My husband and I were recently on a Zoom call with a respiratory therapist who was walking us through the results of his home sleep study. She told him he had mild sleep apnea. Then she pulled up a chart of his sleep stages and pointed out that his sleep was predominantly light sleep, with not enough REM sleep. She looked at the chart and said, matter-of-factly, “Yeah, you're not dreaming.” Then she moved on to talk about deep sleep.

For reasons I couldn't fully express at the time, my eyes became teary as she delivered that pronouncement about not dreaming. 

This newsletter unpacks those feelings and explores why dreaming is such a precious gift, why so many of us are losing it due to sleep apnea and other sleep issues related to our modern living, and what we can do to protect it.

Like many of the miracles hiding in plain sight in our lives, dreaming is a gift we can receive nightly that we rarely stop to marvel at. Every night we have the ability to retreat from our daily lives into imaginative, complex worlds, often with a sense of consciousness still moving through them, and sometimes a sense of being omniscient. Sometimes our dreams are delightful, sometimes meaningful, sometimes scary and unnerving. Most of our vivid dreaming happens during REM sleep, and science still can't fully tell us why we do it at all.

Many traditions teach that dreams are messages from Spirit, carrying guidance not only for the dreamer but for the collective. My goal in life is to know God, so if there is even a possibility that dreams are part of that connection, I want to do what I can to keep that line open. Protecting our dreaming is a way of honoring the mystery of life, and it turns out that the same choices that protect our dreams also protect our metabolic health.

Sleep apnea is touching a lot of us. Using standardized diagnostic criteria, researchers estimated in The Lancet Respiratory Medicine that nearly one billion adults between the ages of 30 and 69 have mild to severe obstructive sleep apnea, including 425 million with moderate to severe disease. That means nearly a billion people are suffocating a little (or a lot) every night, many without knowing it. Their restful, healing sleep is broken again and again. That number has grown in recent decades: in the long-running Wisconsin Sleep Cohort, the estimated prevalence of moderate to severe sleep-disordered breathing rose by 14 to 55 percent, depending on age and sex, in just about two decades. Whole industries have cropped up to address this problem, but at its core, sleep apnea represents what so much of the chronic disease in our world represents: a profound mismatch between our modern environment and what our bodies need to function optimally.

We have to get on top of sleep apnea as a global population. When the airway repeatedly collapses during sleep, the result is drops in oxygen, surges of stress signaling and sleep broken into fragments. Left untreated, sleep apnea hurts nearly every system it touches, doubling the risk of cardiovascular disease, stroke, and premature death, acting as an independent risk factor for type 2 diabetes, and diminishing the daytime alertness we depend on, enough to raise the risk of motor vehicle accidents. It is present in 40-80% of people with high blood pressure, coronary artery disease, atrial fibrillation, stroke, and heart failure, yet it is often not screened for and not treated.

Sleep apnea has many causes, and excess weight is a key one. But plenty of lean, active people are dealing with this, my husband among them. Roughly one in five adults with sleep apnea is not obese. In these cases, airway anatomy often plays a larger role: a recessed jaw, enlarged tongue, or long soft palate can obstruct breathing during sleep. Other risk factors include older age, male sex, genetics, smoking, alcohol, and differences in how the brain regulates breathing and keeps the airway open at night.

Some might think the anatomy piece is immutable, but even our anatomy tells a story about the modern life mismatch. Our jaws develop partly in response to how much chewing we do in childhood. In Breath: The New Science of a Lost Art, James Nestor explores how the shift toward softer, more processed foods may have reduced the demands on our jaws, contributing to smaller mouths, crowded teeth, and compromised airways. Stanford biologist Paul Ehrlich and orthodontist Sandra Kahn make a similar argument in Jaws: The Story of a Hidden Epidemic. The idea is that soft, puréed, highly processed “baby foods” and “kids foods” may fail to provide the chewing forces that stimulate jaw growth, potentially shaping the anatomy they breathe through for life and contributing to mouth breathing, sinus issues, nasal obstruction, dental problems, sleep apnea, and increased chronic disease risk.

(A topic for another day, but “baby-led weaning” (BLW), a feeding philosophy that moves away from purées and introduces appropriately prepared solid, whole foods to babies around six months, aims to give infants more opportunities to develop chewing and swallowing skills. We did this with our baby following the Solid Starts book and it’s been a wonderful experience.)

At the population level, excess weight—particularly visceral fat, the metabolically dangerous fat stored deep in the abdomen around our organs—is a major modifiable risk factor for sleep apnea. In a four-year study of 690 adults, a 10% weight gain predicted a sixfold increase in the odds of developing moderate to severe sleep-disordered breathing, while a 10% loss predicted 26% fewer breathing interruptions. With roughly 72% of American adults living with overweight or obesity, millions may be struggling to breathe properly at night. Alcohol and sedatives compound the problem by relaxing throat muscles and impairing protective responses during sleep.

And all of this gets back to dreaming. Sleep apnea leads to sleep fragmentation that can lead to less dreams, or in some cases, increased frequency of disturbing dreams.

Many traditions consider sleep as far more than rest. In Jewish mysticism, it is believed that part of the soul leaves the body during sleep and rises into the upper worlds. Each morning, the Modeh Ani prayer thanks God for returning the soul to us. In many Indigenous traditions, dreams are understood as information from Spirit meant for the collective, to be shared and interpreted together rather than kept to oneself.

Artists, scientists and philosophers have long trusted this nightly source of inspiration, and some of our greatest works of art and discovery have landed in our reality through the dream world, from Mary Shelley’s Frankenstein to the Beatles’ “Yesterday.” Paul McCartney woke with the entire melody in his head and played it for people for weeks, sure he must have heard it somewhere. Salvador Dalí called his paintings “hand-painted dream photographs.” And in 1921, Otto Loewi dreamed an experiment proving that nerves communicate through chemicals. He ran the experiment it in the middle of the night, and it earned him a share of the Nobel Prize.

In my own life, dreams have guided me in ways that have had real impact. I’ve shared before about how the Bear dream led my husband and me to osha root for his respiratory symptoms. Just before I gave birth, my beloved aunt had a recurring dream about my mom, culminating in a vivid image of her standing behind me at the birth, supporting me. Hearing about this dream from my aunt gave me massively more confidence going into labor. And since giving birth, I’ve had a recurring dream whose message keeps reminding me that God and our ancestors are always available to help, but that the onus is on me to reach out and simply ask. In the recurring dream, it’s as easy to talk to God and ancestors as picking up the phone and calling, and yet, in the dream, I often forget to.

Scientifically, protecting our dreams means protecting REM sleep. REM is a fancy term, but it describes something remarkable. During REM, the eyes dart beneath closed lids, most of the body's muscles are totally paralyzed, and the brain shifts into low-voltage, mixed-frequency activity, with slower theta rhythms in the 4–8 Hz range alongside faster activity that looks like wakefulness. We call them “brain waves,” but what if those brain waves are really our minds tuning into a different dimension of information and energy in the field, one we can't yet understand with our scientific tools?

We want to dream big, both in our sleep and in our waking lives. 

The challenges facing our world require big dreaming: big intuition from a higher power to guide us, and big ideas to move us toward a time of more peace, love and joy on planet Earth.

An invitation for all of us: do what we can to protect dreaming. Here is where the evidence points:

Our dreams may be one of the ways we are spoken to. Let's make room to listen.

With good energy,

Casey

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