The Science of Fighting Our Nightmares

In Japan’s stormy summer of 1983, Ikuo Ishiyama couldn’t stop thinking about a chilling pattern among his patients. They were dead, but that wasn’t what troubled him. As a specialist in forensic medicine at Tokyo University, Ishiyama was accustomed to seeing dead bodies. However, these victims—numbering in the hundreds—shared a similar demise. “The symptoms are the same,” he told the Los Angeles Times. “Young men without medical problems are essentially dying in the same way, without warning.” What way was that? That may be the most mysterious detail: All of the victims died in their sleep.

Ishiyama’s concern grew when he heard about similar deaths halfway around the world, in the Midwestern and Western United States. There, they called it “nocturnal death syndrome,” but the circumstances were just as unsettling. “They passed away in the early hours of the morning,” the science journalist Alice Robb wrote in her book Why We Dream, “lying on their backs, with looks of horror in their eyes.” To this day, their exact cause of death is a mystery. But one University of Arizona anthropologist, who spent a decade studying the phenomenon, argued the victims suffered cardiac arrest due to what Robb describes as “stress, biology, and sheer terror.”

Were they victims of their nightmares?

News of the phenomenon spread, scaring the bejesus out of America’s heartland. It ultimately reached one Buckeye-born psychology graduate named Wes Craven. The story inspired Craven to create a new kind of villain for his breakout 1984 horror film, A Nightmare on Elm Street—one who killed his victims in their dreams.

Contrary what my sadistic older brothers told me, Freddy Krueger is not real. But the health crisis that inspired him demonstrates the genuine physical and mental threats that nightmares pose. Just because Freddy is fictional, that doesn’t mean nightmares are harmless. “I don’t think there’s any contradiction between being pragmatic and believing that dreams can have a very real impact on our lives and our physical and mental health,” Robb tells me when we speak over the phone. “We know that [nightmares] impact us physically—heart rate, sweating, right? They just can disrupt our sleep quality, which obviously can have knock-on effects on all of our systems.”

According to the DSM, suffering from nightmares serious enough to cause symptoms like insomnia, stress, anxiety, and cognitive impairments is a condition known as “nighttime sleep disorder.” Harvard Medical School estimates up to 7 percent of the U.S. population suffers from serious nightmares. For children, that number could be as high as 20 percent. (This is a good time to say that if you think you are suffering from sleep-related health problems, consult a doctor or mental health professional, not an essay that opens with an anecdote about A Nightmare on Elm Street.) But for the larger population, nightmares are also a regular occurrence that haunt us, causing sleepless nights and routine assaults on our wellbeing.

What makes our nightmares so terrifying aren’t the monsters that populate them (no offense, Wolfmen); it’s the phenomenon of the nightmare itself. They are controlled by our minds, and the mind’s capacity for fear is, essentially, endless. Nightmares are unpredictable, they’re relentless, they play upon our weaknesses; who better to terrify us than our own subconscious? But, worst of all, in our nightmares we are passive victims. The most doomed Slumber Party Massacre jock still has a choice, even if that choice is to run upstairs instead of out the door (as they always do). In our nightmares, however, we have no such control. In our nightmares, it seems, we’re helpless.

Or are we? In recent years, a small but dedicated collection of researchers, neuroscientists, sleep coaches, and dreamers around the world have been exploring how we can use a particular set of sleep skills to take back control of our minds during sleep and stand up to the monsters that torment us. In other words, they’re learning how we can fight our nightmares.

In the midst of her book research, Robb found herself crossing the threshold of a medieval monastery in a remote region of the Netherlands. The corridors had been lent to the International Association for the Study of Dreams for an annual conference, so no medieval monks to be seen. (“I guess it was, like, their offseason or something,” Robb jokes.) Monks or no monks, the gothic abbey was a fitting place to learn the science of lucid dreaming, which only recently emerged from the Dark Ages. Westerners have been writing about it as far back as Aristotle, and it plays a role in the philosophy of some Eastern religions, but lucid dreaming—or realizing you are in a dream while dreaming—was not taken seriously by the medical community until the 1970s. Before that, it was considered at best a vague spirituality, at worst a sham. It was, basically, a centuries-long version of nobody caring or wanting to hear about that crazy dream you had last night.

This is, in part, because sleep itself remains one of medical science’s least understood processes of the human body. Scientists didn’t even identify REM sleep, when most dreams occur, until 1953. (This means humanity has been studying quasars 500 million lightyears away longer than we’ve been seriously studying our own dreams.) It wasn’t until the late 1980s that researcher Stephen LaBerge proved lucid dreaming was real, using an ingeniously simple method: In REM sleep, our bodies are basically paralyzed except, crucially, our eyes. Taking advantage of this ocular loophole, LaBerge hooked himself up to a scanner, entered REM sleep, and—while biologically unconscious—made a series of pre-planned eye movements in his lucid dream that scientists could observe. It proved he had dictated his own behavior while in full REM sleep.

But even with lucid dreaming conclusively proven, it remains, as science writer Tom Chivers put it in The Sunday Times in 2019, “a faintly ridiculed topic, researched by the sort of people who believe in UFOs and clairvoyance.” (Some of us believe in only one of those things, thank you very much!) This skepticism may also reflect lucid dreaming’s relative rarity. As few as one in 10 people experience lucid dreams regularly. If we’re to understand lucidity, sleep, and our whole brains on a deeper level, it would be beneficial to get more people to control their dreams, and to conquer their nightmares.

“If you can become lucid during a nightmare you can change your response or do something that empowers you in real time and improve your capacity to cope with the nightmare,” Denholm Aspy, a researcher in psychology at the University of Adelaide, told the BBC. Research backs this claim. A preliminary study coauthored in 2003 by Victor Spoormaker from the Max Planck Institute of Psychiatry found Lucid Dreaming Therapy (LDT) to be “effective in reducing nightmare frequency” and concluded “a single two-hour session of LDT led to a modest but significant reduction.”

But how exactly do we learn to confront our nightmares? Responses range from simply realizing you’re dreaming and thus feeling less threatened, to escaping whatever demon your subconscious has created, to confronting it head-on. To me, this sounded too good (and cool) to be true. Could you really physically fight your demons?

Well, not “physically,” but you get the idea.

What better place to learn more about confronting dreams than Austria, home of Sigmund Freud? Brigitte Holzinger, a psychotherapist at the Medical University of Vienna, explains to me that one of the most crucial steps in conquering our nightmares is comprehending them in the first place. “It’s very important that the person understands what we are doing, and understands what happens when we are dreaming, and what a dream is,” says Holzinger. “We have been brought up with the notion that our dreams don’t have very much to do with us, and we have no influence. It’s not the truth. The truth is it’s our inner pictures. And therefore we can influence. We have influence, and we’re influencing them all the time.”

Holzinger, who established Austria’s Sleep Coaching institute, (sleep)walks me through the regimen she teaches her patients to transform them into nightmare-battling warriors of the neuro-verse (my words, clearly), or to at least get a good night’s sleep. “I make my [patients] aware about the fact that what we are talking about now will already have an influence on the dream,” she says. “You are already working with your nightmare just because we’re talking about it.”

Damn, I was nailing this without even trying.

These initial steps weren’t just designed to boost my confidence. Simply increasing your daily awareness is a fundamental tool in achieving lucidity. The Planck Institute used comparable techniques in its 2003 study, asking volunteers to “intend” on becoming self-aware in their next nightmare. “Participants were encouraged to choose a constructive ending, also referred to as a ‘triumphant ending’ (e.g. talking to or fighting the attacker instead of fleeing).” Triumphant ending. At last, someone else described it in the quasi-mythical language I prefer. A similar technique suggests pausing throughout the day and asking yourself if you are dreaming. Ideally, questioning your reality will become such an organic part of your behavior that you’ll naturally do it in an actual dream—except then, the answer will be, Holy s**t, I am!

These steps are all parts of that first idea of awareness. Holzinger, for example, has her pupils keep a dream journal. I ask her how journaling can be effective at altering your dreams if it’s something you do only after the dream ends. “By keeping a dream journal, you kind of signal to yourself, This is important for me,” she says. The object is to find opportunities to connect our waking life to our dream life. “Because it’s not just about before and after,” she explains. “It’s always around us.”

Awareness of our dreams is all well and good, but how do you use it to, you know, send Freddy Krueger back to Hell? In 2019, a team writing in Frontiers in Science looked at various efforts to control nightmares dating as far back as 1982. One well-established but non-lucid technique, known as “imagery rehearsal therapy,” encourages patients to rehearse alternate outcomes for their nightmares during waking hours, with the goal of the subconscious automatically changing what happens to you in the dream. LDT, in a way, adds lucidity to this approach, allowing you to alter it in real time. After achieving lucidity in a nightmare, you “face the source of fear, such as monsters,” the Frontiers paper says. Simply confronting the monster with the awareness that it cannot hurt you, this tactic demonstrated, can end the nightmare. No epic fight required (he typed begrudgingly).

These techniques have had dramatic effects. Robb notes a 2006 study that found LDT helped reduce nightmares by over 15 percent: “They practiced re-scripting their dreams, making up new endings in which they wrested control back from their demons and averted the usual horrors,” she writes in her book. Writing in Slate, author Mason Currey described his own experience with these skills, including using them to take off into the sky and fly away from two strangers pursuing him (a common theme in nightmares).

Robb also provides a case study of a writer who suffered a chilling recurring nightmare in which a stranger stood outside his window, threatening to kill him. “After several gut-wrenching minutes, the stranger would break into the house and start beating him up.” Eventually, the intruder brought a gun. The writer, however, was able to change his perspective. “When the man started shooting,” Robb says, the writer “realized that the bullets were not hurting him. It was only a dream. The nightmare never came back.”

I was excited to hear these battles with imaginary monsters, but LDT is also about confronting demons more personal, more horrifying, and, ultimately, more real. Holzinger, in a 2021 study, shared a harrowing example about “Mrs. L.” (her initials are altered), who was “traumatized multiple times throughout her life.” Mrs. L. was abused as a child and, after an unhappy marriage ended in divorce, was stalked and threatened by her ex-husband, who would hold a gun to her head, demanding she come back to him. Mrs. L. eventually escaped her ex, but some time later she began having terrifying nightmares “involving her ex-husband stalking and threatening her, occurring several times a week.”

Holzinger’s team and fellow patients in group therapy helped Mrs. L. develop strategies she might be able to use in the nightmare after becoming lucid. The group suggested she try “looking directly at what is happening” to examine the “monster” itself. After multiple unsuccessful confrontations, Mrs. L. wrote this in her diary on March 3, 2009:

My ex chased me in a cab. This time the pointed gun was oversized. With a sadistic grin he yelled that he will kill me. I now yelled back that he should do it. I ran towards a downhill slope, he stumbled and fell down the hill. I looked but couldn’t see him anymore. The cab and he had disappeared. I woke up, this time not frightened, but somewhat relieved.

Mrs. L. did not become some kind of “Dream Warrior” during this time. The nightmares didn’t even stop. But the outcome was no longer out of her control. As Holzinger put it, “the nightmare plot changed.”

These are incredible results, but more research on LDT is needed. After all, nightmares themselves hold more mysteries. Even at this moment, Holzinger is hard at work trying to figure out how dreams are influenced by external stimuli. (You know how when it’s cold in your bedroom, you’re cold in your nightmares? Yeah, science doesn’t totally know what’s up with that yet.)

In the meantime, nightmares continue to plague us. Maybe not to the degree Ishiyama feared, and certainly not to the degree Freddy Krueger wants, but a real problem nonetheless. At the end of our call, Robb tells me how surprised she was at the issue’s scope when she was researching her book. “I was really struck by how many people had really intense dream lives, including nightmares that really affected them,” she says. “I mean, you can say something is ‘just a dream,’ but it’s still happening. It’s still affecting you. You’re experiencing that fear in the moment, and sometimes that carries over into the daytime.”

Fortunately, as Holzinger reminds me, while our own minds may be the source of fear, they’re also the key to overcoming it. “My ambition is that my clients become aware that they always have a choice, and it’s their choice what they do. And being aware of having a choice is very important, particularly when you feel powerless.” Her ongoing quest, and that of her colleagues, may help put that power back in our hands (or brains), reminding us that even our worst nightmares are still our nightmares.