Question

Are vivid dreams a recognised symptom of ME? Like most people with ME I have unrefreshing sleep and sometimes wake up in the night. But I’ve recently been waking in the middle of the night with very clear memories of rather bizarre vivid dreams. Fortunately, nothing frightening has happened so far!

Answer

Vivid or colourful dreams were first described by Dr Melvin Ramsay in his original description of Myalgic Encephalomyelitis. However, this is not a symptom that tends to appear in diagnostic criteria for ME/CFS, or gets mentioned when the various types of sleep disturbance are discussed. But, my impression from talking to large numbers of people with ME/CFS about sleep disturbance over many years is that vivid dreams are actually quite a common occurrence. The cause remains uncertain but there are several factors that seem to increase the risk of having vivid dreams. These include:

• Fragmented sleep and sleep deprivation,
• Stress and anxiety during the day,
• Drugs – including selective serotonin reuptake inhibitors (SSRIs),
• Sleep disorders, including narcolepsy, which causes sudden episodes of daytime sleepiness and which can be misdiagnosed as ME/CFS,
• Pregnancy, especially during the third trimester.

Having said that, vivid dreams aren’t normally something that you need to worry about – the exception being if the dreams are frightening and more like nightmares. In this case, you do need to ask for medical help. So having vivid dreams is not a sleep problem that would be normally treated with medication. But if you feel that this is causing sleep fragmentation and making unrefreshing sleep even worse it would be worth talking to your doctor about the use of a low dose of a drug called amitriptyline, which many people with ME/CFS find helpful for both pain and sleep disturbance. Melatonin (trade name Circadin) needs to be used with care – as there is evidence that it can both help and reduce vivid dreams. If stress or anxiety may be the cause, self-help strategies such as relaxation tapes, aimed at producing peace of mind, can be helpful.

More information

• The ME Association has detailed information about sleep disturbance and dysfunction in ME/CFS available to download from the Free Literature:
  • Sleep disturbances are common in ME/CFS and unrefreshing sleep is a key diagnostic symptom. We examine sleep issues and consider a variety of treatments that could contribute to a more comfortable sleep.
  • We explain how Amitriptyline was developed as an antidepressant, but is now used more commonly to help with pain and sleep problems that occur in ME/CFS.