerful and best evaluated strategy is the Imagery Rehearsal
Therapy developed by Barry Krakow and co-workers (Krakow and Zadra
2006). The basic principles are depicted in Table 7.3.
The first step is confrontation, recording the dream or—for children—
drawing the central dream image. This step already counteracts the usually
applied cognitive avoidance strategy. In the second step, the person is
asked to use active imagination to produce a new ending for the dream,
that is, to cope with the nightmare situation. Ideally, the therapist refrains
from giving suggestions (Schredl 2013a). However, if the dreamer comes
up with something like going into hiding or flying away (avoidance behav-

Table 7.3 Therapeutic principles of the Imagery Rehearsal Therapy (IRT)

Step 1: Confrontation
 Recording or drawing the dream
Step 2: Coping with the situation in the nightmare
 Construct a new dream ending or add something to the drawing that reduces the
anxiety
Step 3: Training of the new coping strategy
 About 5–10 minutes per day over a two-week period
156 M. SCHREDL

ior), the therapist should ask whether there are additional options to cope
with the situation. The new ending of the dream does not have to be
realistic but most psychologists do not recommend an increase of vio-
lence, for example, fighting the monster. This is based on concepts that
dream characters might represent aspects of the dreamer’s personality
(Faraday 1990), for example, a dream monster might reflect the dreamer’s
fear of being aggressive, and, thus, communication with threating dream
characters is encouraged. The new “dream” should be written down
(Krakow and Zadra 2010). Children are asked to complement the dream
drawing with the elements that she/he had come up with and that are
helpful (St-Onge et al. 2009). By imagining this new approach to cope
with the nightmare situation once a day for 5–10 minutes for two weeks,
subsequent dreams will be affected by this training (Germain et al. 2004).
Several meta-analyses (Augedal et al. 2013; Casement and Swanson
2012; Hansen et al. 2013; Seda et al. 2015) of randomized controlled
trials indicate that Imagery Rehearsal Therapy is very effective in reduc-
ing nightmare frequency. This has been shown for adult idiopathic night-
mare sufferers (Krakow et al. 1995), for children with nightmares
(St-Onge et al. 2009), for sexually assaulted women as well as other
patients with PTSD (Seda et al. 2015), and for patients with mental dis-
orders, for example, major depression, and co-morbid nightmare disor-
der (Thünker and Pietrowsky 2012; van Schagen et al. 2016). One large
study in women with PTSD, however, indicated that Imagery Rehearsal
Therapy alone is not sufficient for treating severely traumatized persons,
about 40% of this group dropped out (Krakow et al. 2001). Systematic
studies applying Imagery Rehearsal Therapy as an add-on to standard
treatment of PTSD have not been carried out yet. Interestingly, most
studies indicate that the reduction of nightmares also improves other
clinical symptoms of the patients like depressive mood, daytime function-
ing, and sleep quality (Augedal et al. 2013). In addition, the effectiveness
of self-help programs (Lancee et al. 2010) and online programs
(Gieselmann et al. 2017) have been demonstrated. One study (Kunze
et al. 2017) has tested whether single components of the Imagery
Rehearsal Therapy like exposure or rescripting might be sufficient to
reduce nightmares. In addition to Imagery Rehearsal Therapy, desensiti-
zation in sensu and exposure in sensu have been effective (Augedal et al.
2013), also lucid dreaming (Harb et al. 2016).
 NIGHTMARES 157

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 CHAPTER 8

Lucid Dreaming

8.1   Definitions
A scale measuring lucid dreaming frequency (Schredl and Erlacher 2004)
provides the following definition: “In a lucid dream, one is, while dream-
ing, aware of the fact that one is dreaming. It is possible to wake up delib-
erately, or to control the dream action, or to observe passively the course
of the dream with this awareness.” The basic criterion for a lucid dream is
the awareness of the dreaming state (LaBerge 1985), whereas the ability
to control the dream action and remembering waking life are possible
additional features of lucid dreams (Gackenbach and LaBerge 1986). In
non-selected student sample only 0.3–1.4% of diary dream reports are
lucid (Schredl and Noveski 2017; Zadra et al. 1992). However, results are
dramatically different if the dreamer is presented with a self-rating scale,
for example “I was aware that I was dreaming” (0 = not at all, 1 = just a
little, 2 = moderately, 3 = pretty much, 4 = very much); the percentage of
dream reports with some kind of lucidity was 49.1% (Dyck et al. 2017). As
questionnaires like the LuCiD (Voss et al. 2013) and the TDQ (Stumbrys
et al. 2013b) have been used in experimental studies, the question arises
what the differences between a full-blown lucid dream with explicitly
mentioned knowledge that one is dreaming and dreams with a little bit
of lucidity are. One cannot rule out that it might be a methodological
issue, that is, persons participating in a lucid dreaming study might state
“a little lucidity” to satisfy the experimenter but did not experience lucid-
ity. Further studies, preferably of a qualitative nature, are necessary.

© The Author(s) 2018 163

M. Schredl, Researching Dreams,
[Link]
164 M. SCHREDL

Another dream type that is not fully lucid are so-called pre-lucid dreams:
“The subjects adopt a critical attitude towards what he is experiencing,
even to the point of asking himself ‘Am I dreaming?’ but without realizing
that he is in fact doing so” (p. 23; Green 1968). A dream example of the
author might help to illustrate this dream type. He was flying in a mall and
was wondering why he could fly in the waking state because flying is only
possible in dreaming, that is, he thought he was awake and noticed the
bizarre element in the dream but did not realize that he was dreaming.
The frequency of pre-lucid dreams is comparable to those of lucid dreams
(0.6–1.0%) (Schredl and Noveski 2017; Zadra et al. 1992) and, thus, the
occurrence of pre-lucid dreams cannot explain the high percentage of
lucid dreaming using self-rating scales.

8.2   Frequency of Lucid Dreaming and Its

Correlates
In a representative sample (Schredl and Erlacher 2011) about 50% of the
participants reported having at least one lucid dream; in student samples
the percentage goes up to 80% (Saunders et al. 2016). Interestingly, in
Japan the frequency is lower compared to Germany or the United States
(Erlacher, Schredl et al. 2008), possibly reflecting culture-dependent atti-
tudes toward lucid dreaming. Frequent lucid dreamers with more than
one lucid dream per week are rare: about 5% (Schredl and Erlacher 2011).
Typically, retrospective measures for lucid dream frequency have been
used in the prevalence studies. Although the scales eliciting lucid dream
frequency show a high retest reliability (r = 0.89; Stumbrys et al. 2013a),
the correlation with diary measures is relatively low: r = 0.156 (Zunker
et al. 2015). The main problem is that diaries kept over a brief period of
time show itself a low reliability if lucid dreams did not occur very fre-
quently, that is, it would be necessary to carry out diary studies of at least
eight weeks in order to obtain dependable data on the correlation between
retrospective measured lucid dream frequency and a prospective diary
measure. The question whether participants might overestimate or under-
estimate lucid dreaming frequency is not yet solved (Aspy 2016; Zunker
et al. 2015).
Several studies (Hess et al. 2016; Schredl et al. 2016; Watson 2001)
showed small but significant correlations between lucid dream frequency
and personality factors: openness to experience correlated positively and
agreeableness negatively with lucid dream frequency. Neuroticism was also
 LUCID DREAMING 165

related positively to lucid dream frequency but this association was

explained by nightmare frequency (Hess et al. 2016), that is, if nightmare
frequency was statistically controlled the correlation between lucid dream-
ing and neuroticism was non-significant. In this context, it is interesting
why nightmare frequency is related to lucid dreaming frequency as knowl-
edge regarding the dream state allows coping with the negative emotion
experienced in the dream (Spoormaker and Van den Bout 2006); one
plausible explanation is that nightmares which are often quite bizarre can
trigger lucidity. The findings regarding relationship of other trait factors
like need for cognition (motivation of an individual to engage with and
receive enjoyment from effortful cognitive tasks) to lucid dreaming are
inhomogeneous (Saunders et al. 2017). Interestingly, meditators report
higher frequencies of lucid dreaming than non-meditators (Stumbrys
et al. 2015); it seems plausible that training being mindful during the day
might affect lucidity in dreams.

8.3   Lucid Dreaming Induction

As lucid dreams occur rarely in most people, research has focused on so-­
called induction techniques to increase the probability of dreaming lucidly
(Stumbrys and Erlacher 2014). The most comprehensive review so far has
been published by Stumbrys, Erlacher, Schädlich, and Schredl (2012).
The techniques can be divided into three groups (see Table 8.1).
The most common methods are the Mnemonic Induction of Lucid
Dreams and Reality Checks (Stumbrys et al. 2012). Mnemonic Induction
of Lucid Dreams (MILD) technique involves rehearsing a dream before
falling asleep and visualizing becoming lucid the next time. The reality
checks are carried out five to ten times during the day by asking oneself
whether one is dreaming or not, and examining the environment for pos-
sible incongruences; some authors suggest to looking at the hand, for

Table 8.1 Lucid dream induction techniques

Cognitive techniques
 Dream-Initiated Lucid Dream, for example, Mnemonic Induction of Lucid Dreams,
Reality Checks
 Wake-Initiated Lucid Dream, for example, counting while falling asleep
External stimulation (light, sound, tactile stimuli, transcranial direct or alternate current
stimulation)
Other approaches (Wake-up-Back-to-Bed technique, drugs)
166 M. SCHREDL

example, number of fingers. Both techniques have been shown to be

effective (Stumbrys et al. 2012); however, it might take some time to
experience the first lucid dream. Although there is a long tradition of tech-
niques keeping consciousness while falling asleep in Tibetan Buddhism
(Wangyal Rinpoche 1998), there is no convincing evidence that this tech-
nique, for example, focusing on counting while falling asleep, is effective
in a normal time interval of four to six weeks (Stumbrys et al. 2012).
Using external stimuli as a means of inducing lucid dreams is based on
the findings that external stimuli can be incorporated into the dream (see
Chap. 4.6). With an experimenter watching the polysomnographic record-
ings during the night, the external stimulation during REM sleep can be
easily done; however, it is more complex in the home setting. Typically the
device is constructed like a sleep mask with sensors detecting the eye
movement that are typical for REM sleep and deliver a stimulus (light,
sound) if those eye movements are detected (LaBerge and Levitan 1995).
The task for the dreamer is to recognize the external stimuli, for example,
blinking, and realize that this is the cue to gain lucidity. Empirical evidence
shows that these devices are effective but the overall increase in lucid
dreaming is relatively small (Paul et al. 2014). A more complex approach
is based on the findings that the prefrontal cortex is more activated in lucid
dreaming compared to REM sleep with non-lucid dreaming (Dresler et al.
2012; Voss et al. 2009), that is, the idea is to stimulate the prefrontal cor-
tex and by doing that increase the chance of experiencing a lucid dream.
Using transcranial direct current stimulation (a small amount current
(1 mA)) applied via electrodes in the area of the prefrontal cortex showed
a small positive effect on dream lucidity compared to a sham condition (no
current) but only in experienced lucid dreamers (Stumbrys et al. 2013b).
The findings of the second study (Voss et al. 2014) using alternate current
(25 Hz) for stimulating the prefrontal cortex have to be viewed with cau-
tion as the effects were very small and only measurable on a self-rated
questionnaire dimensions not by analyzing the dream reports that would
indicate that the dreamer was fully lucid. Donepezil and Galantamine, two
acetylcholine esterase inhibitors, can increase lucid dreaming, possibly by
intensifying REM sleep (Sparrow et al. 2016; Stumbrys and Erlacher
2014). L-alpha-glycerylphosphorylcholine (α-GPC), a prescription-free
drug acting as an acetylcholine precursor, however, did not show any
effects on lucid dream frequency (Kern et al. 2017).
The most potent technique studied so far is the Wake-up-Back-to-Bed
technique, typically carried out in the sleep laboratory setting (Stumbrys
et al. 2012). The participant is allowed to sleep for about six hours and is
 LUCID DREAMING 167

then awakened from REM sleep in order to obtain a “fresh” dream. During
the next hour, the participant is instructed to practice MILD (see above)
for this dream. Then she/he can continue sleeping for an additional two or
three hours. The success rate for dreaming lucidly in this second sleep
period was about 50%, even in non-experienced lucid dreamers (Stumbrys
and Erlacher 2014). For experienced lucid dreamers it was even higher:
60% (9 out of 15) (Schädlich et al. 2017). However, the effect in the home
setting is much smaller (Aspy et al. 2017) or even not present (Dyck et al.
2017); the main problem is that the awakening might not be out of REM,
that is, the MILD technique cannot be applied to a “fresh” dream and it
seems difficult to focus on the task for one hour—if not constantly moti-
vated by the experimenter who is present in the sleep lab setting.
Stumbrys et al. (2012) evaluated the induction studies using a rating
system for methodological quality; the results were not encouraging as the
quality of most studies was relatively low. On the other hand, this is
encouraging for future research as many questions are still unanswered,
for example, whether everyone can learn lucid dreaming and which tech-
nique is best for a specific dreamer.

8.4   Content of Lucid Dreams

Typically, becoming lucid is associated with positive emotions (Green
1968; LaBerge 1985) but the empirical data on the topic are not conclu-
sive (Schredl and Noveski 2017); however, larger studies using intra-­
individual comparisons between lucid and non-lucid dreams are still
lacking. Regarding lucid dream content, most common activities were
those that are impossible in waking life (e.g., flying, magic, going through
walls, or breathing underwater) followed by pursuing pleasant activities
(e.g., sex), improving skills (sport, being assertive, academic learning, pro-
fessional tasks), communication with dream characters, and spiritual expe-
riences (Schädlich and Erlacher 2012; Stumbrys et al. 2014).

8.5   Lucid Dreaming in the Laboratory

Although lucid dreaming has a long history dating back over a thousand
years (Wangyal Rinpoche 1998) and several personal accounts about lucid
dreaming have been published over the years (Moers-Messmer 1939; Saint-
Denys 1982; Van Eeden 1913), the scientific breakthrough for this topic was
in the late 1970s by two researchers (Hearne 1978; LaBerge 1980) who
168 M. SCHREDL

independently were able to demonstrate that lucid dreaming occurs during

REM sleep (one argument was that lucid dreaming might occur during brief
periods of wakefulness and, thus, would be according to the definition day-
dreams). The idea behind this approach is simple. As muscle tone in the
whole body is actively suppressed by brain stem centers (Siegel 2017) except
for the muscles controlling the eye movements (eye movements gave this
sleep stage its name), the plan was to instruct proficient lucid dreamers to
perform specific eye movements (left-right-left-­right) during a lucid dream
and study the electrooculogram recordings which are produced by electrodes
close to the eyes measuring the electrical field changes caused by the eye
movements. After the lucid dream the participant was awakened and asked to
report the dream and whether she/he was able to perform the pre-arranged
eye movements (not all dreamers are able to recall the intention and carry it
out, cf. (Stumbrys et al. 2014)). The results of both studies (Hearne 1978;
LaBerge 1980) were clear: the specific eye patterns associated with the
dreamed eye movement were clearly distinguishable from the normal eye
movements occurring during REM sleep. And the electroencephalogram
(EEG) and the electromyogram (EMG) clearly fulfilled the criteria of REM
sleep (American Academy of Sleep Medicine 2007). In subsequent studies
this eye signaling was used in different contexts like counting, singing,
or walking ten steps in the dreams. The lucid dreamer was instructed to sig-
nal both the start and the end of the activity with specific eye movements.
Whether the lucid dreamer was able to perform the pre-arranged task could
be determined by looking at the dream content that was reported after wak-
ing up. The physiological data between eye movements one and eye move-
ments two could then be analyzed. For example, singing in a lucid dream was
accompanied by higher activation of the right hemisphere compared to
counting in the dream (LaBerge 1985). In the study of Erlacher et al.
(2014) the dreamers were instructed to count to 10, to 20, to 30 and also to
walk 10 steps, 20 steps, or 30 steps. Interestingly, the ratios of the time used
for the different long activities were very stable, that is, 10 steps took half the
time of 20 steps. Interestingly, the activities of counting and walking took on
average a little more time in the lucid dream than in waking (about 50%);
clearly contradicting the idea that time is sped up in dreams. The most exten-
sive study was done by Dresler et al. (2011); the lucid dreamer slept in a MRI
scanner (with EEG electrodes for measuring sleep stages) and performed
clenches with the left and the right hand. For two lucid dreams of this lucid
dreamer they were able to show increased activity in the left motor cortex if
the right hand was clenched and vice versa. The activation was comparable to
 LUCID DREAMING 169

imagined hand movements in the waking state, but—as expected—much

lower compared to real hand movements. Despite many nights in the MRI
lab, the research group managed to measure only one lucid dreamer; the
main problems were the noise and the necessity to keep the head from mov-
ing by using specific cushions and a holding device. The most advanced
experiments with lucid dreaming are looking at the possibility to communi-
cate with the lucid dreamer while she/he is sleeping (Appel and Pipa 2017).
In a previous dissertation carried out by Johannes Strelen (2005), the
author was able to show that a lucid dreamer can perform different eye sig-
nals if she/he is hearing different tones (odd-ball paradigm). Appel and Pipa
(2017) were able to show that transmitting a meaningful message (a random
math problem) using Morse code into the dream and answering to it by
using Morse-coded eye movements is possible. These examples show that
lucid dreaming is a state of consciousness that is very interesting for research-
ers as it allows to experimentally manipulate dream content, for example,
hand clenching, walking, and so on.

8.6   Applications of Lucid Dreaming

Two surveys (Schädlich and Erlacher 2012; Stumbrys and Erlacher 2016)
elicited the purposes of persons who are interested in lucid dreaming, that
is, regularly visiting a lucid dream website. The distribution of the motives
for lucid dreaming in the first sample that consisted of 301 lucid dreams
was as follows: 81.4% Having fun, 63.8% Changing nightmares, 29.9%
Problem solving, 27.6% Creativity, and 21.3% Practicing skills (with mul-
tiple answers per participant). As reported above (Stumbrys et al. 2014),
many lucid dreamers engage in pleasant activities like flying or sexuality. A
frequent application is the overcoming of nightmare because the knowl-
edge that you dreaming might decrease anxiety and increase the probability
to face the fear within the dream instead of avoiding it (Spoormaker and
Van den Bout 2006). Whereas systematic studies about the role of lucid
dreaming in problem solving and creativity are still lacking, several empiri-
cal studies have shown that lucid dreaming training has positive effects on
the performance in waking life, for example, tossing coins (Erlacher and
Schredl 2010), finger-tapping (Stumbrys et al. 2016), and throwing darts
(Schädlich et al. 2017). The effects are comparable with mental training in
waking; a technique widely used in sports (Stumbrys et al. 2016). The find-
ings of the second study (Stumbrys and Erlacher 2016) are comparable
with the previous study; in this study the participants were asked about
170 M. SCHREDL

Table 8.2 Applications of lucid dreams (N = 357 lucid dreamers)

Topic Percentage (%)

Wish fulfillment 42.8

Solving waking problems 14.5
Overcoming fears/nightmares 10.8
Spiritual experiences 8.1
Physical/mental healing 6.5
Training motor skills 4.2
Meditation 1.3
Other 12.0

the percentage of their lucid dreams spent with a specific activity

(Table 8.2). New categories were spiritual experience and meditation, tak-
ing up the ancient tradition of Dream Yoga (Wangyal Rinpoche 1998). An
interesting topic for future research would be to study the effect of healing
procedures carried out in a lucid dream (Kellogg 2017) on the health
status of the dreamer. Among other applications participants most often
mentioned exploring the dream space (e.g., visiting unknown dreams-
capes) and performing experiments in the dream (e.g., tasting, smelling
things in dreams).

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 CHAPTER 9

Functions of Dreaming

Before reviewing the major theories regarding dream function(s) that have
been published, it is important to explicate the problems that are inherent
in empirical investigations of dream function. The publication of Dement
(1960) entitled “The effect of dream deprivation” is very illustrative for the
first topic that should be kept in mind. In this study seven young men spent
three to seven nights in the sleep laboratory and were awakened if the poly-
somnographic recording indicated the presence of REM sleep. The num-
ber of awakenings per night had to be increased to 30 because there is an
REM rebound effect, that is, in normal sleep the first REM period occurs
after about 90–100 minutes after sleep onset but depriving REM sleep can
shorten this latency considerably. The normal amount of REM sleep (typi-
cally 20% of the total sleep time) was reduced by 75%, that is, it was not
possible to suppress all REM sleep. In order to control for the effect of the
awakenings on waking life, the participants spent more nights in the sleep
lab and were awakened from NREM sleep as often as in the first set of
nights (REM deprivation). REM sleep was only minimally reduced in this
condition. As participants reported more negative effects of the REM
deprivation part, psychological disturbances such as anxiety, irritability, and
difficulty in concentrating, Dement (1960) concluded that it was the effect
of dream deprivation. First, subsequent studies indicated that this negative
effect of REM deprivation on psychological functioning was explained by
the necessary very frequent sleep disruption and was not REM sleep spe-
cific (Ellman et al. 1978), that is, the findings of Dement (1960) might be
explained by a serial effect as the condition with the NREM awakenings

© The Author(s) 2018 175

M. Schredl, Researching Dreams,
[Link]
176 M. SCHREDL

were always after the REM deprivation condition. Did Dement (1960)
deprive dreaming? Yes and no; he reduced the time of REM dreaming but
did not account for NREM dreaming. Can Dement (1960) differentiate
between the effect of reduced REM sleep and the reduced time of REM
dreaming? No, this is the major problem for these type of experiments:
there is no experimental procedure to carry out an isolated dream depriva-
tion without affecting the sleep, that is, total dream deprivation would
result in total sleep deprivation, and that total sleep deprivation affects the
person in a marked way is obvious and empirically demonstrated (e.g.,
Labelle et al. 2015). So, it is crucial to differentiate between the physiologi-
cal level (sleep in general and especially REM sleep) and the psychological
level (dreaming). The function(s) of REM sleep cannot be equated with
the function(s) of dreaming. In addition, dreaming as subjective experi-
ences, which are recallable after awakening, does not reflect the total brain
activity during REM sleep or other sleep stages, for example, REM sleep
plays a role in memory consolidation (Walker 2005), but this might happen
on a cellular or systems level without any consciousness involved.
The second problem is a methodological one, namely, how can an exper-
iment be conducted to support the idea that dreams are beneficial for sub-
sequent waking life. Rosalind Cartwright, for example, found that divorced
women who dreamed about their ex-husbands were more psychologically
adapted one year after the divorce than women who dreamed about other
topics (Cartwright 1996). One possible conclusion is that working through
the divorce issue within the dream serves an adaptive function. But equally
plausible is the alternative explanation: the women who reported the ex-
husband dreams began to think about their dreams and, therefore, were
able to cope better with the stressful divorce. The problem—and it seems
unsolvable— is that one cannot differentiate between the effect of dreaming
itself and the effect of the recalled, reported dream which is processed by the
waking mind as unremembered dreams are not accessible.
Despite these problems, a variety of hypotheses regarding dream func-
tion have been proposed (see Table 9.1).
Ray Meddis (1977) and Owen Flanagan (2000) put forward the idea
that dreams are a pure epiphenomenon and did not have any additional
functions to the well-documented functions of sleep and REM sleep, for
example, memory consolidation; that is, human consciousness has a func-
tion in waking (problem solving etc.) and nature did not bother to turn
off this function during sleep. This viewpoint is compatible with the
activation-synthesis hypothesis that postulates that dreams reflect the
 FUNCTIONS OF DREAMING 177

Table 9.1 Functions of dreaming

Theories

Dreams as epiphenomenon
Guardian of sleep
Compensation
Iterative programming
Reverse learning hypothesis
Mastery hypothesis
Mood regulation
Systematic desensitization
Threat simulation theory
Protoconsciousness theory
Social simulation theory
Sleep-dependent memory consolidation

efforts of the consciousness to put together a more or less coherent story

out of randomly activated memory fragments (Hobson and McCarley
1977). Sigmund Freud (1900/1991) viewed dreams as the guardian of
sleep because they allow the catharsis of unconscious id impulses which
would have awakened the sleeper otherwise. Based on C. G. Jung’s ana-
lytical psychology, the dream might serve as compensatory mechanism for
the single-minded waking consciousness, that is, dreams incorporate
aspects of the dreamer which are neglected during waking life (Jung
1979). Michel Jouvet (1999) postulated that the function of REM sleep is
to periodically reinforce genetic programs to restore our individuality and
diversity within our species, despite a changing environment. In his model,
dreams are the software deployed on the hardware (the brain) during sleep
and therefore have an additional function.
The reverse learning theory (Crick and Mitchison 1983) assumes that the
human memory can be modeled as a neural network. During the process of
learning, many parasite (unnecessary) modes will be learned in addition to
the useful material. The random stimulation of the brain by Ponto-geniculo-
occipital (PGO) waves according to the activation-synthesis hypothesis
(Hobson and McCarley 1977) activates these parasite modes and unlearn
them. Therefore, the bizarre and illogical associations often occurring in
dreams should not be remembered but are the material we should forget.
The basic assumption of several psychological theories regarding dream
function is that dreaming serves a similar function like waking thought,
which is mainly problem solving (Wright and Koulack 1987). As pointed
178 M. SCHREDL

out in Chap. 4 there are parallels between basic problem solving and
dreaming. Dreams, for example, combine old information of the dream-
er’s past with current waking-life topics and play through different sce-
narios in order to evaluate the possible outcomes. The creative aspect of
dreaming can be seen as a kind of brainstorming to produce new solutions
for the problem (Barrett 2007). The function that dreams regulate mood
was proposed by Milton Kramer (2007) based on his findings that more
extreme emotions in the evening and during the night are evened out in
the morning. The extreme low muscle tone during REM sleep was a key
element for the theory of Perlis and Nielsen (1993). They hypothesized
that REM sleep presents the ideal condition for extinction, that is, experi-
encing anxiety while deeply relaxed helps to unlearn the anxiety, a com-
mon technique applied in cognitive-behavioral therapy. The threat
simulation theory (Revonsuo 2000) postulates that simulation of threats
during dreaming enhances survival and reproductive success because
humans will avoid dangerous situations and places (in the ancestral envi-
ronment thousands of years ago) by rehearsing this information during
sleep. A very recent theory was formulated by Allan Hobson (2009) who
conceptualized the dream as a level of consciousness where the mind can
prepare itself for future tasks that are crucial for living successfully in the
waking world. As mentioned in Chap. 4, social interactions are an impor-
tant topic in dreams much more than academics. As social skills were help-
ful in surviving and producing offspring for our ancestors the social
simulation theory proposes that rehearsing social skills might be a possible
function of dreaming (Revonsuo et al. 2015).
Based on the well-documented findings that sleep contributes to mem-
ory consolidation (Diekelmann et al. 2009), the first question that comes
to the mind is whether dreaming is reflecting the processes involved in
sleep-dependent memory consolidation (Graveline and Wamsley 2015).
In a nap study using a maze learning paradigm, performance gains were
higher if task-related dreams were reported (Wamsley et al. 2010).
However, an overnight study (Schredl and Erlacher 2010) using mirror
tracing as a procedural learning task did not show any relation between
task-related dreams and next day performance gain in the participants.
Keeping in mind that memory consolidation involves processes on a cel-
lular level (long-term potentiation) or on a network level, the question is
whether dreaming is functionally connected with sleep-dependent mem-
ory consolidation or just reflects these processes is not yet answered.
 FUNCTIONS OF DREAMING 179

As skilled lucid dreamers are able to perform tasks they planned to do

prior to sleep (Stumbrys et al. 2014), research has focused on the effect of
lucid dream practice on motor skills. A positive training effect was found
for three different tasks, coin tossing (Erlacher and Schredl 2010), finger
tapping (Stumbrys et al. 2016), and darts throwing (Schädlich et al.
2017), that is, if the participants were able to train the specific task in the
lucid dream accurately, their performance was better compared to a con-
trol group not practicing in the dream.
Even though all these theories seem to have some plausibility (some
more and some less), there is no empirical evidence supporting these theo-
ries due to the immanent methodological problems mentioned above. To
summarize, the question whether dreaming defined as subjective experi-
ences during sleep serves an additional function to the functions of sleep
and especially REM sleep is still unanswered. However, this does not imply
that working with dreams during waking life is not beneficial; there is
empirical data supporting the positive effects of working with dreams (Hill
and Knox 2010).

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 Index

A time course, 78–79

Arousal-retrieval model, 13 Correspondences, 76
Attitude towards dreams, 22 between waking and
Autonomic parameter, 113 dreaming, 76

B D
Bizarreness, 67 Daydreaming, 6
Body-mind interaction, 105 Day-residue effect, 78
Brain activation, 115 Depressive disorders, 126
Dream
aggressors, 91
C definition, 1
Color in dreams, 70 deprivation, 2
Complementary hypothesis, 72 diaries, 37
Content analytic scales, 44 emotions, 52, 68
Contentless reports, 11 lag effect, 78
Continuity manual, 46
emotional, 83 questionnaire (MADRE), 67
emotional valence, 79–81 sharing, 65
formal aspects, 84 Dream content analysis, 35
hypothesis, 71, 123 statistical analyses, 53–55
self-reflective awareness, 84 Dream experiences
thematic, 82 duration, 106

© The Author(s) 2018 223

M. Schredl, Researching Dreams,
[Link]
224 INDEX

Dream function(s), 175 I

problem solving, 177 Imagery rehearsal therapy, 155
Dreamless sleep experiences, 5 Immersive spatiotemporal
“Dream reading,” 118 hallucinations, 2
Dream recall Information processing during sleep, 85
brain activity, 24 Insomnia disorder, 132
definition, 11 Interference hypothesis, 13
during the life span, 17
genetic influence, 20
integrative model, 26–28 L
openness to experience, 20 Laboratory awakenings, 38
reliability, 14 Life-style hypothesis, 13
visual memory, 20 Long-term dream series, 76
Dream-related behavior, 65 Lucid dreaming
changing nightmares, 169
definition, 163
E duration, 108
Eating disorders, 129 induction, 165–167
Electromyogram, 110–113 reality checks, 165
Experimental manipulation of specific eye movements, 168
waking-life experiences, 75 training, 169
External stimuli, 86

M
F Meaningful stimuli, 88
Functional state-shift model, 14 Mental disorders, 123
Function(s) of REM sleep, 176 Mind wandering, 6
Mnemonic Induction of Lucid Dreams
(MILD), 165
G Mood regulation, 178
Gender differences, 89 Most recent dream approach, 36
dream recall, 18
Global rating scales, 45
N
Narcolepsy, 135
H Neuroimaging studies, 116
Hall and Van de Castle coding Nightmare
system, 46 content, 151–152
Hallucinations, 2 definition, 147
 INDEX
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distress, 153 Self-rating scales, 46

genetic factors, 152 Sensory perceptions, 69
Nightmare frequency Sleep
measuring, 150 disorders, 131
Night terrors, 148 duration, 21, 23
mentation, 4
talking, 112
O Sleep apnea syndrome, 133
Olfactory stimuli, 88 Sleep-dependent memory
consolidation, 6, 178
Social simulation theory, 178
P Statistical power, 40
Post-traumatic re-enactments, 148
Pre-lucid dreams, 164
T
Temporal references of dream
R elements, 73
Rating systems, 42 Threat simulation theory, 178
Reliability, 49
REM-NREM debate, 4
REM sleep behavior disorder, 112, 137 V
Repression hypothesis, 12 Validity, 49
Reverse learning theory, 177 Virtual reality, 2

S W
Salience hypothesis, 13 Wake-up-back-to-bed technique, 166
Scanning hypothesis, 109 Waking-life creativity, 66
Schizophrenia, 128 White dreaming, 11
Schredl dream manual, 47 World simulation, 2