Why does Low Dose Naltrexone (LDN) cause vivid dreams?

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Dr Elizabeth Livengood
Dr Elizabeth Livengood
Living Wellness Medical Center

Why does Low Dose Naltrexone (LDN) cause vivid dreams?

LDN definitely can impact sleep and dreaming for several reasons.

First, let’s remember that dreaming can take place during both rapid – eye- movement, or REM sleep and non-REM sleep, but the most vivid dreams occur during REM sleep. So an increase in vivid dreaming may be an indication that a person is getting deeper and longer sleep during REM, which for most people is a benefit.

Also, REM cycles tend to be longer and deeper in the morning (towards the end of our sleep period). So if you have to set an alarm and interrupt this cycle, you are more likely to remember that fact that you had a vivid dream.
Now, according to the Sleep Foundation, some other factors that increase vivid dreaming include anxiety and sleep deprivation: both of which may be experienced coincidentally by many people who take LDN. Simply because their health issues  brought them to this medication, but they already some underlying anxiety or sleep deprivation.

One study found that participants who were sleep deprived for a period of time, experienced longer periods of REM sleep and increased dream intensity when they were finally able to sleep again. So that may be a good thing for some people.

Finally, the most direct way that LDN can cause vivid dreams is via neurotransmitter modulation. Many studies have shown a correlation between increased serotonin and/or dopamine with increased vividness of dreams.

LDN directly modulates dopamine and our endogenous opioids which in turn help regulate serotonin.  One study in 2013 showed that Intake of SSRIs/SNRIs which are anti-depressants, seem to intensify dreaming, and were experienced in different ways by different people, confirming the individualized responses we see in LDN use.

Another study showed that the frontal cortex is very rich with Serotonin 5-HT2A receptors which influence visual pathways during sleep paralysis, this is when our motor centers shut down during sleep, but our visual pathways are heightened. So increased serotonin can induce visual hallucinations such as vivid dreaming.

And then finally, a meta-analysis in Psychology Today in 2016 found a strong correlation between dream recall and the frontal lobes again, which are the primary projection sites for Dopamine fibers. Conversely, people with frontal lobectomies reported reduced dream recall, possibly due to the reduced number of serotonin and dopamine receptors. In this same meta-analysis, Mark Solms proposed that dopamine fuels the hallucinatory dream content.

So for the same reason that LDN can help alleviate pain and depression via opioid and neurotransmitter regulation, we see an increase in vivid dreams as a response to these revived receptors in the brain as well as increased levels of endorphins, dopamine and serotonin. These references can be found at the end of this article and of course in The LDN Book.

Answered by Dr Elizabeth Livengood

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