We’re all aware of comas, but most of us probably just look at them as a really deep sleep. But what actually happens to our bodies when they’re in that unresponsive state? And can we dream when we’re like that?
Read on to find out, plus check out page 9 to learn more about comas and dreams.
What is a coma?
This is really just a deep state of unconsciousness. | KatarzynaBialasiewicz/iStock/Getty Images
In its easiest terms, a coma is a state of deep unconsciousness. It occurs when a person can’t use any of their senses, such as responding to voices or being touched. The person is still alive, but their brain is functioning with very limited activity. Comas can be caused by several things, but brain injuries and medically-induced comas are the most common.
Next: In order to be in a coma, you can’t have any of this.
Your brain must show absolutely no awareness or cognition
Your brain literally shuts off. | Ridofranz/iStock/Getty Images
In order to be recognized as “in a coma” your brain can’t be showing any sign of consciousness. Cognition, which is the process of acquiring understanding through thought, experience, or senses, also can’t be present. If a person shows any form of noticeable cognition, they’re not technically comatose.
Next: But what exactly causes a coma?
Comas are caused by an ‘interference’ between the brain stem and cerebrum
The cause is serous and terrifying. | Ridofranz/iStock/Getty Images
The brain stem is the center “trunk” of the brain; it continues downward from the base of the head to the spinal cord. It connects the spinal cord to the cerebrum, which is the largest part of the brain. The cerebrum is responsible for reasoning, sensory integration, and memory.
Any interference between the brain stem and cerebrum would cause someone to enter into a coma. But what does it take for that to happen?
Next: Here’s what usually needs to happen for your brain to go comatose.
Trauma and stroke are the typical causes for a brain’s shutdown
This may be what causes the brain to shut off. | KenTannenbaum/iStock/Getty Images
There is a system of neural pathways in our brains, known as the reticular activating system (RAS), that controls our brain signals and consciousness. If the cells in the RAS region lose blood supply or oxygen, such as during a stroke, they shut down. Or, if trauma causes brain swelling that presses down on the brain stem, the RAS can shut down. Both of these situations would put a person into a coma.
Next: What happens to the rest of our body when the brain is in a coma?
Most of the time, the rest of the body is unaffected by a coma
The rest of your body may remain strong. | Jacoblund/iStock/Getty Images
You might wonder why people can still have a heartbeat and breathe normally during a coma. This is because, according to Bustle, the brain (primarily, the sensory part) is usually the only part of the body that is affected. So other parts of the body, like the autonomic nervous system that controls heart rate and breathing, remain unaffected. In some cases, people do need to be supplied a breathing tube, but people can often breathe and even digest food on their own.
Next: But this type of coma is different than the rest.
Those in a ‘vegetative state’ have different behaviors than other coma patients
This is a sad state to be in. | Pablo_K/iStock/Getty Images
When coma patients are labeled as in a “vegetative state” it means they’re technically conscious but can’t perform any conscious duties, such as speak or respond. They might open their eyes, yawn, or move their limbs, but they won’t actually be responsive to any kind of stimuli. Family members often wrongly assume their loved one will fully recover once they see any kind of movement, but in a vegetative state, that is usually not the case.
Next: A vegetative state is only one type of coma. Here are the others.
There are several variations of comas
Your doctor will know the types of comas you could experience. | Ridofranz/iStock/Getty Images
Comas are not a “one size fits all” concept. Some comas, such as the vegetative coma where a person has been unresponsive for a long time, can last for years. Other comas caused by a traumatic brain injury might only last a few days. And medically induced comas are comas that a person is intentionally placed under. This usually happens when doctors want to limit brain activity in order to allow the brain to heal. Doctors know exactly how long the coma will last and can wake the patient up if it’s absolutely necessary.
Next: Medically induced comas feel very similar to this.
Medically induced comas are very similar to being placed under anesthesia
This is what happens when your coma is induced. | Martin Barraud/iStock/Getty Images
A medically-induced coma puts someone in a different state than a naturally induced coma would. Induced comas are actually very similar to anesthesia. It ends when the drugs being supplied to the patient wear off, just like anesthesia. They are more predictable than natural comas.
Next: Why do people say they recall dreams during their coma?
You can’t actually dream when you’re in a coma
You may wake with no memory of what happened. | Monkeybusinessimages/iStock/Getty Images
People often wonder: Can you dream when you’re in a coma? The scientific answer is no. Scientific research has found that during a coma, there is no evidence of any sort of circadian cycle. This means people never enter the part of their “sleep” where dreams occur. Business Insider reported that it’s highly unlikely anyone would be able to dream while deep in a coma. However, when people begin the process of waking up from a coma, they might be able to dream something. (But it’s important to note that this information refers to natural comas, not medically-induced comas.)
Next: If you’ve ever heard someone say that had a terrible nightmare during a coma, they might not be lying.
People have recalled having ‘horrible nightmares,’ while waking up from comas
This is a horrible way to exit a coma. | Lighthaunte/iStock/Getty Images
Sometimes, people wake up and recall having troubling nightmares in their coma. But experts told Business Insider that it’s likely these people are remembering something that never actually happened. In fact, they’re probably having vivid hallucinations rather than actual dreams. But why do people hallucinate during comas?
Next: Hallucinations are a direct result of this.
Doctors say the ‘nightmares’ likely result from the brain trying to figure out the senses and sounds around it
Your brain may need time to adjust. | Megaflopp/iStock/Getty Images
When you’re in a coma, your brain is trying its best to make sense of what’s around you, but it’s malfunctioning. Doctors blamed the “nightmares” on people’s brains trying to recognize different sounds and senses going on around them while they’re comatose. The brain works in ways that we haven’t been able to fully understand, and the hallucinations could be the brain’s way of doing its best to figure out the outside world that we can barely feel when we’re unconscious.
Next: What does the word ‘coma’ mean?
The word coma literally means ‘deep sleep’
This is the meaning behind the word. | Ridofranz/iStock/Getty Images
According to Bustle, the word “coma” is derived from the Greek word koma, meaning “deep sleep,” which first appeared in the 17th century. At the time, hardly anything was understood about comas. As a result, doctors often practiced harsh treatment options, such as letting the brain bleed, laxatives, and emptying the stomach.
Next: Here’s how long comas usually last.
Comas normally only last between 2 and 4 weeks
They may seem short to your doctor, but for family this time period can feel like ages. | Jacoblund/iStock/Getty Images
It’s difficult to initially tell how long a coma will last. Most usually won’t last more than two to four weeks. But those in a vegetative state could be in a coma for years. People who spend a long amount of time in a coma are likely to wake up with muscular problems from not using their muscles for so long. And while many people do recover, there can be some type of emotional or physical complication as a result of the coma.
Next: Here’s how doctors determine one’s likelihood of waking up from a coma.
The likelihood of coming out of a coma can usually be determined within the first 24 hours
Talking to the medical staff will help clear any additional questions. | Ridofranz/iStock/Getty Images
Patients are judged based on a sliding scale, known as the Glasgow Coma Scale, in their first 24 hours of being comatose. The scale runs from 3 (the lowest possible coma score) to 15 (the score of a normally functioning person). The lower the scale in that first 24 hours, the less likely they are of recovering.
For reference, about 87% of those who are ranked a “3” in the first 24 hours never recover. Those who rank between 11 and 15 in those first 24 hours have an 87% chance of recovering.
Next: This age group is the most likely to recover after a coma.
The younger you are, the better the chances of fully recovering
Older people may have a harder time recovering. | Wavebreakmedia/iStock/Getty Images
According to BrainInjury.com, if you’re over 40 years old, you have a lower chance of a good recovery than a younger person does. A study done on 140 patients who were in a vegetative state for one month found that those aged 20 and under had a 19% independence rate after one year. Those between 20 and 40 were only at 9%, and those over 40 were at 0%.
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