Why do I dream so much, and is that good or bad?

Dreaming a lot in itself is not a medical problem. You dream every night, even when you do not remember it. Whether your dreams are 'good or bad' depends on what exactly is happening: ordinary dreams are normal, but certain patterns are worth paying attention to.

Nightmares that regularly wake you up are more than just unpleasant. Research in young people shows that frequent nightmares are associated with an increased risk of suicidal thoughts and behaviour, even independent of other sleep problems. If you or someone close to you is experiencing this, take it seriously and discuss it with a doctor.

A rarer but important signal is physically acting out your dreams: hitting, shouting or moving in your sleep. This is an indication of a sleep disorder called REM sleep behaviour disorder. In older adults with this condition, the large majority later develop a neurological disease such as Parkinson's disease. This is not a cause for panic for everyone who dreams vividly, but it is a reason to have it investigated if you or your partner recognise this pattern. Sleepwalking is a related but distinct disorder that occurs in 2 to 4 percent of adults and can also carry a risk of injury.

Do you have a lot of bad dreams and suffer from migraines? People with frequent migraine attacks more often report bad dreams and poorer sleep quality. Cause and effect are not certain here, but the link has been found consistently.

For people who have nightmares as a result of trauma, there are fortunately treatments available. A psychological therapy in which you learn to consciously rewrite your nightmare ('imagery rehearsal therapy') works just as well as the blood pressure medication prazosin, which also targets nightmares. When that psychological approach is combined with cognitive behavioural therapy for sleep problems, the results for sleep quality are the best. There is also research into doxazosin (a similar medication), but its effects are modest and less clear in women.