- Sleeping with a pet is a deeply personal choice.
- Ground rules should be established to keep both animals and humans safe and happy.
- With the right training, animals can help humans deal with obstructive sleep apnea, parasomnias, narcolepsy, nightmares, and more.
The choice to sleep with a pet is a very personal and individual one. If you’re not sleeping with a pet now but think you may benefit from it, you can test it a few nights and see how it goes for both you and your pet. I recommend to my patients that they test out sleeping with their pets only for a short period of time, no more than a couple of nights, so they don’t condition their pets to sleep with them before they decide whether it’s something that’s right for them.
Also, you will want to come up with a few “rules of the room” for your furry friend. Here are some things to think about:
- Will they sleep under the covers?
- Who wants them in bed? (Animals generally prefer to sleep in packs, so they will snuggle in.)
- Do your pets snore? I have a French Bulldog... need I say more?
- Where on the bed will they sleep?
That’s the topic of this fascinating paper I read recently, which describes how trained service animals, emotional support animals, and family pets may be a therapeutic resource for people with sleep disorders, including obstructive sleep apnea (OSA), narcolepsy, nightmares, and other parasomnias, such as sleepwalking. This excellent paper was written by Dr. Mary Rose from Baylor University, an old friend.
As the paper indicates, pets (both trained animals and family pets) are already being used to help with these kinds of sleep problems. And there are dogs being trained specifically to help owners with sleep issues. This is an under-studied, under-tracked, under-regulated, and under-documented area of sleep therapy. But what we do know is pretty fascinating and promising as an emerging avenue of assistance for people with sleep disorders.
Obstructive sleep apnea
There are documented cases of dogs trained to gently alert CPAP users when their masks slip off during the night, helping people with OSA to improve the consistency and duration of their nightly CPAP use. Optimizing adherence to nightly CPAP use is critical to getting the greatest benefit from this therapy, which is the first-line treatment for OSA.
In the case study this paper highlights, the OSA patient experienced discomfort and claustrophobia when wearing her CPAP mask and frequently removed the mask unconsciously throughout the night. Medication and other treatments were not effective in helping her become comfortable wearing the mask throughout her nightly rest. The patient’s dog was trained to place a paw on her mask when she began to remove it in order to keep it in place without waking the patient from her sleep. The dog was also trained to alert the patient when she had removed the mask.
This same patient with OSA also experienced parasomnias, including nightmares, sleepwalking, and aggression when her roommates attempted to help her return to bed. She suffered injuries, including a fractured leg, during her sleepwalking episodes. Medication and psychological therapy were not effective in alleviating her disruptive and dangerous parasomnias. The patient’s dog was trained to successfully redirect her and block her ability to leave her bedroom when she rose from bed to sleepwalk.
Parasomnias, including sleepwalking, sleep terrors, and REM sleep behavior disorder (which involves sleepers act out physically during dreams), pose a risk for the sleeper, their bed partners and housemates, and co-sleeping pets. As the paper’s author notes, there have been cases where pets have been injured while sleeping with a person experiencing these types of parasomnias. Training animals to support and protect their human companions during disruptive parasomnias, to deliver both physical protection and emotional relief and support, seems to have tremendous potential as a non-pharmaceutical therapy. Formal and specific training here is essential to ensure the safety of both people and animals.
I learned in reading this paper that there are organizations now training narcolepsy service dogs. Narcolepsy is a neurological disorder that impairs the brain’s ability to control sleep-wake cycles. People with narcolepsy often experience highly disrupted, deeply unrefreshing nighttime sleep.
Narcolepsy can also significantly affect daily waking functioning. People with narcolepsy can fall asleep suddenly and uncontrollably while being active—these episodes are often referred to as “sleep attacks.” They also can experience extreme fatigue, nightmares, and emotional stress. These symptoms can create challenges for social and emotional health and functioning, as well as risks for physical injury.
Dogs are trained to identify signs of oncoming sleep attacks and give advance warning to patients, and also are trained to use their bodies to help protect patients from falling and injuring themselves.
Nightmares are a complex sleep phenomenon, often arising from a combination of causes and factors. Persistent or chronic nightmares are closely linked to PTSD and anxiety disorders. Service animals are being trained by various organizations, including by the US Veterans Affairs Medical Centers system, to reduce the impact and harm of PTSD-related nightmares. Animals are trained to wake the dreaming patient and comfort them. There’s a truly unique therapeutic role here that trained animals can play in responding in the moment to interrupt a nightmare at the appropriate time, before the patient becomes too highly agitated, distressed, and aroused.
Service animals can provide comfort, security, and relief from anxiety in the wake of a nightmare. And they can help patients lower their stress and reduce the excessive arousal and vigilance that are associated with PTSD and with nightmares themselves. Fear of sleeping and returning to painful, frightening dreams keeps people from being able to fall asleep, and it makes all kinds of sense that a companion animal could be tremendously helpful in reducing this fear and avoidance of sleep that so often accompanies nightmares.
As an animal lover and sleep clinician, I’m heartened and excited by the prospect of this form of therapy for treating sleep disorders. Our pets enrich our lives in so many ways, including enhancing our sleep experiences under the right and safe conditions for both humans and the pets we love.
Michael J. Breus, Ph.D., DABSM
The Sleep Doctor™