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Posts tagged ‘Sleep Disorder’

REM Behavior Disorder – Do You Physically Act Out Your Dreams?

Have you ever physically acted out your dreams, injured yourself and/or your sleeping partner, leapt out of the bed, had frightening dreams, kicked, punched, or ran in your sleep? If any of these sounds familiar you could be suffering from REM Sleep Behavior Disorder (RBD). People with RBD attempt to act out their dreams, which often times are violent in nature.

We typically can’t act out our dreams. The majority of people dream around 4-6 times per night during the REM (rapid eye movement) stage of sleep, the brain becomes as active during this stage as it is when you’re awake. Although the neurons in the brain during REM sleep are functioning as much as they do when you’re awake, REM sleep is also characterized by temporary muscle paralysis. Most people, even when they are having vivid, active dreams, their bodies are still. But, people with RBD are lacking this muscle paralysis, allowing them to act out the contents of their dreams.

RBD can begin by talking, twitching, and jerking while dreaming up to years before a person begins fully acting out their dreams. The risk of developing RBD increases with age and men are more likely to develop RBD than women. For about 55% of people the cause for RBD is unknown, and the other 45% is linked with alcohol or sedative-hypnotic withdrawal, antidepressants, or serotonin reuptake inhibitors. RBD also often precedes the development of some neurodegenerative diseases like Parkinson’s disease and multisystem atrophy; however, not all people with RBD with develop a neurodegenerative disease. People with RBD should consult with a doctor about their problems and can begin medication if needed to treat RBD. Patients will also be encouraged to make their sleeping environment as safe as possible by removing all sharp and breakable objects and ensuring all windows and doors are locked.

 

Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

“Causes & Diagnosis of REM Behavior Disorder.” National Sleep Foundation. Web. 8 Jan. 2015.

Boeve M.D., Bradley. “REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions.” National Institutes of Health. U.S. National Library of Medicine, 1 Jan. 2011. Web. 8 Jan. 2015.

“REM Sleep Behavior Disorder.” Diseases and Conditions-REM Sleep Behavior Disorder. Mayo Clinic, 11 July 2014. Web. 8 Jan. 2015.

How To Reach Your Peak Performance – Sleep DiagnosticTests

Have you ever wondered if you are getting the right amount of sleep or if you could be doing something to sleep better? Preparing your mind and body for peak performance through better sleep is vital, here are four quick True or False tests to help you understand more about sleep to help you reach your peak. Self-test A reveals your general knowledge of sleep, self-test B tells how likely it is that you are sleep deprived, self-test C examines your current sleep practices, and self-test D probes for problems that could indicate you have a sleep disorder.

Self-Test A: What’s My Sleep IQ?
Please indicate true or false for the following statements:

1. Newborns dream less than adults
2. Men need more sleep than women.
3. Not everyone dreams every night.
4. As you move from early to later adulthood you need less sleep.
5. By playing audiotapes during the night, you can learn while you sleep.
6. Chocolate candies provided on your hotel pillow will help you sleep better.
7. If you have insomnia at night, you should take a long nap during the day.
8. Sleeping pills are very helpful for people who have had insomnia for
months.
9. Arousing a person who is sleepwalking can be very dangerous.
10. A soft mattress is better than a hard one for obtaining good sleep.
11. You are most alert when you first wake up.
12. To promote optimal sleep the best time to exercise is early in the morning.
13. A sound sleeper rarely moves during the night.
14. A boring meeting, heavy meal, or low dose of alcohol can make you sleepy, even if you are not sleep-deprived.
15. Sleep before midnight is better than sleep that begins after midnight.

–This test reveals your general knowledge of sleep, all the above statements are false. How did you score?

Self-Test B: Am I Sleep-Deprived?
Please indicate true or false for the following statements:

1. I need an alarm clock in order to wake up at the appropriate time.
2. It’s a struggle for me to get out of bed in the morning.
3. Weekday mornings I hit the snooze button several times to get more sleep.
4. I feel tired, irritable, and stress-out during the week.
5. I have trouble concentrating and remembering.
6. I feel slow with critical thinking, problem solving, and being creative.
7. I often fall asleep watching TV.
8. I often fall asleep in boring meetings or lectures or in warm rooms.
9. I often fall asleep after heavy meals or after a low dose of alcohol.
10. I often fall asleep while relaxing after dinner.
11. I often fall asleep within five minutes of getting into bed.
12. I often feel drowsy while driving.
13. I often sleep extra hours on weekend mornings.
14. I often need a nap to get through the day.
15. I have dark circles around my eyes.

–If you answered true to 3 or more of the 15 items, you are probably not getting enough sleep.

Self-Test C: How Good Are My Sleep Strategies?
Please indicate true or false for the following statements:

1. I go to bed at different times during the week and on weekends, depending on my schedule and social life.
2. I get up at different times during the week and on weekends, depending on my schedule and social life.
3. My bedroom is warm or often noisy.
4. I never rotate or flip my mattress.
5. I drink alcohol within two hours of bedtime.
6. I have caffeinated coffee, tea, colas, or chocolate after 6 pm.
7. I do not exercise on a regular basis.
8. I smoke.
9. I regularly take over-the-counter or prescription medication to help me sleep.
10. When I cannot fall asleep or remain asleep, I stay in bed and try harder.
11. I often read frightening or troubling books or newspaper articles right before bedtime.
12. I do work or watch the news in bed just before turning out the lights.
13. My bed partner keeps me awake by his/her snoring.
14. My bed partner tosses and turns or kicks/hits me during his/her sleep.
15. I argue with my bed partner in bed.

–If you answered true to one of the above questions, it is likely that at least one aspect of your lifestyle is interfering with your sleep.

Self-Test D: Might I have a Sleep Disorder?
Please indicate true or false or the following statements:

1. I have trouble following asleep.
2. I wake up a number of times during the night.
3. I wake up earlier than I would like and have trouble falling back asleep.
4. I wake up terrified in the middle of the night, but I do not know why.
5. I fall asleep spontaneously during the day in response to high arousal, such as when I hear a funny joke.
6. I have been told that I snore loudly and stop breathing temporarily during sleep.
7. I walk or talk in my sleep.
8. I move excessively in my sleep.
9. I have hurt myself or my bed partner while I was sleeping.
10. I become very confused, afraid, and/or disoriented after sundown.
11. I cannot fall asleep until very late at night or cannot wake up in the morning.
12. I cannot stay awake early in the evening and I wake up before dawn.
13. I feel mild pain or a tingling sensation in my legs just before falling asleep.
14. I physically act out my dreams during the night.
15. I am often too anxious, depressed, or worried to fall asleep.

–If you answered True to any of the above questions, you may have a sleep disorder.

 

Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

Mass, James B., Dr. “Sleep Diagnostic Tests.” Power Sleep. N.p., n.d. Web. 20 Dec. 2013. htdocs/diagnostics.htm>.

REM Sleep Behavior Disorder

When the majority of people enter into REM sleep they begin to dream, and during this time the body becomes paralyzed (sleep paralysis typically happens during this time when your brain becomes alert, but your body doesn’t). People with REM Behavior Disorder (RBD) aren’t always paralyzed during the REM portion of sleep and are able to act out dreams and/or nightmares, often causing harm to themselves and others.

The first time RBD was diagnosed was in 1985 by Dr. Mark Mahowald and Dr. Carlos Schenck at the University of Minnesota. They also found that more than 90% of RBD patients are male and the disorder doesn’t strike until after the age of 50, although kids have been diagnosed as early as the age of 9. They also go on to say that most RBD patients are calm, easy-going, and good-natured when awake, here are a few case histories documented by Drs. Mahowald and Schenck.

  • A 77-year old minister had been behaving violently in his sleep for 20 years, sometimes even injuring his wife.
  • A 60-year old surgeon would jump out of bed during nightmares of being attacked by “criminals, terrorists and monsters.”
  • A 62-year old industrial plant manager who was a war veteran dreamt of being attacked by enemy soldiers and fights back in his sleep, sometimes injuring himself.
  • A 57-year old retired school principal was inadvertently punching and kicking his wife for two years during vivid nightmares of protecting himself and family from aggressive people and snakes.

RBD can easily be confused with a number of parasomnias, this is why patients should be observed over night in a sleep center. A single night of monitoring almost always reveals a lack of muscle paralysis during REM sleep that leads to a diagnoses of RBD. After a diagnosis has been confirmed a treatment can begin, most commonly Clonazepam is prescribed, a benzodiazepine that can reduce or eliminate the disorder about 90% of the time.

Drs. Mahowald and Schenck made a startling discovery while conducting research on RBD; they found that 38% of 29 otherwise healthy patients with RBD went on to develop a parkinsonian disorder. “We don’t know why RBD and PD are linked,” says Dr. Mahowald, “but there is an obvious relationship, as about 40% of individuals who present with RBD without any signs or symptoms of PD will eventually go on to develop PD.” Other research has also shown a connection between RBD and neurodegenerative diseases related to Parkinson’s.

If you have any concerns about RBD you should consult with your doctor or find a sleep specialist in your area.

 

2. Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

The Sleep Foundation—REM Behavior Disorder and Sleep
Web. 01 Jan. 2014. <http://www.sleepfoundation.org/article/sleep-related-problems/rem-behavior-disorder-and-sleep&gt;.

Narcolepsy

Narcolepsy is a sleep disorder that causes overwhelming sleepiness and frequent attacks of sleep throughout the day. Narcolepsy is caused when the brain doesn’t have the ability to regulate a normal sleep-wake cycle; which can lead narcoleptics to fall into REM sleep instead of falling into a light to deep sleep cycle. Narcolepsy seems to affect both genders equally and begins showing signs in adolescence or young adulthood, and is often left undiagnosed.

Narcolepsy is characterized by excessive daytime sleepiness, hypnagogic hallucinations, sleep paralysis, cataplexy, interrupted nocturnal sleep, leg jerks, nightmares and restlessness. Along with excessive sleepiness and sudden onset of sleep the next primary symptom is cataplexy; a momentary loss of muscle tonus typically causing the person to fall to the ground, this usually results from a strong emotion such as surprise, laughter, anger, or elation. Hypnagogic hallucinations and sleep paralysis are also common and can be extremely scary symptoms of narcolepsy, causing feelings of suffocation, being on fire, drowning, or being attacked.

What causes narcolepsy? While there isn’t one definite answer, doctors have found that people suffering from narcolepsy have low levels of Hypocretin and even lower levels were found in people who also suffered from cataplexy. Hypocretin is a chemical that helps regulate sleep-wake cycles and REM sleep, what causes the loss of Hypocretin producing cells in the brain is still unknown. There are studies being conducted on Hypocretin replacement, Hypocretin gene therapy, and stem cell transplant in hopes of finding a more effective treatment or cure.

How to cope with narcolepsy: start by adding several short naps to your daily routine, establish a routine sleep schedule, eat and exercise on a regular schedule, and avoid caffeine, alcohol, and nicotine. If the above behavior treatments don’t work on the narcolepsy then there are different treatment options available. Medications for narcolepsy include stimulants, drugs that stimulate the nervous system to help them stay awake during the day. If stimulants aren’t effective then amphetamines may be prescribed, but can produce side effects such as nervousness, heart palpitations, and can be addictive. Tricyclic antidepressants may be used with people who also suffer with cataplexy; and in more extreme cases Sodium Oxybate can be prescribed, but can include some serious side effects.

Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

“Narcolepsy and Sleep.” Narcolepsy Symptoms, Treatment & Remedies. N.p., n.d. Web. 15 Dec. 2013. <http://www.sleepfoundation.org/article/sleep-related-problems/narcolepsy-and-sleep&gt;.

Mayo Clinic Staff. “Narcolepsy.” Mayo Foundation for Medical Education and Research, 24 Oct. 2012. Web. 16 Dec. 2013. <http://www.mayoclinic.com/health/narcolepsy/DS00345/DSECTION=treatments-and-drugs&gt;.