The amount, idea content, visual imagery and emotional tone of dreaming can be changed by trauma. The lives of patients with PTSD is much more influenced by dreams than “normal” people. PTSD patients have dreams with greater complexity, fright and anxiety, which they recall more vividly than other people, and to which they compulsively return each night, sometimes for months, years, even decades. Patients with TBI experience shortened, fragmented REM sleep and tend to have fewer dreams.
If the Traumatic Brain Injury (TBI) is severe enough it can wipe out the ability to dream by damaging structures or circuits in the medio-basal forebrain, medial temporal lobe, inferior parietal cortex or occipito-temporal cortex. Dreaming is associated with many positive functions including memory consolidation, problem solving and psychological integration of self. Disruption of dreaming by trauma can have a very negative impact on sufferers of TBI, which is often ignored or neglected in patient histories, and in diagnosis and treatment.