How do you evaluate and manage patients who report vivid, distressing dreams or “epic dreaming” that disrupt sleep quality?

I am not well-versed in this area, but intense dreams could be a sign of narcolepsy, which I view as the disaggregation of the 4 elements of normal REM sleep (unconsciousness, hyperarousal, muscle paralysis, and dreaming). The tricyclic antidepressants suppress intensified REM sleep in depression an...

For some patients, I have taught techniques for lucid dreaming to take advantage of the dream experience. I used the techniques as an undergrad and PhD student (less time to sleep in medical school and residency), and the experience of lucid dreams helped me problem solve some important issues (rela...