Billy Joel gets a lot of song ideas in his dreams, and often struggles to remember them when he wakes up. For this song, however, he woke up with the song in his head, but tried NOT to write it. He explained on The Howard Stern Show in 2010: "I thought, Who the hell am I to try to pull off this gospel song, so I took a shower to wash this song away. I sang it in the shower and knew I had to do it." In Joel's dream, he was "walking in his sleep," which inspired that lyric.
Joel has said that the phrase "River of Dreams" is a play on the phrase "Stream of Consciousness."
This is a very spiritual song where Joel, who identifies himself as an atheist, includes some biblical imagery, including the line, "Through the valley of fear," which is a reference to Psalm 23:4 - "Though I walk through the valley of the shadow of death, I will fear no evil." Joel also says that the river is a religious image, as "there's baptizing in a river and you have to cross the river - people are getting dunked in the river and there's rivers of blood."
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