Your Sleep Questions Answered: Part 2

I wanted to get back to your sleep questions.  Please see my disclaimer on last blog.  These questions and answers are meant to be educational and not to be used to replace your own physician.

Question:

1. REM Behavior disorder (RBD) sounds interesting.  What if the person, in this case a nine year old child is somewhat awake or walking about and talking, is that related to RBD?
2. I'm 29 years old and married.  I have always been a deep sleeper and am more of a night owl.   My spouse on the other hand tends to be more of a lark.  On occasion, especially when I am woken up in the morning I have conversations which I don't remember, can be verbally abusive, have physically lashed out at people, and have had participated in sex with my husband and don't remember it.  Is there a name for this or am I just a good sleeper with a nasty temper?

Answer:

Parasomnias are unusual complex behaviors arising from the sleep period.  Sleepwalking or somnambulism, sleep talking, confusional arousals (this can be best defined as waking up being "drunk" with sleep), sleep terrors, and "sexsomnia" are parasomnias that occur during non-REM sleep, particularly during very deep sleep, called slow wave or delta sleep.  Another parasomnia, RBD occurs out of REM sleep. 

RBD is a sleep disorder that allows the sufferer to act out their dreams without the normal "paralysis" that occurs while we are in the REM stage of sleep.  While RBD can occur at any age, it is most common in middle age, particularly in males.   (For more info on RBD, please refer to my recent blog devoted to REM-Behavior Disorder.)  It is more likely that the symptoms described in question 1 are related to a non-REM parasomnia.

Non-REM parasomnias, or disorders of arousal (DOA) occur more commonly in children, simply because children tend to have more slow wave sleep compared to adults.  However, these disorders may continue, or even start during adulthood.   Recent population surveys seem to show that DOA occur more often in adults than previously thought, being reported by 3-4% of all adults.  Some of the actions described in question 2 may be the result of disorders of arousal. 

In both of these cases, these issues should be raised with a doctor.  One very important note is that untreated obstructive sleep apnea can cause symptoms almost indistinguishable from DOA.  There have been some cases in recent memory, where these issues can have legal implications- check out these links below.

http://en.wikipedia.org/wiki/R._v._Parks

http://www.cnn.com/US/9905/25/sleepwalk.defense/

http://www.mywire.com/pubs/LegalAffairs/2005/05/01/838479

Question:

Recently, I noticed that at the point where my body is falling into sleep I sense that I am losing control over my muscles, sometimes it feels like my muscles are twitching, and I take breaths and try to keep consciousness.  This all occurs when I am in a half-conscious state just before I go into sleep mode.  I feel like I might die if I go to sleep.  What is this all about?