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Sleep, Sleeplessness And Nightmares

( Originally Published 1920 )

The most common explanation for the fact that we go to sleep is that we are tired and need rest.

A close examination of the organism in its sleeping condition fails to lend plausibility to that theory.

The heart continues to beat and to send the blood stream on its course through the body. The lungs continue to gather in oxygen, the liver to accumulate glycogen. The stomach and bowels keep on digesting and eliminating, our beard keeps on growing, all our glands keep on producing various secretions. Some, like our sweat glands, are in-finitely more active in our sleep than in our waking state. Our mind does not rest by any means for we probably dream every minute of every night.

Our vagotonic activities, that is, the autonomic nervous activities which upbuild the body and tend to perpetuate the race, are infinitely stronger in sleep than the sympathicotonic activities which restrain them.

Our sense organs are as acutely sensitive in sleep as in the waking state, for the slightest stimulus brings about a reaction of some sort, mostly in the form of a dream.

Besides the fact that we do not move our arms and legs, or at least move them very little while asleep, it is rather difficult to mention any part of the body which actually "rests" in sleep.

The explanation that sleep enables us to eliminate from the organism the various fatigue products is not convincing, for inactivity not accompanied by unconsciousness would enable the blood to carry off those products as completely as in-activity does when accompanied by unconsciousness.

The same answer could be given to those who claim that in sleep we store up again the substances (for instance sugar) which waking activity has spent lavishly.

It is not clear why unconsciousness would help that process.

What is it, then, which a conscious state does not give us and which we only find in unconsciousness?

Only by studying dreams will we find a satisfactory answer to that question.

Dreams secure gratification for thousands of ex-pressed or repressed desires; dreams find solutions, some of them absurd, some of them acceptable, to problems which have puzzled us in our waking hours; dreams, even though they SEEM frightening, painful or humiliating, always fulfil some conscious or unconscious wish. The process is very obvious in gross sexual dreams, less obvious in dreams which cloak themselves with complicated symbolism, and not at all obvious in nightmares.

When dreams transform the dreamer into an irresistible Don Juan or a millionaire, he is quite willing to accept the theory of wish fulfilment. When a young girl dreams that she is pursued or bitten by a dog she may feel rather sceptical as to the universal application of that theory.

Most of our dreams, however, are symbolical, that is, they say what they have to say in a language which we ourselves do not understand, paradoxical as it may seem.

We throw shoes and rice at newlyweds without actually understanding the meaning of that act. Yet we are expressing in that symbolical way a wish which is quite appropriate to the occasion, and which we would not dare to express in any other way.

Shoes are a symbol of the female genitals, rice the symbol of the male fecundating element.

Shoes and rice have that meaning not only in more or less fantastic and in accurate dream books but in all the folklore of all races (rice being in certain cases replaced by wheat or other local cereal).

Thus we express symbolically the wish that the newly married pair may be prolific, a wish which the delicacy or hypocrisy of our modern civilization would not enable us to formulate too directly.

And curiously enough the symbol which unconsciously we understand quite well, has been invested by many with a different conscious meaning. Many people whom I asked for their interpretation of that custom answered, "Well, I suppose it is meant to say: `May the young couple always have enough to eat and shoes to wear.' "

The orange blossoms which crown brides were originally an allusion to the great fertility of the orange tree which bears fruit twice a year. The shyness which the modern mind shows in the presence of "brutal" sexual facts has gradually placed the stress on the colour of those blossoms and has caused them to symbolize maidenly purity, which after all is only another sexual fact.

In both cases, the repression of sexual instincts by the growing complexity of community life has managed to add a conscious meaning to a ritual which has an entirely different unconscious meaning.

But it is the unconscious meaning which symbols retain in our dream life, for then the repression is infinitely less powerful.

Dreams aim at giving us absolute freedom of action and expression but they do not always succeed completely in spite of the symbolical mask which they assume in so many cases.

Life's repressions may be so severe that even in sleep the pentup urges encounter obstacles to their gratification. The result is anxiety dreams, popularly known as nightmares, which are at times the source of a great deal of suffering, until the subject understands their symbolic meaning.

The woman pursued in her dreams by snakes, or trampled upon by horses, or bitten by dogs, etc., is one suffering from lack of sexual gratification and attaining that satisfaction in her sleep in symbolical ways. A subject obsessed by suicidal ideas but who did not wish to leave his family unprovided for, owing to the suicide clause in his insurance policy, would dream night after night that he was put to death for some crime, thus accomplishing his object without causing his dependents any financial loss.

While dreams of being trampled down by animals or being put to death are not to be considered at first glance as constituting the fulfilment of wishes, the first anxiety dream is clearly a symbolic form of wish fulfilment, the second, when interpreted with the help of the subject, appears a simple solution of a problem which at one tithe agitated the subject's mind and hence is also a wish fulfillment.

The function of sleep, then, is to compensate us for all the things we must forego in our waking life, for all the desires we must repress in order to conform to civilized standards. Sleep is a means of escape from reality and from the monotony of existence.

The more complex civilization becomes the more necessary sleep becomes and the more frequent are mental disturbances due to lack of sleep. At the same time, it must be noticed that certain people whose lives are extremely strenuous do not require as much sleep as others do who lead a much more peaceful existence. Napoleon hardly ever slept more than four hours before he reached the Island of Saint Helena. He then slept much longer. Edison does not require more sleep than Napoleon. Many other famous men managed to live a healthy life while taking very little rest.

But those men also led a life in which they fulfilled almost all their wishes. Their work was not drudgery. Napoleon's life was a. continuous romance of the most exciting sort. Edison's inventive genius vouchsafes his ego innumerable forms of satisfaction.

The Napoleon type and the Edison type are at the opposite poles, the first being highly negative, self-centred and destructive, the other highly positive, socially useful and constructive, and yet both types lived their dreams in their waking hours.

The drudges, on the other hand, only realize their desires in their sleep and hence need more sleep. Every one knows how sleepy small towns and their inhabitants always appear. People in country towns sleep more than dwellers in large cities although the latter lead a much more active life and hence should require a longer period of rest.

Large cities with their varied life, their exciting bustle, their noise, their accidents, etc., make life, even for the very poor, the overworked and the stupid, a more stimulating set of experiences than the well regulated existence one must lead in a small, settled and uninteresting village.

Monotony seems to be after all the direct cause of sleep. One falls asleep While witnessing a monotonous play, while listening to monotonous music or a monotonous sermon. While noises are supposed to prevent us from sleeping, a very monotonous noise like the tic tae of a metronome or the rumble of a train, can induce very profound and "restful" sleep. In fact a subject who has fallen asleep while concentrating on the beat of a metronome is likely to wake up suddenly when the instrument is stopped. I sleep well in Pullman cars but I invariably wake up when the train stops at a station, although the whispered conversation of other travellers entering the sleeping car and their footsteps muffled by heavy matting are incomparably less noisy than the thundering of a speeding train.

Likewise drunken stupor overtakes the weak and inactive sooner than the strong and active who proceed to satisfy their cravings in their waking state and grow jovial or coarse, if not violent.

Sensitive, dissatisfied people never seem to have enough sleep and escape reality in their waking hours through day dreams which are very similar in every respect to night dreams and during which the subject's anaesthesia is almost as complete as in sleep, the subject being indifferent to many sounds or light stimuli, being as we say, "absent-minded," in a sort of hypnoidal state which does not strike observers as sleep because his eyes remain open.

If we sleep mostly at night it is precisely because night, on account of the lack -of colour, which makes the world more uniform, and the lack of light, which makes motions slower and more difficult, creates the very monotony which induces sleep.

Many experiments have been made on dogs, proving that as soon as their eyes have been closed painlessly, their ears plugged and their legs wrapped in soft rags, the animals fall asleep and remain asleep until exterior stimuli are once more allowed to strike their senses and supply them with the "entertainment" which they probably seek in sleep. For animals dream, as any one who has watched hunting dogs asleep can testify.

That fatigue should enable us to sleep is not an argument in favour of the rest theory but is due to the fact that after over-exercise, our preceptions are not as keen as they were and life is perceived more dully and appears more monotonous. Hence the escape from it through dreams.

The theory of rest through unconsciousness is exploded by the fact that when overtired we can-not sleep. The reason is not far to seek.

When the organism reaches the point of exhaustion, the phenomenon of the second wind takes place. An excessive amount of glycogen comes out of the liver, filling all the muscles with new energy, much as a motorist piloting a weak engine up a hill would "step on the gas," and adrenin creates a tension which seems to make all our sense perceptions infinitely keener (hence the irritability of the very tired person, contrasting strongly with the apathy of the moderately fatigued individual).

In over-exertion the mind becomes unusually alert and often obsessed by one apparently important idea. Hence the lack of monotony and stimulation which otherwise would induce sleep.

Fatigue, we say, is conducive to sleep, but in certain respects, fatigue is sleep. For fatigue in its turn is easily induced by very monotonous tasks. The limit of exhaustion is reached more slowly if at all when the occupations are varied and work is performed in a constantly changed environment.

Fatigue is often produced without any physical or mental exertion by a monotonous stimulus. We hear very often people complaining that some one's droning voice "tired them out." Every one of us has had the experience of feeling an uncontrollable desire for sleep when in the company of some extremely dull person whose personality and intelligence radiate absolutely no stimulation.

This view of sleep may throw a little light on the nature and causes of sleeplessness.

Sleeplessness may have physical causes. Over-indulgence in coffee, tea or cocoa creates a state of anxiety which is not favourable to sound sleep as it makes one more sensitive to stimuli, causes one for instance "to jump" at slight noises and other unexpected happenings.

Lack of physical exercise leaves the body stocked up with energy-producing fuel which we may finally eliminate by tossing about in our bed more or less angrily (anger, by the way, is a good fuel-producing factor leading to more sleeplessness).

Drinking too much water before retiring may compel us to arise several times to urinate. Par-taking of laxative fruit or drugs may initiate abdominal activity likely to wake us up, even if no movement is induced.

Overeating and hunger alike create great dis-comfort unfavourable to peaceful sleep. Heat and cold also can keep one awake. People suffering from cold feet should use a bed warmer; people perspiring freely will perspire even more freely at night and hence should avoid piling up too many blankets on their beds.

In most households beds face a window, which enables the first rays of light to awake the sleeper. Too many husbands and wives share the same bed, thereby disturbing each other's sleep by tossing about or snoring.

All the physical causes should be removed first and can easily be removed when one is troubled with sleeplessness.

Of the so-called mental causes, worry is the most common and the most distressing. It is perfectly absurd to advise a patient not to worry. When some person dear to us is in danger of death, when one is threatened with a catastrophe of some kind, when some terrible responsibility has to be borne and some weighty problem involving one's future or reputation has to be solved, such advice should be, and generally is, resented. Sleeplessness in such cases is unavoidable but should not be taken tragically, the less so as it is hardly ever unbroken by "cat naps" or spells of almost complete unconsciousness.

People exaggerate greatly their sleeplessness. Experiments made at a Western University when several men were kept forcibly awake for 90 hours showed that on several occasions, when the subjects imagined themselves awake, they had been actually dozing with their eyes open. Their in-ability to notice certain stimuli showed that for varying periods of time they had not been awake, although they remained in a sitting or standing position. On several occasions too, their answers to questions showed that they had been dreaming.

Old people, in particular, tell very unreliable stories about their inability to sleep. As a matter of fact old people whose vagotonic activities are at a very low ebb, need little dream-producing sleep.

Repressed and ungratified desires do not torture the old as they do the young.

Resenting or fearing sleeplessness are undoubtedly the most insidious ways of inducing or prolonging it. As I mentioned before, anger creates a nervous tension and causes the release of energy producing secretions, and so does fear, although to a different degree.

The person who works himself up into a rage because he cannot sleep, and he who retires with his mind full of fear at the possibility of a sleepless night are not likely to "rest" peacefully.

An obsession is easily created: "I am losing my sleep," and it can be used neurotically in an unconscious attempt at obtaining sympathy and shirking some of life's duties. After which, it establishes itself as one of the expedients of the negative life.

Some subjects are unable to sleep on account of their fear of nightmares. This amounts to a stubborn unconscious resistance against some craving which expresses itself symbolically through an anxiety dream. Some of the symbolic dreams I mentioned at the beginning of this chapter will help the reader to understand what I mean. A very puritanical woman might well remain awake to avoid an anxiety dream satisfying her sexual cravings in a symbolical and apparently painful way.

It is evident that when no physical cause can be discovered which would induce sleeplessness, and when no definite worry is keeping the mind (and the liver and adrenals) in a state of activity, there is some recurring dream, forgotten night after night, which the sleepless one is trying to avoid because it expresses some craving subjected to a strong repression.

In both cases, analysis is the only possible means of dealing with the difficulty. The harrowing anxiety dream must be interpreted and the craving it satisfies abnormally, made clear to the sufferer.

In the second case, the unknown complex must be unearthed and the unknown dream traced through day dreams induced in the analyst's office.

Insight into nightmares is easily acquired which soon divests them of their symbolic mask and trans-forms them into simpler and grosser wish-fulfilment dreams devoid of any anxiety element. A conscious search for the "unknown nightmare" starts an unconscious activity which breaks down the resistance owing to which it is constantly forgotten; after which it can be disintegrated or translated into its actual meaning.

Thousands of recipes for curing sleeplessness have been offered to sufferers, most of them inefficient when not dangerous.

It goes without saying that avoiding all the physical causes of sleeplessness which I listed above should be the first step in any commonsense treatment of that disturbance. But that alone cannot be relied upon to effect a cure when some complex is responsible for the insomnia.

We have all met healthy individuals who manage to sleep like logs in spite of having committed all the possible dietetic indiscretions and of leading the most unreasonable existence. Those are not troubled by any conscious factors.

Staring at, or listening to, a monotonous stimulus may help in many cases. Prayer, recommended by Dr. Thomas Hyslop, by William James and by Dr. Richard C. Cabot, can be considered as such a stimulus; when repeated many times, without emotion and with the automatism which characterizes the delivery of pieces learnt early in childhood, it naturally creates the monotony from which we strive to escape through sleep.

Under no circumstances should narcotics be used. They do not produce sleep but a form of unconsciousness akin to death. They are merely poisons taken in too slight a dose to kill us.

Sleep induced by narcotics may not be accompanied by any dreams and is therefore useless. Users of narcotics often complain of terrible nightmares. Such nightmares may not be the gratifying wish-fulfilment dreams which alone make sleep valuable and refreshing.

Sleep should be a display of vagotonic activity in an obvious or symbolic form. Narcotics creating a deep disturbance of the normal life functions, probably occasion in the organism a terrific struggle accompanied by intense organic fear which can-not be beneficial.

Treatment Of Sleeplessness
Sleep Disorders including, Sleep Apnea, Narcolepsy, Insomnia

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