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CNN LIVE EVENT/SPECIAL
Encore Presentation: Sleep
Aired May 21, 2006 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: I'm tired every day.
UNIDENTIFIED FEMALE: Hard to really get out of bed.
UNIDENTIFIED FEMALE: He twitches and carries on all night.
UNIDENTIFIED MALE: Sleep is a very dynamic and complex process.
UNIDENTIFIED MALE: Why do we need to sleep? Do we need to sleep?
UNIDENTIFIED MALE: We are confronted by a 24-hour world.
UNIDENTIFIED FEMALE: I get a little anxious and wired up.
UNIDENTIFIED MALE: Our society is horribly sleep-deprived.
UNIDENTIFIED MALE: Your reaction time is slower.
UNIDENTIFIED MALE: The next thing I knew, I had gone off the road.
UNIDENTIFIED MALE: Our sleep is getting squashed.
UNIDENTIFIED MALE: So the dreaming process is a process of memory integration.
UNIDENTIFIED FEMALE: Dreams are symbolic.
UNIDENTIFIED FEMALE: Your help is as close as your pillow.
(END VIDEO CLIP)
DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: Each and every night most of us undergo a profound change. We leave the waking world and we go to sleep.
Hello. I'm Dr. Sanjay Gupta. Over the next hour, we're going to look at what's keeping us up and how to get a better night's sleep. We'll also look at the dangers of fatigue.
We begin in the middle of the night, and one woman's failed attempt to try and sleep. (BEGIN VIDEOTAPE)
GUPTA (voice over): It's 4:00 a.m. Jolie Fainberg (ph) wakes up and can't get back to sleep.
UNIDENTIFIED FEMALE: I'm very tired. I woke up.
GUPTA: We've all been there, insomnia. But for some, like Jolie, it happens all the time.
She's busy enough during the day to be tired, so why can't she sleep?
UNIDENTIFIED FEMALE: Pick them up. OK. Daddy will (INAUDIBLE).
GUPTA: She and her husband Stan, both in their mid 40s, are raising two energetic toddlers. Esther is 4 and costume-loving Sophia (ph) is 3.
Jolie cooks, cleans and shops...
UNIDENTIFIED FEMALE: How about...
UNIDENTIFIED FEMALE: He says we don't like bad ones.
UNIDENTIFIED FEMALE: No, we don't like bad ones. That's for sure.
GUPTA: ... has clothes laid out a week in advance and dinner on the table every night by 5:30.
(on camera): Would you -- would you call it stressful?
UNIDENTIFIED FEMALE: Yes. I mean, it's very busy. There's a lot going on.
GUPTA (voice over): Jolie also works at Children's Health Care of Atlanta, where she heads up a program that fits implants on children with severe hearing impairments.
UNIDENTIFIED FEMALE: Raise your hand. Remember, you listen? We're going to do that.
So I leave the office and sometimes I leave things undone. And I will often wake up in the middle of the night and realize, "I didn't do that. Oh my gosh, I forgot to call them back. Oh no."
GUPTA: Jolie is usually in bed by 10:30, and asleep by 11:00. But she doesn't stay asleep, and that's the problem. We asked Jolie to videotape those moments when she wakes up and can't get back to sleep.
JOLIE, SUFFERS FROM INSOMNIA: It's Sunday night and it's about -- I think about 1:30. I've actually been up for an hour or so. I didn't realize so much time had gone by. I'm feeling a little anxious and wired up. It's still Sunday night. It's now about 4:00 a.m. I think I was back here at about 1:30. I've just been dozing on and off for about the last three hours.
GUPTA: Jolie is among an estimated 50 to 70 million Americans who have trouble sleeping.
Dr. Mark Rosekind, a former NASA scientist and sleep expert, consults the U.S. Olympic Training Center about sleep.
DR. MARK ROSEKIND, PRESIDENT, ALERTNESS SOLUTIONS: On average, most adults need about eight hours and the estimates are that most of us are getting probably an hour and a half less than we need.
GUPTA: Researchers still don't know precisely why we need sleep, but they do know lack of sleep has serious consequences. Both physical and mental.
ROSEKIND: We are talking about your reaction time, decision- making, coordination, memory, learning -- everything we do is going to be degraded or even impaired.
GUPTA: So what is sleep? Dr. William Dement at Stanford University, considered the father of sleep medicine, says sleep is a state when the mind loses consciousness.
DR. WILLIAM DEMENT, STANFORD UNIVERSITY: It's just a perceptual shutdown. And even if your eyelids are taped open, at the moment of sleep, you become blind.
ROSEKIND: Most people think your head hits the pillow and it's all quite. It's not at all. Sleep is a very dynamic and complex process that goes on every single night.
GUPTA: Every 90 minutes, we cycle through five different stages. One stage called REM, or rapid eye movement sleep, is when we do most of our dreaming, and our bodies are actually paralyzed. That's why we don't act out our dreams.
This man does. He has asleep disorder called REM behavior disorder. He's not paralyzed during REM and can harm himself and others, acting out his dreams. I'll have more on this and other disorders a little later.
Other stages of sleep are non-REM, including deep sleep. The body is not paralyzed, but movement is minimal.
ROSEKIND: Non-REM is critical, especially the deep sleep because it's most responsible for memory consolidation as well as physical restoration during the night.
GUPTA: So if you're physically active, deep, non-REM sleep is crucial for performing at your peak.
ROSEKIND: But REM sleep is critical, too, because that's the time when most of the memory and learning is being consolidated, and it's when we dream, which is a very important part of our emotional life. GUPTA (on camera): Here's one way to tell if you're sleep deprived. Two or three hours after you wake up, sit in a comfortable chair in a dark room for 10 minutes. Just sit. No distractions. If you fall asleep, it's a sure sign you need more sleep.
JOLIE: Sometimes when I first wake up in the morning, it's hard to really get out of bed.
GUPTA (voice-over): Jolie is feeling those signs.
JOLIE: I'm tired a lot. I definitely am. And I think it's more that I can't always keep track of things. My memory is probably not as good as it should be.
GUPTA: To help her, we arrange for Jolie to undergo asleep assessment with psychologist Russell Rosenberg.
RUSSELL ROSENBERG, PSYCHOLOGIST: Have you ever talked to your family physician?
GUPTA: He has her wear a special watch, called an actograph, to record her movements during sleep.
ROSENBERG: And this shows where you had periods of wakefulness, where you were awake in the middle of the night.
GUPTA: Who will help detect if she has asleep disorder.
Like restless leg syndrome, a condition that affects as many as 12 million Americans, keeping them awake and twitching, with shooting pains up and down their legs and arms. Today there are medications to help.
Sleep apnea affects an estimated 18 million Americans. Snoring is a sign, but the real danger is when snoring and breathing stop for long periods. With sleep apnea the airway collapses during sleep, cutting off air supply. Being overweight increases your risk.
DR. MEIR KRYGER, UNIVERSITY OF MANITOBA MEDICAL SCHOOL: There's an epidemic of obesity and there's an epidemic of sleep apnea.
GUPTA: Dr. MEIR KRYGER, a noted author on the subject, says sleep apnea brings more people to his clinic than anything else.
Today there are devices called CPAP machines that open airways and pump in oxygen.
KRYGER: And she's sleeping literally there like a baby.
GUPTA: Increasingly, Americans are turning to prescription drugs to help them sleep. More than 8 million people are taking prescription sleeping pills. And it's not just adults taking sleep meds, prescriptions for children age 10 to 19 are up 85 percent since 2000. Annual sales of sleep drugs now top $2 billion in the United States. Even so, drugs are not the most common sleep aid. KRYGER: More people in the U.S. use alcohol to help them sleep than use sleeping pills. And Alcohol is a lousy sleep aid. You may initially doze off quicker after alcohol, but three or four hours later you're awake, you're wired and you may not be able to fall asleep again.
GUPTA: Few things can disrupt sleep like working the night shift. Being awake at night and asleep during the day throws our internal body clocks, known as our circadian rhythms, out of whack.
Sunlight signals or bodies when to be awake. But even deprived of any natural light, we will still feel a surge of fatigue in the middle of the night. And to a lesser extent, in the middle of the afternoon.
Our body clocks can only adjust an hour a day to different time zones. That's why we experience jetlag.
It's not jetlag, but a racing mind that Jolie says is keeping her up at night.
JOLIE: Since I've had children, I've really set a limit on what -- the amount of overtime I will do. So I leave the office and sometimes I leave things undone. And sometimes that will wake me up and get me, you know, going, thinking about a list of all the stuff that I didn't get done for the day.
ROSENBERG: So I have a couple of techniques that might help you with that.
GUPTA: Later in the show, we'll hear what Rosenberg and others recommend to help patients cope with insomnia.
ANNOUNCER (voice-over): Still ahead, what do your dreams really mean?
But first, the life and death dangers of not getting enough sleep.
ANNOUNCER: We now return to sleep, with Dr. Sanjay Gupta.
GUPTA: We live in a world where day and night no longer matter. We can work, play, eat, pretty much do anything we want around the clock. What we don't do enough of is sleep.
UNIDENTIFIED MALE: I would say that I average about six hours asleep.
UNIDENTIFIED MALE: About four to six hours, maybe.
UNIDENTIFIED MALE: Probably get four or five hours.
UNIDENTIFIED MALE: Four or five hours.
UNIDENTIFIED MALE: I'm tired every day, you know. Every night, I'm tired. GUPTA: As a society, we are chronically sleep deprived, researchers say. Most of us need seven and a half to eight hours of sleep, but we're only getting an average of about six and a half during the week. A little more on weekends.
This shortfall doesn't go away. In fact, it builds. Researchers call this our sleep debt.
DAVID DINGES, UNIVERSITY OF PENNSYLVANIA: Day after day, living on reduced amounts of sleep, you become more and more impaired, more dependent on caffeine, have more difficulty concentrating, at greater risk for falling asleep, more difficulty remembering, but you think you're doing fine.
The facility is set up to control those factors that typically influence sleep-wake behavior.
GUPTA: David Dinges runs a sleep and chronobiology lab at the University of Pennsylvania. His lab deprives healthy people of sleep to see how they do.
UNIDENTIFIED FEMALE: The baby cried and upset her...
UNIDENTIFIED FEMALE: Mother.
UNIDENTIFIED FEMALE: George could not believe his son stole a...
UNIDENTIFIED FEMALE: Quarter.
UNIDENTIFIED MALE: Blue, red, green.
GUPTA: Stay up for 24 hours, like this test subject, and you're likely to perform as well as someone who's had a couple of drinks.
Here's something else, experiments show for the vast majority of people, sleeping six hours a night for a week will result in mental lapses and sleepiness as severe as if you'd stayed up all night long.
Long-term lack of sleep can have serious consequences on our health.
DINGES: The less you sleep, the more likely you are to die of all causes or to have a heart attack or a stroke or have diabetes or to have weight gain.
TOM CALLAGHY, LOST WIFE IN ACCIDENT: My name is Tom Callaghy. I'm a professor of political science at the University of Pennsylvania.
GUPTA: You don't have to wait years for fatigue to take a tragic toll. It can happen in the blink of an eye.
CALLAGHI: My wife and I were coming back from our daughter, Julie's (ph), show in Virginia. And we actually left in the middle of Sunday afternoon. And it was a gray, sort of overcast day and had been drizzling. But I was getting sleepy. I turned on the radio, opened the window a lip bit. I moved around. And I actually had my hand part way across the seat to wake her up. And the next thing I knew, I had gone off the road and into the trees.
GUPTA: Tom Callaghy's wife, Janie, died in that crash. Callaghy talks about the accident, to warn others about the dangers of drowsy driving.
CALLAGHY: My kids had a mother one day and simply not the next. I mean, Kathleen said -- my daughter, said that Mom went away for the weekend and just never came home.
GUPTA: In a first of its kind study, the Virginia Tech Transportation Institute wired up 100 cars for a year to capture driver behavior. The cars got into 82 accidents during that time, and researchers say fatigue contributed to 10 of them.
Here, we see a driver in the study nodding off for a moment and almost running off the road.
According to federal estimates, drowsy driving causes 100,000 crashes a year in the United States, resulting in 1,500 deaths and 71,000 injuries.
Dr. Charles Czeisler is chief of the Division of Sleep Medicine at the Brigham and Women's Hospital in Boston.
DR. CHARLES CZEISLER, BRIGHAM AND WOMEN'S HOSPITAL: Every second in this country somebody is nodding off or falling asleep at the wheel. And every two minutes -- that's 30 times an hour -- there is a fall asleep crash on our nation's highways associated with people who haven't gotten enough sleep at night.
GUPTA: If you are nodding off, experts agree, pull over immediately. If possible, find a place to stay. If not, drink a cup of coffee and take a half hour nap. When you wake up, the caffeine will have taken effect. Still, give yourself another half hour before you start driving again.
The latest research shows the grogginess right after you wake up can also be dangerous. Fatigue can have catastrophic results in many areas, not just driving.
UNIDENTIFIED MALE: The engine is beginning throttling down now.
GUPTA: The commission investigating the 1986 Space Shuttle Challenger disaster said, overworked and sleep deprived managers at Kennedy Space Center ignored known risks and allowed the launch to take place.
UNIDENTIFIED MALE: Challenger, go at throttle up.
GUPTA: When the Exxon Valdez ran aground in 1989, the third mate was at the helm. He had slept only six hours in the previous 48.
According to the National Transportation Safety Board, fatigue contributed to this 1999 American Airlines crash in Little Rock, Arkansas. The captain had been on duty more than 13 hours, when he tried to land in a thunderstorm shortly before midnight. He and 10 passengers died; 134 passengers were injured.
And the NTSB says fatigue played a role in the 1997 crash of Korean Air Flight 801 into a hillside in Guam. The cockpit voice recorder picked up the Korean pilot uttering the words, jung maro, jawri so (ph), really sleepy, as he made his final approach. Two hundred twenty-eight people died.
JOHN CALDWELL, U.S. AIR FORCE FATIGUE COUNTERMEASURES: For a long time we thought, well, you know, if you have the right stuff, if we train you enough, if we give you the best equipment, then you won't have fatigue-related problems. But now we know that that's just simply not the case.
GUPTA: John Caldwell is the lead researcher for the Air Force Fatigue Countermeasures Program.
CALDWELL: The NTSB had a report basically saying that there are more commercial accidents in crews that have been awake longer than in those that had not.
Your reaction time is slower. Your attention span becomes shorter. Your memory is somewhat impaired. And so all of those are bad things when you're having to rapidly assimilate information, when you've got a lot of people's lives at stake, depending on the accuracy of your performance.
GUPTA: Caldwell says night flights, jetlag, multiple flight lags, changing shifts and insufficient rest between shifts all contribute to pilot fatigue. Airline pilots occasionally work up to 16 consecutive hours. Sometimes with schedules that leave time for only five or six hours for sleep. As a result, this 767 pilot says captains and first officers often trade notes on how tired they are.
UNIDENTIFIED MALE: So you have to be honest with each other and as the day moves on, to go, you know, I didn't get a great night's sleep last night, you know, keep an eye on me.
GUPTA: On regional airlines where pilots do more takeoffs and landings, fatigue may be a bigger problem. A survey of more than 1,400 crew members at regional carriers found 80 percent -- that's 80 percent --- had nodded off during a flight. Something this pilot is familiar with. He asked that we not show his face and alter his voice, so it could not be recognized.
UNIDENTIFIED MALE: You're kind of doing the head bob, keep yourself awake type of thing. You just have to kind of get into it, just shake yourself awake and get focusing again.
GUPTA (on camera): What can't we do as well because of fatigue?
CALDWELL: Typically we like to put people in the simulator and see how well they can perform basic flight maneuvers. And so we find that as people become tired, they have to ask the safety pilot to repeat instructions to them because they can't remember the headings and altitudes as well that they were told to fly.
GUPTA: I hope I don't crash this thing.
NASA gave me a chance to pilot its 747 simulator. First during the day, and then at night after being awake for 24 hours.
UNIDENTIFIED MALE: OK, let's go ahead and decelerate to 190.
GUPTA: The infrared camera mounted outside the cockpit captures my growing fatigue. I also take a test that measures my reflexes, which have started slowing.
The newness of the experience probably helps keep me awake, but I still set off a warning alarm when I stray away from my assigned altitude.
(Voice-over): Technology is now being tested to save us from dangerous drowsiness. Paul Chapman, a driver with Pitt Ohio express as an electronic companion each night in the cab of his truck. It's called a driver fatigue monitor. And Chapman says the experimental device may have saved his life.
PAUL CHAPMAN, DRIVER, PITT OHIO EXPRESS: I was driving from Pittsburgh to Charleston, West Virginia. It was early in the evening. My eyes were -- started to get heavy.
GUPTA: The driver fatigue monitor measures how heavy eyes are becoming by monitoring the eyelids. If they cover the eyes for three or four seconds, several times in a minute, an alarm sounds.
Richard Grace invented the driver fatigue monitor.
RICHARD GRACE, ATTENTION TECHNOLOGIES: We're not trying to keep them away. We're giving them information that will encourage him to stop and do the right thing.
GUPTA: On a recent trip Paul Chapman's eyes started getting heavy.
CHAPMAN: All of a sudden the unit goes off and sounds the alarm and it sort of set me back a little bit there. I said, man, this thing knew I was getting tired.
GUPTA: On this night Chapman finishes his shift at 2:30 in the morning, 364 miles without incident.
CHAPMAN: I had a pretty good trip here. I didn't get tired. It was a nice, easy trip. I got a lot of sleep yesterday, so I only yawned about three times last night.
GUPTA (on camera): If you're one of those people who turns up the radio or cracks the window when you start nodding off behind the wheel, stop. Experts agree that nothing works well to keep you awake for more than just a few minutes. The only real solution is to get off the road.
APOLO OHNO, OLYMPIC SPEED SKATER: It doesn't matter how hard I'm I training. If I'm not getting enough sleep, it's just wasted.
ANNOUNCER: Later, we take you inside the rooms designed to help U.S. Olympic athletes sleep better.
UNIDENTIFIED MALE: You're amazed of how people ignore these critical factors.
GUPTA: You're looking at good sleep gone bad. A twilight zone, where the normal barrier between sleep and wakefulness is blurred. These people are actually asleep, but they suffer conditions called parsomnias, disorders that frequently interfere with sleep, like sleepwalking or night terrors. In extreme cases, parasomniacs show all sorts of strange behavior, eating, talking...
UNIDENTIFIED FEMALE: Oh, oh wait, wait, wait. No, no, no, no.
GUPTA: Throwing punches or worse.
Toronto Native Kenneth Parks drove a car 14 miles to his in-laws house where he stabbed and beat his mother-in-law to death. But he was acquitted of murder on the grounds that he was probably asleep at the time.
DR. CARLOS SCHENCK, MINNESOTA REGIONAL SLEEP DISORDERS CENTER: We're at the Minnesota Regional Sleep Disorder Center.
GUPTA: Dr. Carlos Schenck helped discover one of the most bizarre and sleep conditions. REM behavior disorder, or RBD.
SCHENCK: Men with REM behavior disorder usually either stay in bed and become violent or charge out of bed, run into the furniture or the wall and then awaken. Whereas, sleepwalkers actually leave their room, leave their home and may even drive a car.
GUPTA: The REM cycle is when we do our most active dreaming. In healthy REM sleep, the body is paralyzed even as the mind races. But with RBD, the safeguard of paralysis is gone. And patients act out their often violent dreams.
CAL POPE (ph), SUFFERS FROM RBD: Well, kicking, fighting, cussing, whatever.
GUPTA: Cal Pope (ph) was one of Dr. Schenck's first patients, more than 15 years ago. By the time we caught up with him, he and his wife, Rowena, were getting ready to celebrate their 60th wedding anniversary.
ROWENA POPE (ph), HUSBAND SUFFERS FROM RBD: Oh, they said it would never last.
GUPTA: They came to the clinic after suffering nine years of Cal's (ph) violent nightmares. Rowena (ph) says she'll never forget the first one. R. POPE: He was dreaming that he was trying to kick a neighbor out of the bed, and what he was doing was kicking me just with all of his power. He was just pummeling me with his feet, and literally kicked me out of bed.
GUPTA: In the sleep center, patients go to bed wired with more than 20 electrodes. The machinery of sleep and dreams plays out, as technicians watch from a separate room.
SCHENCK: Now we can enter our mission control.
GUPTA: Watching the patients, it's hard to believe they're really unconscious. But Schenck says sleep is impossible to fake.
SCHENCK: That indicates the deepest stage of sleep.
GUPTA: This is a sleep chart of another patient with RBD during a REM cycle, probably during a dream. The top two lines track the normal rapid eye movements. The black line here is a sensor on a chin muscle. That's a good marker since in healthy people it would be totally paralyzed, the line would be straight. On this chart, it does something else entirely. That indicates a parasomnia.
SCHENCK: Cal's (ph) was quite severe, as severe almost as the most severe case that we have seen.
R. POPE: You want to get some water to make coffee.
GUPTA: And yet Cal Pope's (ph) case was in some ways typical, in that the patient wasn't really aware of what was happening.
C. POPE (ph): Maybe once a week, but it wouldn't be that bad.
R. POPE: Well, this happened every time he went to sleep, and more than once a night.
GUPTA: Desperate, the loving couple was forced into separate beds.
R. POPE: It was a lonely thing to do. It's like a death. It's like a separation.
GUPTA: Fortunately, it turned out there is a very effective treatment. The National Sleep Foundation says a drug called clonazepam stifles symptoms in nine of 10 patients if taken in the proper dosage every night.
Cal Pope (ph) showed us a hole he kicked in the wall on the night when he missed a single dose.
Ninety percent of patients are men, mostly older men. No one knows exactly what causes RBD. But Schenck has found one major clue. A disturbing discovery. That a majority of patients develop Parkinson's disease within 10 or 15 years. It may be that RBD is caused by the disintegration of neurons controlling movement, the same disintegration that's responsible for Parkinson's. Pope is lucky. It's been 27 years since his first escapade, as he calls it. And he shows no signs of Parkinson's. He can enjoy his seven children, 16 grandchildren and 14 great-grandkids. And at age 81, he can finally get a good night's sleep.
ANNOUNCER: Coming up, our sleep-deprived working mom puts her sleep assessment to the test. Will it help her? And can it help you?
And do we dream for a reason? Dr. Sanjay Gupta gets wired to find out.
ANNOUNCER: Once again, "Sleep," with Dr. Sanjay Gupta.
GUPTA: When we sleep, our bodies may be still, but our minds are very active. We dream off and on through the night. Our dreams are filled with images, with stories, sometimes even full-length features. Where do they come from? And what, if anything, do they mean?
What's in a dream? A memory, a movie, a solution, a picture? We all dream. We just don't all remember. And some of us can't forget.
LAURIE ANDERSON, PERFORMANCE ARTIST: I tend to have these dreams that were really super vivid, long. And I -- sort of an epic, and so I decided to draw them -- completely out of self-defense so that I wouldn't just have a kind of big mental meltdown, living in my own private theater.
And I hung up the phone.
GUPTA: Like many creative people, Performance Artist Laurie Anderson began using her dreams as material.
Recently holding an exhibition at a New York City gallery of her nocturnal imagery. From her drawings, came a short film, featuring a corpse, a fox, her brother with a camera and herself observing.
ANDERSON: If I had to really say what my dreams were about, I would say I'm thinking about those things that are going through my mind during the day in a slightly different way, looking at them in a different way. And sometimes obsessing or sometimes attaching them to emotions that I didn't realize I had.
GUPTA: Anderson is among renowned artists and scientists like Salvador Dali, Paul McCartney, August Kegulay (ph), whose dream-based works have produced famous paintings, hit songs and molecular discoveries.
So what is going on as we dream?
Sigmund Freud interpreted dreams as wish fulfillment. But by the late 1970s, modern science had tossed Freud's theories aside.
ROBERT STICKGOLD, BETH ISRAEL DEACONESS MEDICAL CENTER: The dreaming process is a process of memory integration, where different memories are brought together; and how well they fit or don't fit, is examined by the brain. GUPTA (on camera): Bob Stickgold is a biochemist and a dream researcher at Harvard's Beth Israel Deaconess Medical Center.
(Voice-over): Dreams, he says, are efforts to fit memories together. And while they may be influenced by personality, he believes they're generated randomly in the brain stem.
STICKGOLD: This activation comes up and it produces an activation that's sort of diffuse, so it doesn't produce an image of your mother. It doesn't produce an image of a baseball game. It's more like it produces a flicker in your peripheral vision.
GUPTA: But Neuropsychoanalyst and Dream Researcher Mark Solms believes differently.
MARK SOLMS, UNIVERSITY COLLEGE LONDON: I think that we owe Freud something of a scientific apology. It's not something that's just like a whole -- it's like a drunkard at a piano keyboard, sort of randomly banging on the keys, and then all of this random sort of noise occurs.
GUPTA: Solms says the latest evidence suggests dreams and motivation are linked. A lot like Freud's belief a century ago.
SOLMS: The brain mechanisms that produce dreams are highly connected with motivated action. The mechanisms that get us up and get us going, get us doing things that drive us to communicate, to interact, to live interactively in our world, are the same mechanisms that generate our dreams.
GUPTA: Since the 1950s, researchers believe sleep and dreams began in the same place, in the back of the brain. After studying brain damage patients, Solms is now convinced that dreams also come from an area in the forebrain, an area connected with desire, hallucination and motivation.
STICKGOLD: While Mark's theories are basically strong derivatives from Freudian's theory, and I disagree with them.
GUPTA: The two researchers do agree that if you wake someone up during the REM stage of sleep, you're likely to get a vivid dream report. But about 25 percent of our dreams occur in non-REM sleep, just after you drift off.
And it's in this, hypnogotic stage of sleep where Stickgold's current study is attempting to determine how the brain forms dreams...
UNIDENTIFIED MALE: Start the clock.
GUPTA: ... with the help of a videogame. I spend three 45- minute sessions on this virtual alpine skier, navigating through winding courses and obstacles.
I think I'm done. That night, they wire me up with electrodes around my head, including a specially wired bandanna to measure my brain waves during various stages of sleep.
Each time I doze off into the first stages of sleep, a computer wakes me up and asks me to give dream reports.
COMPUTER: Please report now.
GUPTA: I was thinking about some tunnels and they were sort of dimly-lit. And I was going through them. And then there were some fields that looked like wheat, and I was sort of flying over the fields.
Eventually I'm allowed to sleep without interruption.
And in the morning we go over the results.
And then there were some fields that looked like wheat, and I was sort of flying over the fields. And they looked like they had been cut into certain patterns. That's about it.
STICKGOLD: So here's one of those places where you see all the problems of dreams, because I can turn to you and say, Sanjay, wheat fields? What we didn't see with you that we often see with people who have been playing the games, is we'll get that same sort of repetition, but they'll be actually describing the game.
GUPTA: In fact, Stickgold says 85 percent of the study subjects report at least once that they were skiing.
STICKGOLD: The whole point of this research is to help us figure out what the brain uses as its rules for constructing dreams.
GUPTA: While the rules are still being studied, the interpretation of dreams is still entirely up to you.
ANDERSON: For me, it's fun to take something very literally like, well, are you influenced by your dreams? Yes. Well, what are your dreams? And than really try to see what they are.
ANNOUNCER: When "Sleep" continues, dream interpretation.
LAURI LOEWENBERG, PROFESSIONAL DREAM ANALYST: So everything in your dream, no matter how bizarre, how strange or even how disturbing the object or the character is in your dream, it's placed there for a reason.
JOLIE: It's still Sunday night. It's now about 4:00 a.m.
ANNOUNCER: And later, can a few simple changes in a routine help a stressed out mom sleep better?
ANNOUNCER: We now return to "Sleep," with Dr. Sanjay Gupta.
UNIDENTIFIED FEMALE: Hello, is this Carrie?
UNIDENTIFIED FEMALE: Carrie, go ahead with your dream for Lauri.
CARRIE: OK, I have weird dreams that can I fly. I'll be in a hallway or something, like as if I'm back in high school and if I raise my arms to my side, I can fly over the clouds and stuff.
LAURI LOEWENBERG, PROFESSIONAL DREAM ANALYST: When you get flying dreams, it means you've accomplished something or mastered some sort of skill or you're feeling really good about yourself and about your life.
LOEWENBERG: This dream is reassuring you, kind of patting you on the back and letting you know you've got the ability to rise above, to reach those high goals you've set for yourself.
CARRIE: Well, that's cool.
GUPTA: Professional Dream Analyst Lauri Loewenberg is in high demand these days, making appearances on radio and television programs across the country.
UNIDENTIFIED MALE: I have repetitive dreams about plane crashes. I've had these dreams for many years. What do they mean? This comes from Celine, here in Nashville.
LOEWENBERG: Plane crash dreams almost always are going to point to your career. Because like a plane, you want your career to take off, soar to new heights, keep you on the up and up.
GUPTA: Loewenberg has hit a nerve in the American psyche, by giving meaning to her nocturnal allusions.
LOEWENBERG: Well, everything in your dream, no matter how bizarre, how strange or even how disturbing the object or the character is in your dream, it's placed there for a reason. It's there to tell you something about your life and about your behavior right now.
GUPTA: Tell us something, but what? How do we explain certain dreams? Like one about death?
LOEWENBERG: Many people dream of their own death, of a family member's death, and it's not showing you the future. Death is symbolic, dreams are symbolic. And so death in a dream is all about the end of something within you or the end of something in your life.
GUPTA: Loewenberg has lots of company in the dream interpretation business. There are literally dozens of books that attempt to decipher our dreams. But they don't always agree. For instance, one book claims that teeth falling out signifies the loss of power. Another claims it's a sign of gossip. A third, about failure.
LOEWENBERG: This is why you can only call dream analysis, interpretation because there are variations in everybody. But there are what we call archetypes that pretty much fit the bill for most everybody across the board.
UNIDENTIFIED FEMALE: When the dream temple was in full...
GUPTA: Author and Psychologist Patricia Garfield has spent most of her career studying dreamers and dream cultures around globe. She says that people who may be worlds apart in their waking life, share a common culture while sleeping.
PATRICIA GARFIELD, AUTHOR AND PSYCHOLOGIST: It's both universal and particular in the sense that everyone has dreams about being chased, for instance. It is the most common negative dream theme around the world of any age, bar none.
Little kids dream more often about wild animals after them. Adults dream more often about wild people after them.
GUPTA: Garfield says it's the particulars that vary from culture to culture.
GARFIELD: I did a study of children in India, and there were -- in their dreams, many vultures were attacking the dreamer, compared to American kids who had more super heroes and no vultures at all. But if they had seen the movie "Jaws," there were many shark dreams.
GUPTA: With work, she believes you can confront your fears in your dreams.
GARFIELD: You can actually prepare yourself for dreaming by saying, look, the next time that so and so is after me in that dream, I'm not going to run. I'm not going to hide. I'm going to turn around and face it.
GUPTA: Garfield has kept a personal dream journal for more than 50 years.
GARFIELD: It's taught me incredible amounts about myself. It's sort of like having two or three encyclopedia sets on you.
You can begin to cope with your fears and work on your hopes right now. Your help is as close as your pillow.
ANNOUNCER: Coming up, tips and techniques to get a better night's sleep.
GUPTA (on camera): It's been a few weeks since you and I last sat down. You've had a sleep assessment since then. How you sleeping?
JOLIE: Actually a lot better.
ANNOUNCER: Once again, "Sleep" with Dr. Sanjay Gupta. UNIDENTIFIED FEMALE CHILD: Mommy, will you help me?
GUPTA: Jolie Thainberg (ph), a working mother of two, has insomnia.
UNIDENTIFIED FEMALE CHILD: So I (inaudible) anything.
UNIDENTIFIED MALE CHILD: I pick one.
JOLIE: That's okay.
GUPTA: Between her children, the work, the shopping and preparing meals, she finds time to exercise, even dance.
All this and still, Jolie can't get a good night's sleep. She kept a video sleep diary for us.
JOLIE: It's Sunday night and it's about -- I think about 1:30. Feeling a little anxious, I'm not sure why. Now I'm trying to settle down a little bit, maybe write a few things down and see if I can't get back to sleep.
GUPTA: Write down worries and concerns on note cards before going to bed. That's one of the recommendations Jolie received during a sleep assessment with Psychologist Russell Rosenberg.
ROSENBERG: So you don't have that in the middle of the night, oh, my gosh I forgot to do something.
GUPTA: He also says Jolie should make a list at night of all she has to do in the next two days.
JOLIE: Then I don't think about them as much.
GUPTA: Rosenberg also says Jolie should do more invigorating workouts like weightlifting earlier in the day, but continue more relaxing exercises like stretching at night.
At home, Jolie is already avoiding the stimulations that keep many people awake. She avoids caffeine later in the day. There's no TV or computer in the bedroom, no ringing cell phones or buzzing Blackberries to disrupt that peaceful night's sleep. Her thermostat is set for good sleeping, between 66 and 70 degrees.
Rosenberg adds another twist. When you wake up in the middle of the night and can't get back to sleep, don't stay in bed worrying. Get up until you feel sleepy. Then go back to bed.
JOLIE: I've done that a couple of times, but it's been tough.
ROSENBERG: Get a good CD that you like, to listen to music or a book on tape.
GUPTA: The idea, to make the bed a place for sleep. That's something the U.S. Olympic Training Center embraced when it took part in a promotion to renovate athletes' rooms. Bigger beds, neutral wall colors. Nothing bold or bright. And blackout curtains to block out light.
Olympic Speed skater Apolo Ohno says to win a gold, sleep is as important as training.
APOLO OHNO, OLYMPIC SPEED SKATER: It doesn't matter how hard I'm training, if I'm not getting enough sleep, it's just wasted, you know, because my body is just not regenerating. The cells aren't regenerating, my muscles aren't recovering. So my next workout is just going to become sluggish.
GUPTA: For Jolie, those changes are already making a difference.
ROSENBERG: How have things been going since you were here last?
JOLIE: Pretty good. I did most of the things that you recommended. Doing the relaxation before I go to bed has really helped a lot. GUPTA: Jolie's sessions with Rosenberg, called cognitive behavior therapy, is designed to identify and change behaviors that keep you awake.
For Jolie, the subtle adjustments she's made in her routine could change her life.
GUPTA (on camera): It's been a few weeks since you and I last sat down. You've had a sleep assessment since then. How are you sleeping?
JOLIE: Actually, a lot better. I'm still waking up some at night, but I'm going right back to sleep. I'm not having these long extended awake periods.
GUPTA: How has your life changed?
JOLIE: I feel a lot better. It's easier to get through a day at work if I'm not feeling completely exhausted and out of sorts. I think it's easier to be around my kids when I'm not coming home from work and feeling like I need to go lay down or something. It's incredible.
GUPTA: Can you put more hours in a day for me, please? Do you think you can do that next?
JOLIE: That's what I need. That's what I would love to have, yes, a few more hours just to get everything done. Absolutely, that would be great.
GUPTA: You know the old phrase, "sleep on it?" Well, researchers now believe that sleeping on a problem, really can offer us insights.
I'm Dr. Sanjay Gupta. Thanks for watching. TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com