I was a co-founder and the Chief Dream Officer of DreamWell, a mobile app for mindfulness, sleep and dream well being. I wrote this essay as a way to ground DreamWell’s culture and curriculum in dream studies literature. It documents my understanding of dreams at the start of my D-SETI work and may be relevant to those who want an overview of sleep, dreams, and mindfulness.

Introduction

“Sleep well, dream well, be well” is the motto of Dream Well, which is a mobile app dream journal that offers a dream journal and audio meditations for sleep, dream, and mindfulness. The app is designed by a team of experts with experience in mindfulness, sleep, and dream practices. Dream Well is a public benefit corporation and our mission is to support the natural well-being of all dreamers everywhere by building engaging digital tools that promote and inspire healthy sleep and dreams.

While it seems obvious to us, the DreamWell team, that sleep, dream, and mindfulness practices are mutually supportive and lead to greater well-being, we feel that it is important to clearly define our activities and base all of our recommendations in science. In our Western consumerist cultures, it is tempting to neglect sleep for work or entertainment and to dismiss dreams as meaningless fantasy. However, we invite you now to take a moment to explore the science behind DreamWell to discover that your sleep, dream, and mindfulness habits have a functional relationship with your well-being.

In this paper, we will provide working definitions of sleep, dreams, and mindfulness. We will offer scientifically-based hypotheses about sleeping well, dreaming well, and being well, which we invite you to test in your own life through establishing habits using the Dream Well app. We’ll present scientific literature that connects sleep, dreams, and mindfulness practices to well-being.

Disclaimers and Terms of Inquiry

Making meaning from dreams requires participation

Your journey to sleep well, dream well, and be well is a journey through your subconscious mind into the unknown. It’s really important to realize that dreams are essentially irrational because they come from your whole psyche. Finding meaning in dreams isn’t a spectator sport or Newtonian physics where you can be a passive and objective observer. Dreams invite full participation much in the same way the observer effect in quantum physics involves the scientist. In other words, you will need to participate in dreaming in order to make meaning from dreams.

Dreams may bring up unresolved emotional challenges

Dreams involve your whole being, not just your ego or persona. Therefore, you may encounter difficult experiences within dreams especially if you have unprocessed emotional trauma or repressed memories. We believe that dreams only present such challenging material only when your psyche believes you to be ready to process that material, but that decision is up to you. If you would rather continue to repress experiences, then working with your dreams may not be right for you at this time.

The science of dreams is sparse

Even though dreams have been central to the development of the scientific method and inspired many scientific discoveries, the science of dreaming is sparse compared with objective sciences. Freud wrote his influential book, On the Interpretation of Dreams, only about a century ago, which provided a working theory by which to study dreams called “psychoanalysis”. However, psychoanalysis involves the relationship of a therapist to client, which does not actively lend itself to objective study through reproducible experiments because of its non-dual or inter-personal nature.

The science of dreaming has evolved since Freud. We see developments along three lines:

Dreamwork, which is similar to psychoanalysis and explores dreams in interpersonal or transpersonal way to provide healing, insight, or transformation to the dreamer
Physiological or neuroscientific study, which looks to the physical basis of dreaming through use of fMRI, EEG, or other sleep laboratory tools
Content analysis studies, which look to the contents of dream reports to make conclusions about dreams or dreamers

It is important to note that there are no consistent definitions or theories of dreaming. While science is generating facts about sleep and dreams, it can not provide a unified theory of dreaming much in the same way it has not yet produced a unified field theory. Much of our scientific understanding of dreams comes from very limited sample sizes (the largest database of dreams for academic study is only around 40k).

Finally, it is important to note that your attitudes about dreaming are predictors of your well-being. Having a positive attitude towards dreaming is a predictor of positive waking emotion and well-being. Therefore, we encourage you to use personal discernment when working with scientific theories and facts regarding dreaming.

You are the decision maker regarding the significance of your dreams

While we are presenting scientific literature regarding dreams, it must be noted that you are the decision-maker regarding the significance of your dreams. This is an ethical principle of dreamwork as put forward by the International Association for the Study of Dreams. We understand this principle in two contexts:

Interpretive meaning, which involves the exploration of the dream with regards to symbols. For example, dreaming of water may be associated with heightened emotionality in general populations, but for you, it may be associated with a particularly strong memory of water.
Ontological meaning, which involves theories or understanding of dreaming as a phenomenon. For example, materialist scientists might dismiss dreaming as mere “processing” or “wish-fulfillment” experiences that are insignificant.

You are the sole authority regarding the significance of your dreams especially regarding their interpretation and your attitudes towards dreaming. Dreaming is a personal experience similar to waking consciousness. Just as you do not need to consult scientists about the significance of events in your life, you do not need to consult scientists about the significance of events in your dreams. Just as scientists are unable to explain the mysteries of life, they are unable to explain the mysteries of dreaming. Therefore, we emphatically encourage you to explore dreaming just as you explore waking life.

Definitions and Norms

DreamWell takes a commonsense approach, informed by science, when working with sleep, dreams, and mindfulness. While it is hard to come to a universal definition of dreaming or of dreaming well, we believe that you can experience both dreams and dreaming well. In our dream journal check-in, we’ll ask you how well you slept, how you feel, and how you dreamed. We don’t define exactly what that means because we think it’s going to be a little different for everyone.

However, we do find value in clarity of words and grounding all of our work in scientific discussion. In this paper, we’ll present relevant scientific definitions of sleep, dream, and mindfulness and discuss Dream Well’s orientation within those definitions.

Well Being

Dream Well is a public benefit corporation with a mission to support the well-being of all dreamers everywhere. While it is possible to attempt definitions of well-being, we feel that it is up to each dreamer everywhere to define well being for themselves.

Methods

This paper presents an overview of scientific literature related to sleep, dreams, and mindfulness. Most papers were discovered through databases such as Google Scholar or APA PsychNet. The papers cited here were selected for their clarity to provide an overview of the subject matter. We have striven to present citations that are universally acceptable and represent viewpoints of basic science that are in line with common sense.

Sleep

“Normal” Sleep

While sleep and sleep health are hard to define and we still don’t know exactly why we sleep, it is beneficial to understand the patterns of normal sleep. Carskadon and Dement describe normal human sleep in their chapter Normal Human Sleep in the book Principles and Practices of Sleep Medicine (2011).

Most contemporary definitions of sleep use the terms NREM and REM to refer to two different stages of sleep. NREM (non-REM) sleep is generally divided into four stages defined by EEG waves. These stages correspond with a depth-of-sleep continuum measured by arousal thresholds, with the lowest in stage 1 and highest in stage 4. NREM sleep is associated with minimal mental activity within a moveable body.

REM (rapid eye movement) sleep is defined by EEG activations, muscle atonia, and bursts of rapid eye movement. REM is not subdivided into stages, but is characterized by phasic activity such as the bursts of rapid eye movement or muscle twitching. REM is often associated with vivid dream recall. REM sleep may be characterized by brain activity within a paralyzed body.

The authors describe the normal pattern of sleep for a healthy young adult as:

Sleep onset through NREM (non-REM)
First sleep cycle
Stage 1, persisting 1-7 minutes characterized by a light sleep
Stage 2, continues for 10-25 minutes, characterized by lowered arousal sensitivity and “sleep spindles” in the EEG
Stage 3/4, lasting only a few minutes and transitions to stage 4
Stage 4, usually lasts 20-40 minutes in first stage, characterized by deep sleep, and identified by high-voltage slow-wave activity in EEG
REM, lasting only 1-5 minutes in the first cycle
NREM-REM Cycle
Average length of cycle is 90-110 minutes
Cycle lengthens over the night (70-100 minutes for first cycle and 90-120 minutes for last cycle)

The authors offer the following generalizations about sleep:

Sleep is entered through NREM sleep.
NREM sleep and REM sleep alternate with a period near 90 minutes.
SWS predominates in the first third of the night and is linked to the initiation of sleep and the length of time awake.
REM sleep predominates in the last third of the night and is linked to the circadian rhythm of body temperature.
Wakefulness in sleep usually accounts for less than 5% of the night.
Stage 1 sleep generally constitutes approximately 2% to 5% of sleep.
Stage 2 sleep generally constitutes approximately 45% to 55% of sleep.
Stage 3 sleep generally constitutes approximately 3% to 8% of sleep.
Stage 4 sleep generally constitutes approximately 10% to 15% of sleep.
NREM sleep, therefore, is usually 75% to 80% of sleep.
REM sleep is usually 20% to 25% of sleep, occurring in four to six discrete episodes.

The authors note that sleep patterns change over time as a function of age. At birth, babies on average experience 50% REM sleep. After about 2 years, the percent of REM sleep drops to around 20-25% (Carskadon and Dement, 2011). We also see a decrease in the amount of sleep over time, from around 14 hours per day during the first 2 months of life, to around 9.5 hours at age 6, and finally to around 7.4 at age 18 (Chaput et al., 2018).

Sleep Duration

People often wonder how much sleep is ideal or if they are sleeping too much or too little. In a review paper involving meta-analysis of international and cross-demographics studies, Chaput et. al (2018) conclude:

Sleep duration recommendations (public health approach) are well suited to provide guidance at the population-level standpoint, while advice at the individual level (eg, in clinic) should be individualized to the reality of each person. A generally valid assumption is that individuals obtain the right amount of sleep if they wake up feeling well rested and perform well during the day.

The National Sleep Foundation has put forward sleep duration recommendations that vary between age groups. These include:

Children (6–13 years): 9-11 hours
Teenagers (14–17 years): 8-10 hours
Young adults (18–25 years): 7-9 hours
Adults (26–64 years): 7-9 hours
Older adults (≥65 years): 7-8 hours

In their study of a representative population of the United States, Ram et al. (2019), report:

6.9 hours mean sleep duration
20.7 minute sleep latency (minutes needed to fall asleep)

Sleep Health

The challenges of defining sleep health are well-known. Buysse writes in his well-cited paper, Sleep Health: Can We Define It? Does It Matter?, “The potential difficulties surrounding a definition of sleep health are illustrated by attempts to define health itself. Many have questioned whether it is even possible to define health.” Further, Buysee acknowledges that sleep health is multidimensional in nature. He offers a definition for sleep-health that we, at Dream Well, adopt as our working definition:

Sleep health is a multidimensional pattern of sleep-wake-fulness, adapted to individual, social, and environmental demands, that promotes physical and mental well-being. Good sleep health is characterized by subjective satisfaction, appropriate timing, adequate duration, high efficiency, and sustained alertness during waking hours. (Buysee, 2014)

Sleep Quality

When we conducted our survey of the scientific literature related to sleep quality, dreams, and mindfulness, we found the Pittsburgh Sleep Quality Index (PSQI) was used in the most relevant studies. It is important to note that the PSQI focuses on experiences from the past month. The PSQI consists of 19 self-rated items (survey questions) that are then scored to produce values for 7 components, yielding a global score with a range of 0-21 points (Buysse, et al., 1989).

The 7 components are:

Subjective sleep quality, based upon:
self-rating of sleep quality from very bad to very good
Sleep latency, based upon:
self-report of how long it usually takes to fall asleep
Self-report of number of times sleeper cannot get to sleep within 30 minutes
Sleep duration, based upon:
Self-report of average hours of actual sleep per night
Habitual sleep efficiency, based upon:
Ratio of number of hours of sleep compared with number of hours in bed
Sleep disturbances, based upon:
Self-report of number of occurrences of 8 categories of disturbances such as uncomfortable breathing, pain, or bad dreams
Use of sleeping medications, based upon:
Self-report of frequency of consumption of sleep medications
Daytime dysfunction, based upon:
Self-report of frequency of trouble staying awake while driving, eating, or social activity
Self-report of how much of a problem it has been to keep up enough enthusiasm to get things done

Sleep Disorders

It is important to note that there are several major types of sleep disorders. Pavlova and Latreille reviewed 6 major sleep disorders as an aid for their diagnosis. Their findings summarize the characteristics of sleep disorders (2019).


Condition	Defining Features
Insomnia	Difficulty with: - Sleep initiation or - Sleep maintenance Results in: - Fatigue/malaise Mood disturbance/irritability - Reduced productivity Chronic: >3 times/week and >3 months
DSWPD (delayed sleep−wake phase disorder)	- Sleep occurs systematically later than needed - Sleep length is normal and the patient is refreshed when sleeping according to his/ her desired time
ASWPD (advanced sleep−wake phase disorder)	- Sleep occurs systematically earlier that needed - Sleep length is normal and the patient is refreshed when sleeping according to his/ her desired time
OSA (obstructive sleep apnea)	- Snoring/apneas/gasping upon awakening - Other nonspecific symptoms - Mrning headache - Attention deficits - Mood disturbance - Nocturia, night sweats - Aggravation of other disease
Narcolepsy	Classic tetrad: - Sleepiness - Sleep paralysis - Hypnagogic hallucinations Type 1: Cataplexy Type 2: Without cataplex
REM behavior disorder	- Abnormal behaviors, emerging from REM sleep - Occur in the later parts of the night - Typical behaviors: talking, screaming, punching, kicking - Associated with a vivid dream recall

Ram et al. (2009) performed a study on the prevalence of sleep disorders and habits in the United States. They report the prevalence of physician-diagnosed sleep disorders:

4.2% sleep apnea
1.2% insomnia
0.4% restless leg syndrome
1.3% other

They also report on the prevalence of sleep-related habits and difficulties, with habits defined as percentage of those with at least five times a month):

15.9% Trouble falling asleep
19.8% wake up with trouble getting back asleep
17% wake up too early not able to get back to sleep
26.5% Feel unrested during the day regardless of hours of sleep
18.5% Feel excessively or overly sleepy during the day
26.1% not getting enough sleep
8.6% take sleeping pills or other medications to help with sleep

Sleep Paralysis

Sleep paralysis is important to note in the context of dreaming. Aspy, in his International Lucid Dream Induction Survey, included information regarding sleep paralysis (2020). Denis and Poerio (2017) conducted a survey of 1928 participants regarding the correlation of lucid dreaming and sleep paralysis. They provide the definition “Sleep paralysis is a period of inability to perform voluntary movements at either sleep onset or upon awakening”. They found:

Consistent with anecdotal reports and theoretical accounts of their neurophysiology, the frequency of sleep paralysis and lucid dreaming were correlated positively, indicating the common co-occurrence of these sleep experiences.

Sleep paralysis is common and associated with a variety of extra-ordinary sleep and dream phenomena. Denis (2018) reports that:

Prevalence estimates of lifetime episodes of sleep paralysis vary widely, with one systematic review suggesting a lifetime prevalence estimate of 7.6% (with individual study estimates ranging from 2% to 60%).18 In a meta-analysis focusing specifically on incubus experiences, a lifetime prevalence of 11% was found.

In their survey of 974 passerbys, Raguda et al. (2020), asked questions to examine the correlation between sleep paralysis, lucid dreams, false awakenings, and out of body experiences. They reported:

Of those surveyed, 88% have experienced at least one of the phenomena of interest (i.e., LD, OBE, FA, and SP), which appeared to be closely correlated to each other.
43% of respondents stated that they often experience at least one of these phenomena.
The recurrence of these phenomena correlated with sleep duration and dream recall frequency.

Denis (2018) describes the experience of sleep paralysis as related to REM sleep and its characteristic muscle atonia:

Sleep paralysis involves a period of time at either sleep onset or upon awakening from sleep during which voluntary muscle movements are inhibited. Ocular and respiratory movements remain unaltered, and perception of the immediate environment is clear. Sleep paralysis is most closely linked to rapid eye movement (REM) sleep, as opposed to non-REM (NREM) sleep. REM sleep is associated with vivid dreaming. Throughout periods of REM sleep, there is total muscle atonia (save the eyes and respiratory system). This paralysis is a natural feature of normal REM sleep, possibly driven by GABA and glycine inhibition of motor neurons. One likely reason for this muscle paralysis is to prevent unwanted and dangerous movements from occurring during dreaming, when the cerebral cortex including motor cortex is active. The state of sleep paralysis is thus believed to arise from an ongoing continuation of the REM-induced muscle paralysis into a waking state.

It is important to note that there are dream-like and frightening hallucinations associated with sleep paralysis:

In addition to the ongoing muscle atonia, around 75% of sleep paralysis episodes are typically accompanied by a wide range of bizarre and often terrifying hallucinations. These hallucinations typically fall into three categories. Intruder hallucinations consist of a sense of evil presence in the room, along with vivid multisensory hallucinations of a bedroom intruder. Incubus hallucinations describe a sense of pressure on the chest, often accompanied by sensations of being choked or suffocated. These two categories of hallucinations typically co-occur. The third category, vestibular-motor (V-M) hallucinations involve illusory feelings of movement, out-of-body feelings, and out-of-body autoscopy.

Dreams

Definition of Dreams

Like well-being and sleep, it is hard to come to a single definition of dreaming. Pagel et al. in their 2001 paper, Definitions of Dream: a Paradigm for Comparing Field Descriptive Specific Studies of Dream, state, “there is no accepted definition for ‘dreaming’.” They collected 20 different definitions of dreaming from the academic journal Dreaming from 1991-1999. Their working group came to consensus on several points:

The comparison of research data between various studies requires a clear definition of the object of study.
A dream should not be exclusively defined as a nonconscious electrophysiologic state.
A single definition for dreaming is most likely impossible given the wide spectrum of fields engaged in the study of dreaming.
Definitions of dreaming can be considered to have three primary characteristics: wake/sleep, recall, and content.

Rather than propose a single and exclusionary definition of dreaming, their working group suggest defining dreams using continuums along the three primary characteristics of dreaming. These continuums are described as follows:

Wake/sleep: sleep, sleep onset, dreamlike states, routine waking, and alert waking
Recall: no recall, recall, content, associative content, written report, and behavioral effect
Content: awareness of dreaming, day reflective, imagery, narrative, illogical thought, bizarre hallucinatory thought

It is important to note that the authors agree that dreaming may be best understood as a continuum extending throughout the stages of sleep and waking. In this way, the authors include mental experiences of dream-like states such as hypnagogia, meditation, day-dreaming, and hallucinations as part of the continuum of dreaming.

The inclusion of waking fantasy states in the continuum of dreaming is supported by the paper, The Relation of Waking Fantasy to Dreaming, by Leven and Young (2002). They studied the relationship between waking fantasy and nocturnal dreams in a large non-clinical population and concluded they are continuous, not discreet, states of consciousness.

The notion that dreaming is a continuum is supported by the findings that there is a broad overlap between dreaming and psychedelic states (Kraehenmann, 2017). Similarly, Barrett describes a continuum between nocturnal dreams, hypnotic dreams, and waking fantasy (1989). A hypnotic dream may be defined as an dream-like experience arising from a suggestion to have a dream within a trance state.

Theories of Dreaming

No one scientific theory explains dreaming

There are many different theories about dreaming and none of them fully explain the phenomenon. In their review paper of theories of dreaming, Zink and Pietrowsky identify 11 theories of dreaming and evaluate their ability to explain lucid dreaming (2015). They classify theories using two categories: structural & biological theories and evolutionary & adaptive function theories. The following tables are quoted from their paper:

Structural & Biological Theories


Random Activation Theory	Dreaming is a synthesis of random cerebral activation and a nonfunctional epiphenomenon constructed by erratically activated memories during REM-sleep.
Reverse Learning Theory	Aim of the dream process is to eliminate and forget unnecessary information. REM-sleep regulates brain activation patterns to optimize emotional responses, fear learning, and anxiety level.
AIM-Model	On a neurophysiological level, all conscious states can be described as a point in a three-dimensional space: the level of brain activation (A), the origin of inputs (I) to the activated areas, and the mode (M), that means the levels of activation of aminergic and cholinergic neuromodulators.
Continuity Hypothesis	Dreams are assumed to reflect previous waking life experiences.
Protoconsciousness	Waking and dreaming states cooperate and have a functional interplay that is necessary for the optimal functioning of both. It is a gradual, time-consuming and lifelong process that con- stantly builds on and maintains consciousness and develops along with brain development.

Evolutionary & Adaptive Function Theories


Psychoanalytic Theories	Freud: Latent dream content of the subconscious in order to protect the sleeper from disturbing sexual or aggressive wishes until it can pass a censorship instance and become a manifest dream. If this dream content cannot be modified appropriately the dream will be suppressed and cannot be transferred into the wake state. Jung: Dreams try to communicate with the dreamer via images and symbols. The unconscious communicates to the dreamer in a compensatory function in order to become more complete and have more meaning in life. Behavior, cognitions, and feelings occur in dreams, that have previously been neglected by the waking consciousness.
Costly signaling function	REM features influence dream content, mood, and emotional displays for the next wake episode, whether or not dream content is recalled. Dreams are an emotional burden, greatest if a negative dream was recalled. If the individual is able to display appropriate and functional behavior in the face of the emotional burden, the emotional signals are honest and hard to fake.
Sentinel Function	Dreams have a predictive and preparatory function for the situation in which the individual awakes. REM-sleep increases the level of brain activity and prepares for brief awakenings and immediate fight or flight reactions if danger is detected while awakening. Dreams prepare the individual for fight and flight if information from the environment leads to that conclusion.
Problem Solving & Creativity Function	Psychological problem solving function has a creative and psychotherapeutic effect, in particular for traumatic incidents. Broader connections during dreaming help linking information in new ways that were evolutionarily useful, which have a creative and problem solving function.
Psychological Healing Theories	Dreaming maintains psychological balance and is necessary to adjust in current waking life. It promotes coping capabilities, psychological well-being, and recovery from traumatic experiences.
Simulation Functions	General: Dream experience is functionally constructed for simulating waking life experience. Play Function: Dream experience resembles play behavior in mammals. Social Stimulation Function: Dreaming about the intentions of others prepares us for social encounters when awake. So practicing how to manage complex human social life interactions may have an important adaptive value. Threat Simulation: Dream consciousness is specialized in the simulation of various threatening events to which our ancestors were exposed to and improves survival success of the individual.

Shamanic and Indigenous Perspectives on Dreaming

Dreams define worldviews

In addition to Western scientific views on dreaming, it is important to note that there are indigenous perspectives regarding dreams. Guzy describes the role of dreams in the transmission of worldviews (2021):

Eco-cosmologies are indigenous worldviews, knowledge systems and life-worlds relating the human intrinsically with the non-human, the cosmos and the other-than-human sphere such as the earth, trees, animals, rivers, mountains…These worldviews and local knowledge systems [are] transmitted through shamanic dreams and dialogical ecological ritual practices.

It is important to note that shamanic dreaming is not absent from European cultures. Guzy writes:

Shamanic dreams are a crucial characteristic of shamanic worldviews and life worlds. Shamanic dreams are not exclusively apparent in non-European indigenous contexts. They have not disappeared from European cultures. Dreams that transmit both personally or communally transformative knowledge from other realms continue to manifest within the Balkan’s Christian and Islamic cultures. In the Balkans and Eastern Europe careers of healers are commonly initiated through shamanic dreams.

Extraordinary dreams are not uncommon

While the materialist worldviews do not acknowledge or explain dreams as a way of knowledge it is important to note that dreams have traditionally been seen as a means of knowledge and healing throughout history. To see the importance of dreams even within the consensus worldview, one needs only to remember that the modern expression of the scientific method was inspired by a series of three dreams by the philosopher Rene Descartes.

It may be tempting to ignore dreams as a magical means of knowledge and healing because they are unexplained by materialistic science. However, it is important to note that 8.1% of a representative sample of dreams were classified as “exotic”, meaning they were telepathic, healing, precognitive, etc. (Krippner & Faith, 2001).

Cross-cultural conclusions

When western anthropologists study indigenous dreams, they encounter a world of spirit that is actually real in some way, in which they may participate. Goulet describes the interaction of anthropologists and the dreaming cultures they study :

Experiences of dreams or visions and accounts of them clearly inform social interactions in non-western societies in which the world of spirits is as real as that of work, though real in different qualitative ways. The ethnographic record shows that western anthropologists who enter such worlds, and suspend as far as possible their own social conditioning, consistently report dreams or visions that are consistent with the ones described by the people they “study.”

Laughlin and Rock conducted a cross-cultural exploration of shamanic dreaming. They describe two major functions of dreaming within shamanic cultures:

Shamanic calling and initiation, observing that dreams are “integral to the calling, selection, and empowerment of shamans”.
Shamanic healing, observing that the “role of dreaming in causing, divining, diagnosing, and healing sickness is widespread among the world’s cultures”.

The authors summarize the major elements of core shamanism as they appear to influence dreaming:

Dreams are real, observing that “dreams are another dimension of reality in which entities, forces, and places that are normally invisible during waking consciousness become visible”
“Big” and “little” dreams, observing the “distinction between ‘little’ dreams having to do with common, everyday events, and ‘big’ dreams that have special spiritual significance. Shamans are often specialists in evoking, having and interpreting “big” dreams.”
Spiritual journeying, observing “dreaming and having visions are commonly conceived by polyphasic peoples as the separation of the “soul” or spiritual body from the material body.”
Oneirocritiscim, observing that “all polyphasic cultures have the facility to interpret dreams, and that facility is an integral part of the society’s cycle of meaning. Shamans may play the role of oneirocritic, or there may be specialist priests that perform that role. Just as often, interpretations are generated in the process of dream sharing.”
Control of dream experience, observing that “every ethnographic indication is that shamans master and control dream (and vision) journeying to the extent that they may enter and leave ASPs (altered states of phenomenology) at will.”
Dream calling, observing that “Shamans and others performing shaman-like social roles often receive their initial calling to that role by way of profound “big” dreams in which they encounter spiritual entities that give them power and instructions.”
Dreaming as transpersonal experience, observing that “for polyphasic people dreaming may be considered a transpersonal experience; that is, an experience of ‘going beyond or transcending the individual, ego, self, the personal, personality, or personal identity’“.

Core shamanic theory of dreaming

Harner coined the term “core shamanism”, which is an academic framework of the cross-cultural study of shamanism. He puts forward a core shamanic theory of dreams in ten principles (2010):

Spirits are real.
Spirits produce dreams.
These spirits have a variety of characteristics, along with different kinds and degrees of power, and differing preoccupations.
Spirits producing dreams can be: personal souls; helping spirits, including guardian spirits; or they can be non-helping ones, such as suffering beings or other intrusive spirits.
“Bad” dreams or nightmares can be beneficial warnings from one’s soul or helping spirits, or may be manifested by non-helping spirits.
Persons of substantial spiritual power tend to be resistant to receiving unsought dreams from non-helping spirits.
Major helping spirits can manifest as Big Dreams and convey important spiritual power and information.
The above principles apply to all kinds of dreams, including sleeping, waking and day dreams, and visions.
To learn the meaning of their dreams, people can merge with a helping spirit to call back dreams for study, or they can take shamanic journeys to their most important divinatory spirit helpers to obtain information.
These journeys should include the extensive study of metaphors, especially as they pertain to the meaning of spirit communications and thus to the meaning of dreams.

Attitudes toward Dreaming

Attitudes predict subjective well-being

It appears that attitudes towards dreaming predict subjective well-being. Selterman performed a study that revealed (2016):

attitudes toward dreaming, as well as appraisal of dreams as more emotionally positive than negative, were associated with increased subjective psychological well-being. To the degree that participants expressed positive attitudes/beliefs about dreaming, they also reported greater life satisfaction and greater positive waking affect.

In the study, “Participants completed a 7-item questionnaire assessing general attitudes toward dreaming (e.g., ‘Dreaming is of importance for me;’ ‘Thinking about one’s dreams will enhance knowledge about him/herself,’)”, (Selterman, 2016).

Attitudes of American Sample

Bulkeley and Schredl looked at the relation of socio-demographic variables and attitudes towards dreaming. They looked at six items for attitude to dreams. Their findings are summarized for the entire survey of 5,255 American people in the following table (2019):

They conclude:

The results of this survey suggest that ethnicity and religious orientation are consistently correlated with people’s attitudes towards dreaming, in addition to age and gender effects. Education seems to have a more modest impact. Overall, a demographic portrait begins to emerge of what may be called “hyper-dreamers” (those who are most intensely engaged with dreaming) and “hypo-dreamers” (those who are most dismissive of dreaming). It seems that in contemporary American society, hyper-dreamers are most likely to be young, female, non-white, slightly less educated, and more spiritual than religious. The hypo-dreamers of the present-day U.S. are most likely to be older, male, white, slightly more educated, and atheist. We hope to explore this portrait in more detail with future studies in different countries with various cultural and religious backgrounds.

Multidimensional approach reveals 3 profiles

Beaulieu-Prévost, Simard, and Zadra put forward a multidimensional approach to belief about dreams through factor analysis of dream questionnaires. They found 7 factors, which they describe as:

Dream significance is comprised of 12 items related to the personal significance, meaning, and importance that people attribute to the experience of dreaming. It is globally equivalent to the unidimensional construct of “attitude toward dreams” traditionally measured in the field
Dream positivity represents one’s global perception or retrospective evaluation of the positive components in the content of one’s own dream experiences.
Dream recall consists of eight items concerning peoples’ dream recall, including its perceived frequency, clarity, consistency, intensity, and vividness.
Dream apprehension captures people’s dream-related fears and worries as an independent dimension and points to one of the ways people can deal with unpleasant dream experiences, namely, by avoiding such dreams and the thoughts associated to them.
Dream entertainment captures one’s tendency to derive pleasure from dreaming and provides a way of separating pleasure-seeking versus meaning-seeking interests in dreams.
The dream continuity dimension shows that the concept of continuity between one’s waking state and dream content is not only a theoretical model held by many dream researchers and clinicians, but also a notion that makes intuitive sense to nonexperts.
Dream guidance represents the tendency to view and use dreams as a source of personal guidance.

The authors performed a cluster analysis to reveal 3 profiles of dreamers:

Indifferent dreamers, globally uninvolved in and uninterested by dream-related issues and activities (55% of the sample, 69% of Men, and 54% of Women)
Interested dreamers, highly involved in and interested by dream-related issues and reporting having rich but generally negative dream content (23% of the sample, 19% of men, and 32% of women)
Apprehensive dreamers, characterized by their reportedly general positive dream content and high level of dream-related worries and fears (21% of the sample, 11% of men, and 15% of women)

Number of Dreams

It appears that dreaming is closely associated with REM sleep and that everyone dreams. Eiser observes that (2005):

In their earliest report, Aserinsky and Kleitman found that 74% of awakenings from REM sleep resulted in recall of a dream, as compared with only 9% of awakenings from NREM sleep. The association between dreaming and REM sleep was subsequently replicated by many other investigators; typically, around 80% of REM awakenings yield dreams.

While it appears that nearly everyone dreams in both NREM and REM sleep, dream recall is variable. Researchers (Zadra and Robert, 2012) define dream recall frequency (DRF) as a ratio between the number of remembered dreams per time period. They use several different measures for DRF including a) estimated DRF through questions like “how many dreams per month do you remember?”, b) diary DRF based upon number of narrative entries in a dream journal, and c) checklist log DRF based on indication of if a dream is recalled, without request to write narrative text.

Based on their study of 358 dreamers, Zadra and Robert conclude: .

Our results indicate that checklist dream logs yield higher prospective DRF than narrative logs, that significant differences between retrospective and prospective DRF are limited to checklist logs, and that prospectively measured DRF tends to peak at the beginning of the log and then remain stable over time.

It is difficult to find a single number for dream recall frequency of a representative population. There are several studies that offer perspectives:

In a study of 528 participants, researchers found “ dream recall frequency was very high, with a mean of 3.58 mornings with dream recall per week” (Schredl et al., 2016)
In a study of 479 participants, research found “Subjects’ mean retrospective estimate of the number dreams recalled per week was 4.5 ± 2.8” (Zadra and Robert, 2012)
In an early study of 295 participants, researchers found DRF varying between age groups (Herman & Shows, 1984)
9.8 dreams / month for late teens
6.1 dreams / month for ages 30-39
4.2 dreams / month for ages 40-49
4.5 dreams / month for ages 60-69

Dream recall seems to vary with religious/spiritual experience, gender, and age:

Nielsen (2012) found “females recalled more dreams than males”
Nielsen (2012) also found that “DRF increased from adolescence (ages 10–19) to early adulthood (20–29) and then decreased again for the next 20 years. The nature of this decrease differed for males and females.”
Schredl et al., (2016) found “there is a relationship between spirituality and dream recall, possibly mediated by mindfulness skills.”

Types of Dreams

There are many different types of dreams and it is recommended to define dreaming in a continuum from sleep to waking, therefore include day dreams and hallucination. There is no single ontology of dreams put forward in the scientific literature. We may consider the typology of dreams along several dimensions:

Physiological, relating to the sleep/wake cycle, e.g., day, NREM, or REM dreams
Psychological, relating to the experience of the dream itself, e.g., nightmare, anxiety, existential, etc
Transpersonal, relating to the spiritual or ontological significance of the experience, e.g., “big” dreams, visitation, shared, exotic, etc. dreams

REM and NREM Dreams

One of the major physiological categories of dreams is NREM and REM dreams. Several findings are relevant:

Bizarreness seems to be a factor related to NREM/REM dreams (Colace, 2003):
38% of dreams at sleep onset are bizarre
61% at NREM stage 2
51% at NREM stages 2 and 4
74% at REM
The Self (representation of the dreamer) never acted as aggressor in NREM dream states and was almost always the befriender in friendly interactions in NREM dreams. Conversely, the REM-related dream Self preferred aggressive encounters (McNamara et al., 2007)
Carr and Nielsen (2015) studied nap and day dreams, reporting, “Our finding of frequent dream recall from both REM and NREM daytime naps supports our first and most general expectation that dream recall from naps would be at least as frequent as for nocturnal sleep.

McNamara et al. (2010) describe the difference of NREM and REM dream reports in their review article that examined hundreds of dream:

When subjects are awakened from REM sleep, they generally report a “dream”—a narrative involving the dreamer who interacts with others in ordinary or extraordinary ways in both familiar and strange settings. The emotions in the dream are often unpleasant and the events recounted occasionally involve bizarre and improbable elements. When someone is awakened from stage II NREM sleep, however, reporting bizarre and improbable elements and unpleasant emotions is less likely and the settings are more often familiar. Such is the typical, though by no means consensus, view of the content differences in dreams associated with REM and NREM sleep states…What is surprising, however, is that when one looks at content differences taken from reports emerging from REM versus NREM sleep, one finds very dramatic differences for a small but extremely significant set of content indicators—namely, social interactions. It appears then for this small set of content indicators that there may be two dream generators: one for REM and one for NREM sleep, each with specialized functions.

Types of impactful dreams

Busink, R., & Kuiken (1996) performed a replication study to classify impactful dreams using cluster analysis based on the dream reports of 36 participants. They identified 5 major categories of impactful dreams from their sample of 72 impactful dreams:

Existential Dreams (n=10), expressing the following attributes:
Agonizing Distress
Separation and Loss
Bodily Felt Ineffectuality
Sensory Vividness
Emergent Self-Awareness
Intensely Real Dream Endings
Anxiety Dreams (n=12), expressing the following attributes:
Intense Fear
Avoidance of Harm
Immobilization and Activity
Environmental Vigilance
Unreflective Self-participation
Fear-Induced Awakening
Transcendent Dreams (n=11), expressing the following attributes:
Ecstasy and Awe
Magical Abilities and Goal Attainment
Graceful and Vigorous Movements
Uplifting Bodily Sensations
Emergent Self-Awareness
Dream Endings
Mundane Dreams (n=12), expressing the absence of the attributes found in other dream clusters.
Alienation Dreams (n=27), expressing the attributes similar to existential dreams, but a narrower range of emotions related to feelings of alienation.

Nightmares and bad dreams

Nightmares and bad dreams are a common type of dream. Robert and Zadra (2008) examined the prevalence of bad dreams and nightmares, comparing self reported estimates with dream log measures. They offered the following definitions:

Nightmares were defined as very disturbing dreams in which the unpleasant visual imagery and ⁄ or emotions wake you up (i.e., the dreams unpleasant content woke you up while the dream was still ongoing)
Bad dreams were defined as very disturbing dreams which though being unpleasant do not awaken you (e.g., you feel that the dream occurred earlier in the night prior to your awakening, you remembered it only after being awakened by external factors such as your alarm clock, or you only remembered the dream later during the day)

They found that “when compared to daily logs, retrospective self-reports significantly underestimate current nightmare and bad dream frequency”. They report the following results:

On the 1-year retrospective measure, the mean number of nightmares reported per year was 5.9 (SD = 8.3) and the mean number of bad dreams was 15.8 (SD = 16.5).
The mean number of nightmares reported in the narrative logs is 6% lower than the 1-month retrospective estimate (ES = 0.06) and 36% higher than the 1-year retrospective estimate (ES = 0.14).
The mean number of bad dreams reported in the narrative logs is 14% higher than the 1-month retrospective estimate (ES = 0.09) and 72% higher than the 1-year retrospective estimate (ES = 0.43)

Zadra and Donderi (2000) observe that 5-8% of the population report a current problem with nightmares. In that study, they examined the correlation between self-report measures of well being and frequencies of nightmares and well being. They found:

On the 12-month retrospective measure, the mean number of nightmares reported per year was 4.21
A greater number of well-being measures were significantly related to nightmare frequency than to baddream frequency
Studies have shown that nightmare frequency is only moderately related to the waking suffering or distress associated with nightmares
These results form a pattern that suggests that scores on measures of well-being are inversely related to the position of a dreaming experience on the dimension of negative dream affect

Exotic Dreams

Dreams are often associated with bizarre, strange, and extraordinary states of consciousness. Krippner and Faith called these “exotic dreams” and performed a cross-cultural study of dreams to examine their prevalence. They performed analysis on 1,666 dreams, out of which 8.1% were categorized as exotic. They provided definitions and prevalence rates for the following types of exotic dreams:

Creative dream (0.3%), in which an actual problem from waking life had to be solved or a new product had to be brought into actuality.
Lucid dreams (1.7%), in which the dream report had to specifically state that the dreamer was aware that he or she was dreaming before awakening from the dream
Healing dream (0.2%), in which the dream report had to contain a statement that the dream content assisted in ameliorating or preventing physical, emotional, or spiritual distress at a point in time following the dream experience
Dream within a dream (0.6%), in which the dream report mentioned entering a different state of consciousness within the dream itself, or appearing to wake up from the dream only to discover that the dream was still going on.
Out of body dream (1.4%), in which the dreamer needed to report the sensation of leaving his or her body while the dream was going on
Telepathic dream (0.1%), in which the dreamer claimed that a dream matched the mental content of a distant person in external reality
Mutual or shared dream (0.1%), in which the dreamer and someone else claimed that they had experienced similar dreams on the same night.
Clairvoyant dream (0.3%), in which the dream report needed to match a distant event, and that a purported confirmation of this match was made during wakefulness
Precognitive dream (1.0%), in which the report was one that provided specific information about a future event that supposedly matched information later gleaned about that event
Past life dream (0.3%), in which the dreamer had to report taking on a different identity than his or her ordinary identity, one subjectively associated with a purported former lifetime or “incarnation.”
Initiation dream (0.9%), in which the dream report had to describe the introduction of the dreamer to a non-ordinary reality, to membership in an esoteric social group, or to a previously unexplored vocational path; in each case, this initiation needed to be agreeable and meaningful
Visitation dream (1.1%), in which the dream report involves a deceased person or an entity from another reality had to provide counselor direction that the dreamer found of comfort or value.

Typical Dream Themes

There appear to be common dream themes. Schredl et al. (2004) administered the Typical Dream Questionnaire to 444 participants. The questionnaire involves asking participants if they have dreamed of 55 themes at least once in their life. The top ten themes are:

School, teachers, studying (89.2%)
Being chased or pursued (88.7%)
Sexual experiences (86.7%)
Falling (74.3%)
Arriving too late (68.5%)
A person now alive being dead (68.0%)
Flying or soaring through the air (63.5%)
Failing an examination (60.8%)
Being on the verge of falling (56.5%)
Being frozen with fright (56.3%)

They found:

there appear to be dream themes that are experienced by many people and that are very stable in their relative frequency across different populations
gender seems to affect the frequency of several typical dream themes
Many typical dream themes are characterized by not being directly continuous to waking life, such as being chased or pursued, falling, flying, failing an examination
Men dreamed more often about sexual experiences and physical aggression (being killed or killing someone), whereas women dreamed more often about a person now alive being dead, being a member of the opposite sex, and failing an examination

Dream Disorders

Pagel examined nightmares and disorders of dreaming (2000). They summarize the symptoms and incidence rates for frightening dreams:


TYPE OF DREAM	INCIDENCE	SYMPTOMS	SLEEP STAGE	ASSOCIATED FACTORS
Frequent nightmares in children	20 to 30%, declines with age	Frightening, detailed plots Difficult return to sleep	REM sleep, usually late in sleep period (i.e., 4 to 6 a.m.)	Usually reflects no pathology
Frequent nightmares in adults	5 to 8%	Increased awakenings Daytime memory impairment and anxiety	REM sleep	“Thin-boundary” personality/creative personality May have associated psychopathology
Post-traumatic stress disorder	Variable 8 to 68% of war veterans At least 25% of trauma victims	Stereotypic dreams of the trauma Intense rage, fear or grief	REM sleep and sleep onset	Significant trauma Daytime hyper arousability and anxiety
REM sleep behavior disorder	Most common in late middle age and in men	Acting out of dreams Nocturnal injuries	REM sleep Increased REM sleep EMG tone on polysomnogram	Degenerative neurologic illness in 50% of affected persons
Night terrors	1 to 4% of children Declines with age Rare in adults	Blood-curdling screams Autonomic discharge Limited recall	Deep sleep, early in sleep period (i.e., 1 to 3 a.m.) Stages 3 and 4 arousals on polysomnogram	No pathology in children Psychiatric and neurologic disorders in adults

Pagel lists REM Sleep Parasomnias and Arousal Disorders that are associated with dreaming:

Arousal disorders (usually associated with deep sleep)
Confusional arousals
Sleepwalking
Sleep terrors
Parasomnias (usually associated with REM sleep)
Nightmares
Sleep paralysis
REM sleep behavior disorder

Lucid Dreams

Lucid dreaming may be defined as “A lucid dream is a dream in which the dreamer is aware that he or she is dreaming and can often consciously influence dream content” (Stumbrys et al., 2014). They report that “about half the general population has had a lucid dream at least once in their lives, and about one in five people have them regularly, at least once a month.”

They conducted an online survey of 571 dreamers to describe the phenomenology of lucid dreaming. They reported that their sample expressed:

3.4 lucid dreams per month
Had their first lucid dream at 14.8
83.4% had their first lucid dream spontaneously
13.9 minute average lucid dream duration
48.5% remembrance of intentions
44.1% accomplishment of intentions

The process of intentionally having a lucid dream is called “lucid dream induction”. There are many different types of induction techniques. Aspy examined the efficacy of several techniques in his International Lucid Dream Induction Study with 355 participants (2020):

Reality Testing (RT), which involves examining one’s environment and then performing a reliable test that differentiates between waking and dreaming, repeatedly throughout the day
Wake Back to Bed (WBTB), which involves waking up after several hours of sleep for the purpose of lucid dream induction
Mnemonic Induction of Lucid Dreams (MILD), which involves creating a prospective memory intention to remember that one is dreaming by repeating the phrase “next time I’m dreaming, I will remember I’m dreaming” (or some variation).
Senses Initiated Lucid Dream (SSILD), involves waking up after approximately 5 h of sleep (as with MILD) and then repeatedly shifting one’s attention between visual, auditory, and physical sensations before returning to sleep
A hybrid technique (MILD + SSILD)

Aspy reports the following observations:

Lucid dreaming rates were significantly correlated with general dream recall rates
lucid dreaming occurred 86.2% more often when participants fell asleep within 5 min of completing the MILD technique
Sleep quality was superior on nights when participants successfully induced lucid dreams compared to nights when they failed to induce lucid dreams
Conclusions regarding induction techniques
Findings provide the strongest evidence to date that the MILD technique is effective for inducing lucid dreams.
Findings indicate that the SSILD technique is similarly effective.
RT appears to be an ineffective lucid dream induction technique – at least for short periods such as 1 week in the present study.

Dream sharing is the process of sharing dream narratives with others, which is often associated with dream work or group interpretation methods. In their research of dream sharing and empathy, Blagrove et al. point out that dream sharing leads to increase of insight regarding waking life experiences and dream content for the person sharing their dreams. The authors further point explore the benefits of listening dreams concluding that discussion of dreams enhances empathy toward the dream-sharer.

It is important to note that studies regarding dream-sharing frequency vary. Schredl and Bulkeley performed a survey of 5,255 American adults with diverse backgrounds. They found that 23% of the sample shared a dream at least once a week, while 24% never shared a dream. They found that age, gender, dream recall frequency, attitude towards dreams, education, relationship status, and ethnicity were factors in dream sharing frequency.

Vann and Alperstein surveyed 241 individuals regarding dream sharing. In their review, the authors point out that dream sharing is culturally bound and that the rules of dream sharing vary among cultures. They reported the following findings:

84.2% of respondents reported dreaming several times a week
98% reported telling a dream to someone
59% tell dreams to friends, 24% tell dreams to roommates, 11% to significant others, 5% to family members, and only 0.4% to therapists
50% report telling dreams for entertainment, wily only 5.7% reported telling dreams for therapeutic reasons

Schredl and Gortiz conducted a survey of 2,929 dreamers to ascertain the frequency of people contacting other persons who they have dreamed of. The authors found:

37% of the participants contacted other persons because they dreamed about them. Dream recall frequency, attitude towards dreaming, younger age, and female gender was associated with contacting the person(s) dreamed of. Moreover, extraversion was also related to the frequency of contacting the person(s) dreamed of – similar to the relationship found for dream sharing frequency and extraversion.

Dream Work

Dreamwork is a process of working with dreams generally for the purpose of insight or healing. The International Association for the Study of Dreams offers these definitions:

We define dreamwork herein as an effort to discover and explore levels of meaning and significance of any dream experience recalled from sleep, and work with the insights gained for the purpose of self-growth and/or therapeutic benefit. A dreamworker is anyone who works with people professionally or non-professionally to help them explore dreams for purposes such as therapy, personal growth, spiritual guidance, or general health and well-being.

While dreamwork is popularly associated with psychotherapy through the work of Freud and Jung, it appears that the prevalence of dream presentation is difficult to estimate and the time spent on dreams in therapy is surprisingly low. Hackett summarizes several previous studies in his review of dreamwork in therapy:

Estimates of dream presentation in therapy vary from 15% to 83%
Dreams are used in 10-15% of psychotherapies
The amount of time spent on dreams in therapy appears to be low, around 5%

There are several dreamwork methods presented within the scientific literature. These methods are generally applied to dream groups. These methods include:

The storytelling method of dream interpretation (TSM), which works word associations to move into interpretation (DiCicco)
The Ullman dream appreciation method, which involves detailing dream content, waking life events, and discussing connections (Edwards et al.)
Schredl’s Listening to the Dreamer method, which also involves detailing dream content and discussing waking life experience (Edwards et al.)
Sparrow’s Five Star Method, which involves several steps derived from a co-creative theory of dreaming (Sparrow)

Dream Recall Frequency and Logbooks

Traditional wisdom and dream researchers believe that keeping a dream journal or logbook enhances dream recall frequency. However, their is limited empirical evidence for this hypothesis in the scientific literature. In their review paper, Aspy et al. observe, “despite it being theoretically plausible and widely believed among dream researchers that logbooks enhance dream recall there is a lack of empirical evidence that unambiguously demonstrates this.”

In a subsequent study, Aspy (2016) found that:

Retrospective measures yielded lower dream recall rates than logbook measures.
Findings indicate that retrospective measures underestimate true dream recall rates.
Findings also indicate that keeping a logbook tends to enhance dream recall.

Mindfulness

Definitions

There is much interest in mindfulness and indications of psychological and physical benefits. We look to mindfulness-based stress reduction (MBSR) as a definitive notion of mindfulness within Western culture. Dorjee describes MBSR and provides definitions:

The predominant notion of mindfulness in Western psychology stems from the mindfulness-based stress reduction (MBSR) program and is based on Buddhist mindfulness practices. MBSR describes mindfulness as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment”. Experientially, the most common form of mindfulness practice in MBSR directs individual’s attention, habitually caught up in the endless flow of thoughts, judgments and ruminations, to a simple mode of observing current sensations and perceptions. (Dorjee, 2010)

It appears that the predominant notion of mindfulness, as defined by MBSR, has its roots within Buddhist practice. Kabat-Zinn writes, “Historically, mindfulness has been called “the heart” of Buddhist meditation. It resides at the core of the teachings of the Buddha traditionally described by the Sanskrit word dharma, which carries the meaning of lawfulness as in “the laws of physics” or simply “the way things are,” as in the Chinese notion of Tao. (2003)”

It must be noted that current definitions of mindfulness present challenges for research. Analayo writes:

Meta-analyses published in 2007 and 2014 show that more conclusive research is required to establish fully the potential and benefits of mindfulness. To remedy this, several problems need to be addressed. One of the fundamental issues is the lack of a clear definition of the core quality under investigation. The existing semantic ambiguity of the term ‘mindfulness’ makes generalizations and comparisons across studies difficult (2019).

Benefits

In general, we may call any application of mindfulness for clinical benefits a mindfulness-based intervention (MBI). In his paper discussing the need for more consideration of the definition of MBIs, Chiesa summarizes the evidence for the efficacy of MBIs:

Taken together, mindfulness-based interventions (MBIs) have shown efficacy for several mood and anxiety disorders (Chiesa and Serretti 2011b; Hofmann et al. 2010; Ruiz 2010), for miscellaneous types of chronic pain such as musculoskeletal pain, rheumatoid arthritis, and fibromyalgia (Chiesa and Serretti 2011a), for the reduction of psychological symptoms in cancer patients (Ledesma and Kumano 2009; Shennan et al. 2011), for borderline personality disorder patients (Lynch et al. 2007), and for the reduction of stress levels in healthy subjects (Chiesa and Serretti 2009). Psychological studies further suggest that increased acceptance, self-compassion, and positive emotions as well as decreased rumination and negative emotions might account for the clinical benefits underpinning MBIs (Keng et al. 2011). Furthermore, evidence from neurobiological and neuropsychological studies indicates that meditation-based MBIs are associated with significant changes in brain function and architecture that are suggestive of improved levels of attention, memory, and executive functions (Chiesa et al. 2011b), of a favorable impact on sleep and cortisol secretion (Brand et al. 2012), as well as of reduced emotional reactivity and enhanced emotional balance (Chiesa et al. 2010, 2011a; Lutz et al. 2008).

In their 2021 review paper, Zhang et al. found evidence for the benefits of MBIs for many conditions in many contexts. They review the evidence for mental heath:

For depression and anxiety, the efficacy of MBIs is sufficiently confirmed with meta-analyses demonstrating moderate to strong effect sizes for the reduction of the two conditions.
Current evidence overall supports a moderate effect of MBIs on reducing stress; however, more robust studies are needed to make clear conclusions among different populations.
The current evidence on the effects of MBIs on insomnia and sleep disturbance is promising.
Current studies provided preliminary evidence on the potential effects of MBIs on eating disorders.
Another systematic review and meta-analysis also found that MBIs may help reducing body image concern and negative affect, while promoting body appreciation.
Literature supports the efficacy of MBIs in both substance and behavioural addictions. A systematic review of 54 randomised controlled trials found that MBIs were successful in the reduction of dependence, craving and other symptoms related to addiction, and the improvement of mood state and emotion dysregulation.
It seems that MBIs have potential benefits for people with psychosis, but further research is warranted.
MBIs among post-traumatic stress disorder (PTSD)-diagnosed participants were less conclusive. A systematic review and meta-analysis of 10 trials on meditation interventions have shown that the effects for PTSD were positive but not statistically significant.
There is a need for further research before determining the effectiveness of MBIs on attention-deficit hyperactivity disorder (ADHD) despite current studies showed that it can be a promising intervention.

The authors review the effects of MBIs on physical health. Those with clear benefits are listed below:

A systematic review and meta-analysis of 30 RCTs on chronic pain conducted in 2017 showed improvement on chronic pain management after mindfulness meditation intervention
A systematic review and meta-analysis of five studies on MBSR showed reduction on systolic and diastolic blood pressure in people with hypertension or elevated blood pressure.
Mindful eating is an effective intervention for weight control, especially among people with binge eating or emotional eating tendency.
There may be some benefits of MBIs on the physical health outcomes in cancer patients especially on cancer-related fatigue and pain, besides psychological benefits.
There is evidence supporting effects of MBIs on social health and prosocial behaviours.

David and Hayes review the benefits of mindfulness in a psychotherapy context (2011). They list benefits for the client including:

Emotional regulation
Decreased reactivity and increased response flexibility
Interpersonal benefits, including relationship satisfaction, constructive response to relationship stress, skill in identifying and communication emotions, empathy, etc.
Intrapersonal benefits, including self-insight, morality, intuition, and other health benefits

They list benefits for therapists including:

Empathy
Compassion
Counseling skills
Decreased stress & anxiety
Other benefits such as gratitude, body awareness, and patience

Types of mindfulness apart from MBSR or MBIs

There are many other types of mindfulness and meditation that are put forward in MBSR or MBIs. It is important to note that mindfulness in the context of MBSR is derived from a rich Buddhist tradition that is often intertwined with the practitioner’s culture. We understand that the practice of mindfulness is generic and universal, which is applied to specific and particular practices such as MBSR, meditation, mantra, etc.

Soler et al. examined the relationship between meditative practice and self-reported mindfulness. They write:

According to the traditional roots of mindfulness, it is assumed that long-term meditation practice cultivates mindfulness skills and that development of such skills, in turn, promote psychological well-being. From this perspective, several authors have described mindfulness as an inherent capability that can be learned and practiced by everyone. (2014)

In their survey of meditation practice, the authors include: MBSR, mindfulness based cognitive therapy (MBCT), sitting meditation, body scan, yoga, Zen practice, and Vipassana. In their survey of 670 respondents, they found 47% practiced Zen, 49% practiced Mindfulness/Vipassana, and 14% practiced other types like Tibetan meditation or yoga. They found no significant difference between types as measured by the Five Facets of Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). They found that “frequency and lifetime practice – but not session length or meditation type – were associated with higher mindfulness skills”.

Meditation may be understood to be the practice of mindfulness within a specific cultural, spiritual, or religious context. Thomas and Cohen provide a definition for meditation:

The term “meditation” refers to mental and emotional control practices from a number of cultural contexts including those of Christianity and Islam, yet is most frequently applied to those originating in the Eastern spiritual traditions of India, Tibet, China, and Japan. Meditation has been adopted in western countries both as a spiritual practice and a mind–body therapeutic intervention….Given the wide range of practices called “meditation,” issues of definition continue to hamper research in this area, as predicted in an early review of the area…In an extensive review of meditation practices in healthcare, the US Department of Health and Human Services found a definitive taxonomy of meditation practices was not possible due to the lack of specificity of the concept of meditation. (2014)

Awasthi provides a summary of meditation definitions along with citations for the study of the wide variety of meditation practices (2013):

In the modern context, meditation has been defined in a variety of ways, including attentional training to mindfulness (Kabat-Zinn, 2003) and relaxation-based methods (Benson et al., 1974) to automatic self-transcending (Travis and Shear, 2010). Some research suggests that different forms and practices can be seen as variations of concrete operationalizations of meditation (Bærentsen et al., 2010). A section of research studies continue to label a wide variety of mental training techniques as meditation, including, for example, imagery of the Buddhist deity (Kozhevnikov et al., 2009), Hatha Yoga, Omkar meditation (Harinath et al., 2004), mantra meditation, Yoga, Tai Chi, Qi Gong (Ospina et al., 2008), brain-wave vibration meditation (Jang et al., 2011), and Kirtan Kriya (KK) meditation (sound repetition with finger-thumb touching; Moss et al., 2012). Others, like Baijal and Srinivasan (2010), studied a concentrative form called Sahaj Samadhi meditation, while Vago and Nakamura (2011) studied the Mindfulness-based Meditation Training (MMT) program involving a combination of concentrative and open monitoring (OM) types of meditation, breath and body awareness, light stretching, and relaxation exercises.

Prevalence

How prevalent is mindfulness? There are several studies that examine the prevalence of mindfulness and meditation. It should be noted that the definition of mindfulness and meditation require further elaboration. A quick search of scholarly databases for mindfulness reveals many associated terms: meditation, yoga, mantra, prayer, visualization, and so on.

In 2015, Olano et al. provided an examination of sociodemographic predators of engagement in meditation, yoga, tai chi, and qi gong in the United States. Their data comes from the National Health Interview Survey conducted in 2002, 2007, and 2012. They found prevalence of practices within the previous 12 months:

0.3% qigong
1.2% tai chi
7.5% yoga
7.6% meditation
13.1% of adults engaged in at least one of the practices

They summarize the sociodemographic predictors of mindfulness practice as follows:

education beyond high school compared to less than HS was associated with the greatest increase in the odds of engaging in any of the practices
Men were approximately half as likely as women to engage in any of the practices and more than three times less likely to practice yoga
significantly lower odds of engagement in any practice were associated with black and Hispanic race/ethnicity when compared with non-Hispanic white, while Asians had higher odds of engaging in all practices except meditation

Cramer et al examined data from the 2012 US National Health Interview Survey (2016). They found:

Lifetime meditation prevalence for health reasons was 5.2%, representing 11.8 million US adults that had ever practiced meditation.
Corresponding numbers for different types of meditation practices were 2.6% (5.8 million) for mantra, 2.5% (5.7 million) for mindfulness and 3.7% (8.3 million) for spiritual meditation practices.
Among those who had ever used meditation, 78.6% had practiced meditation within the past 12 months.
Among individuals who had used meditation in the past 12 months, 16.8% consulted a practitioner or participated in a class for meditation.
Many participants retrieved information about meditation from books, magazines or newspapers (41.7%), the Internet (30.6%), scientific articles (17.3%) and DVD’s and CDs (17.8%) among other sources.
Most respondents reported practicing meditation for general wellness or disease prevention (76.2%), to improve their energy (60.0%), and/or to improve their memory or concentration (50.0%).
Large percentages of respondents reported that meditation helped to reduce stress or to aid relaxation (89.4%), to feel better emotionally (86.9%), to improve overall health and make them feel better (79.0%) and/or to sleep better (69.3%).
Meditation use was mainly recommended by friends (40.6%), and family members (28.9%), and less commonly by medical doctors (10.6%). Similarly, meditation use was disclosed to a personal health care provider by only 34.8% of users.

Examining the same 2012 US NHIS data, Burke et al. focus on the prevalence of use of mantra, mindfulness, and spiritual meditation for adults in the US and observe that:

The 12-month prevalence for meditation practice was 3.1% for spiritual meditation, 1.9% for mindfulness meditation, and 1.6% for mantra meditation. This represents approximately 7.0, 4.3, and 3.6 million adults respectively.
Across meditation styles use was more prevalent among respondents who were female, non-Hispanic White, college educated, physically active; who used other complementary health practices; and who reported depression.
Higher utilization of conventional healthcare services was one of the strongest predictors of use of all three styles.
the meditator sample had more middle aged respondents (45–65 years of age, 42% vs 35%) and fewer seniors (65 or older, 11% vs 18%)
more respondents who were female (61% vs 51%), White (86% vs 81%), college graduates (61% vs 38%), living in the West (33% vs 22%) but not in the South (26% vs 37%), and with higher family income ($75,000 or more, 39% vs 35%)
only 23% of meditators reported engaging in no regular physical activity compared with 44% of non-meditators
Only 10% of meditators reported lifetime abstinence from alcohol compared with 21% of non-meditators, and more meditators reported being former smokers (28% vs 22%)
Meditators were significantly more likely to be 45–64 years of age, female, White, college graduates, with higher incomes, and living in the West. They were more likely to be physically active, consume alcohol, be up-to-date for cholesterol screening, and use other complementary health practices. They also had a healthier body weight status, indicated more functional limitations, chronic low back pain, and depression, had private health insurance, and visited conventional healthcare providers more frequently in the past year.

Relationship of Sleep, Dreams, and Mindfulness to Well Being

Dream Well hypothesizes that sleep, dream, and mindfulness are related. You need to sleep well to dream well. Mindfulness helps you both sleep and dream well. While there has been few studies that focus on the interrelation of sleep, dream, and mindfulness, the scientific literature indicates that there is a general relationship between sleep, dream, and mindfulness. The relationship may be summarized in the following list:

Good sleep is a predictor of:
1. Well being
2. Positive emotions in waking
3. Dream frequency
Meditation is a predictor of
1. Well being
2. Lucid dreams
3. Sleep quality
4. Less disturbing dreams
Mindful dreaming is a predictor of:
1. Insight in to reality
2. Decrease of nightmares
3. Creativity and problem solving
4. Empathy via dream sharing

Overview of findings

The Relationship between Mindfulness and Sleep Quality is Mediated by Emotion Regulation

Talley and Shelley-Tremblay investigated the relationship of mindfulness and sleep quality in a survey of 367 undergraduates. They found that:

higher levels of intrusive thoughts, avoidance, and hyperarousal are correlated with lower overall sleep quality, and the use of mindfulness techniques such as acting with awareness and being non-reacting to negative thoughts or hyperarousal may help predict an individual’s sleep quality.

The effects of sleep quality on dream and waking emotion

Conte et al. examined the effects of sleep quality on dream and waking emotions on a study of 50 people (23 good sleepers, 27 poor sleepers). They conclude:

Overall, our findings show that good sleepers experience a notable change in emotionality between wakefulness and dreaming, with a prevalence of positive affect during daytime and predominant negative affect during dreaming, whereas poor sleepers are characterized by equal intensity of positive and negative emotionality in both states.

Attitudes towards dreams and their relation to intimacy and sleep quality

Olsen examined the relationship of attitudes towards dreams with relationship intimacy and sleep quality. His findings include:

No correlation was found between sleep quality and dream recall, but a positive correlation was found between sleep quality and dream attitude
Significant differences in dream recall frequency was found between participants that “Sleeps too little” and those that “Sleeps sufficiently” and “Sleeps enough”.
An interesting positive correlation between sleep quality (KSQ) and dream attitude (DAS) was found. This practically means that the worse your sleep quality, the more positive you are towards dreams.
As hypothesized, lower sleep quality does not necessarily result in lower dream recall, as e.g. frequent nocturnal awakenings can actually result in higher dream recall frequency

Dream Reports may serve as markers of mental health

Sikka, Pesonen, and Revonsuo examined the relationship of peace of mind and anxiety with waking states and dream reports. While dream reports have been considered markers for mental health through their association with psychopathology, this study indicates that dream reports may be markers for well-being. The authors describe two common Western conceptualizations of well-being, termed hedonic and eudaimonic well-being. Hedonic well-being is understood as subjective well-being, while eudaimonic well-being is understood to refer to optimal functioning.

The researchers studied peace of mind using a Peace of Mind scale based upon a questionnaire and characterized peace of mind as associated with well-being, inner peace, and harmony. They found peace of mind “to be positively correlated with measures of life satisfaction and positive affect, and negatively correlated with measures of negative affect, depression, and anxiety”.

The authors offer the following proposals and conclusions:

We propose that whereas anxiety may reflect affect dysregulation in waking and dreaming, peace of mind reflects enhanced affect regulation in both states of consciousness. Therefore, dream reports may possibly serve as markers of mental health. Finally, our study shows that peace of mind complements existing conceptualizations and measures of well-being.

Continuity of awareness across waking and dreaming states

Authors Lee and Kuiken looked at the continuity between waking mindfulness and dream mindfulness, as well as the effect of dream mindfulness on waking thoughts and feelings.

They examined reports from 131 participants.

The authors identified measures of three fairly stable and distinct forms of waking reflective awareness:.

Mindfulness, characterized by a two-component definition of “simply noticing” without “attachment”
Self-reflection, defined as open and sustained attention to personal thoughts, feelings, and activities
Rumination, defined as inflexibly repetitive attention to personal thoughts, feelings, and activities.

They describe several types of dreams:

nightmares involved fear, harm avoidance, auditory anomalies, vigorous activity, physical metamorphoses, and intense affect at the end (arousal)
existential dreams involved sadness and despair, separation, light/dark contrast, inhibition (fatigue), affective shifts, and intense affect at the end (enactment)
transcendent dreams involved ecstasy and awe, magical success, extraordinary light, vigorous activity, shifts in perspective, and moderately intense affect at the end
mundane dreams, in contrast, generally lacked all these features

The authors used the Dream Reflective Awareness Questionnaire (DRAQ) to measure dream reflective awareness. The DRAQ includes five subscales:

lucid mindfulness: a form of reflective awareness, analogous to waking mindfulness, involving explicit lucidity and detached acceptance of ongoing thoughts and feelings;
dual perspectives: a form of reflective awareness involving two separate and autonomous agents (e.g., two levels of self representation);
depersonalization: a form of reflective awareness in which the dreamer’s sense of self seems strange or unreal;
intradream self-reflection: a form of reflective awareness involving attention to personal thoughts, feelings, and activities within the dream (without explicit awareness of dreaming);
willed appearances: a form of reflective awareness involving the emergence of dream objects or figures in response to the dreamer’s wishes

The authors offered the following conclusions:

Results are compatible with a modified version of the hypothesized cross-state continuity
Presleep mindfulness predicted a specific form of dream reflective awareness (the combination of intradream self-reflection and dual perspectives)—although only in mundane dreams
Dream mindfulness (the interactive combination of intradream self-reflection, dual perspectives, and lucid mindfulness) predicted postdream increases in self-reflection—especially after transcendent dreams
transcendent dreams, which contained high levels of intradream self-reflection, were followed by reported spiritual potential and spiritual release
existential dreams, which also contained high levels of intradream self-reflection were followed by reported self-perceptual depth and existential disquietude

Nightmares, Mindfulness And Lucid Dreaming

Tzioridou et al. examined the relationship between mindfulness, nightmares, and lucid dreaming. They conducted two studies with 338 and 187 dreamers. In general, they found that wakeful mindfulness is associated with the quality of dreams. They conceptualize mindfulness via two factors: presence, referring to the ability to be fully aware of experience, and acceptance, referring to a non-judging mindset towards experience. The authors see mindfulness as a disposition that can be enhanced through meditation practice.

They present the following conclusions:

Mindfulness is negatively associated with nightmare frequency, specifically mindful acceptance
Mindful acceptance is associated with nightmare distress
A positive correlation exists between mindfulness and lucid dream frequency, but which component of mindfulness is unclear
Use of lucid dream inductions seem associated with nightmare frequency and distress
Meditation experience is correlated with lower nightmare frequency
Time passed since last meditation session is positively related to nightmare frequency
Type of meditation did not play a role in nightmare frequency
Lucid dream frequency is negatively correlated with nightmare distress, however lucid dream frequency is also correlated with nightmare frequency

Meditation, dream imagery, depression, and anxiety

Miller et al. studied the relationship of meditation on dream imagery, depression, and anxiety in a sample of 22 university students. The participants reported on dreams, answered questionnaires related to depression and anxiety, and practiced Natural Stress Relief Meditation for 15 minutes twice a day during the study. They found that:

There is a significant relationship between meditation and changes to dream imagery
Dream Imagery reflected waking day depression and anxiety with images consistent with previous research
There was a significant decrease of anxiety scores from the pre to post condition, such that anxiety decreased after one week of meditation from moderate to minimal levels of anxiety
Depression scores significantly decreased from a mild mood disturbance to normal as well
Depression scores significantly decreased from a mild mood disturbance to normal as well

Other findings

Mindfulness, sleep quality, and subjective vitality were significantly and positively associated with each other in a study of older adults (Visser et al.)
Increased lucid dream frequency in long-term meditators (Baird et al.)
Mindfulness and lucid dream frequency predicts the ability to control lucid dreams (Stumbrys and Erlacher)
Mindfulness is inversely related to disturbed dreaming and predicts less severe dream disturbances (Simor et al.)

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