When fashion commentator and content creator Sufi Motiwala recently broke down on Lock Upp Season 2 while speaking about living with Dream-Reality Confusion Syndrome (DRC), his revelation sparked conversations around a phenomenon that remains largely unfamiliar to many. Recounting how he repeatedly dreamt of being trapped inside the Lock Upp jail and how those dreams felt so real that they brought back memories of his earlier struggles. Sufi highlighted what experts describe as the brain’s inability to consistently distinguish between dream experiences and real-life memories.
“Dream-Reality Confusion occurs when a person finds it difficult to distinguish whether an event actually happened or was only experienced in a dream. Unlike vivid dreams, where people recognise the experience after waking, it leaves lingering uncertainty, affecting memory, emotions, and occasionally day-to-day decision-making,” says Dr Virinchi Sharma, consultant psychiatrist, Apollo Hospitals, Financial District.
From a sleep science perspective, the explanation lies in what happens inside the brain during Rapid Eye Movement (REM) sleep. “When vivid dream content is mistakenly recalled as a waking experience, it is known as Dream-Reality Confusion (DRC). From the standpoint of sleep science, this primarily represents overlap between the brain systems that produce dreams and those that encode memories,” explains Dr V Nagarjuna Maturu, senior consultant, clinical and interventional pulmonology, Yashoda Hospitals, Hitec City.
“The hippocampal and cortical networks involved in memory consolidation are still active during REM sleep, the sleep stage most frequently linked to vivid, narrative dreams. The brain can create intricate, memory-like traces during intense or emotionally charged REM dreams that are later challenging to discern from waking experiences,” he adds.
Dr Virinchi says the overlap between dreams and memories is further complicated when stress or psychological conditions affect the brain’s ability to monitor reality. He notes, “The brain processes memories and dreams using overlapping neural networks. During sleep, emotional experiences can be strongly encoded without clear reality checks. If memory monitoring is affected by stress, poor sleep, or psychological conditions, the brain may mistakenly label dream experiences as real-life memories.”
Sleep disorders can also increase the likelihood of dream-reality confusion. According to Dr Nagarjuna, narcolepsy is among the strongest associations because of disrupted REM regulation. He states, “Narcolepsy may have REM intrusions into wakefulness, including hypnagogic hallucinations and sleep paralysis, making it difficult to distinguish between sleep and wakefulness. These REM phenomena make it more likely that dream imagery will be encoded while only partially conscious.”
He adds that narcolepsy is not the only culprit. “Chronic insomnia, obstructive sleep apnea, and circadian rhythm disorders fragment sleep architecture. These conditions interfere with normal memory consolidation and raise REM pressure. Confusion can also be exacerbated by increased REM intensity during recovery sleep or after sleep deprivation,” highlights Dr Nagarjuna.
Mental health, too, has an important role to play. “Dream-reality confusion is more common in people with anxiety, PTSD, depression, or borderline personality disorder. These conditions often involve emotional distress, disturbed sleep, intrusive thoughts, and altered memory processing, making it harder for the brain to separate dream experiences from actual events,” adds Dr Virinchi.
He further notes, “Chronic stress and trauma disrupt healthy sleep patterns and increase vivid dreaming. Emotional distress also affects memory processing and reality monitoring, making dream-reality confusion more likely.”
Poor sleep habits can make matters worse, warns Dr Nagarjuna. He continues, “Lack of sleep increases REM rebound and hinders frontally mediated source monitoring, which is the cognitive function that distinguishes between real and dreamed memories. Shift work, frequent time-zone travel, and irregular sleep-wake schedules similarly impair memory discrimination.”
For people who experience frequent episodes, both specialists stress the importance of seeking help rather than dismissing it as ‘just vivid dreams.’ “Multiple Sleep Latency Testing (MSLT), overnight polysomnography, a thorough sleep history, actigraphy, and sleep diaries can help determine whether DRC is linked to an underlying sleep disorder,” says Dr Nagarjuna.
Dr Virinchi advises consulting a professional if the episodes become frequent or disruptive. “Professional help is recommended if dream-reality confusion becomes frequent, causes distress, affects work or relationships, or is accompanied by severe anxiety, depression, hallucinations, memory problems, or sleep disturbances,” he concludes.
