parasomnia

Learn More about Parasomnia in Shreveport

Parasomnia is a term used to describe undesirable physical events that occur at sleep onset, during sleep or upon arousal from sleep.  Those events reflect nervous system activity breaking through normal sleep. Parasomnias are characterized by physical acts that occur during sleep. Common parasomnias include sleepwalking, sleep talking, sleep terrors, nightmares, and teeth grinding.

SLEEPWALKING

Sleepwalking occurs when you get up from bed and walk around although one is still asleep. It may also be associated with other complex actions. In some instances this is associated with confusion and fear.  In some instances, especially when confronted hostile and violent behavior may occur.


Sleep driving, sleep eating, indecent exposure and sexual behavior may occur in some instances.  Sleepwalking most often occurs in the first third of the night’s sleep in relation to slow wave sleep.


Sleepwalking may be a benign part of childhood that most children outgrow.  If however, the sleep walking behavior poses any danger to the person or others, then it needs to be evaluated and treated.


There is a strong familial component to sleep walking. Chances of having sleep walking can double if a parent had any sleepwalking either as a child or as an adult.


Tips for Parents


  • Calmly help your child return to bed during a sleepwalking episode.
  • Tie a bell to your child’s doorknob to alert you when the door is opened.
  • If your child sleeps upstairs, install a safety gate at the top of the stairs.
  • Make sure that all windows in the house are locked securely.
  • Install locks out of your child’s reach on all doors that lead out of the house.
  • If episodes occur regularly at the same time of night, briefly wake your child just before that time.

SLEEP TERRORS - NIGHT TERRORS

In a typical episode, you will sit up in bed and pierce the night with a "blood-curdling" scream or shout. This scream can include kicking and thrashing. You may say or shout things that others are unable to understand. You will also have a look of intense fear with eyes wide open and heart racing. You may also sweat, breathe heavily and be very tense. At times, you may even bolt out of bed and run around the house. This response is more common in adults. It may also lead to violent actions.


Individuals having an episode of sleep terrors will not respond to voices and can be hard to wake up. Once they do wake up, they will be very confused. They may not know where they are or what is going on. Most often, they will not have any memory of what took place. At times, they may recall brief bits of a dream. This dream will likely involve great danger or fright. It can take a long time to comfort the patient once the episode is over.


It most often occurs in the first third of the time that you are asleep. This is during the slow-wave cycle of sleep. Episodes in adults can occur at any time in the sleep cycle. Adults are also more likely to recall a dream that was a part of the event.


Serious and even deadly injury can occur. Attempts to escape from bed or to fight can result in harm to the patient or others. Individuals may be embarrassed by the sleep terrors. This can greatly affect their relationships with others.

It is fairly normal for a child to have sleep terrors. It does not normally need medical treatment. Parents should simply keep a close watch on their child. An adult who continues or begins to have sleep terrors is at a greater risk of injury. In this case, it would be a good idea to seek a doctor’s advice.


Your doctor in Shreveport will likely have you do an overnight sleep study if you are an adult. This is called a polysomnogram. The polysomnogram charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. This shows if there are other disorders, such as sleep apnea, that are causing your sleep problems.

REM BEHAVIOR DISORDER (RBD)

RBD occurs when you act out vivid dreams as you sleep. These dreams are often filled with action. They may even be violent. Episodes tend to get worse over time. Early episodes may involve mild activity. Later episodes can be more violent. RBD is often ignored for years. At some point it is likely to result in an injury. Either the person dreaming or the bed partner may be hurt.


RBD can be confused with sleepwalking and sleep terrors. In these other disorders, the sleeper is usually confused upon waking up. He or she does not become rapidly alert. In contrast, it is normally easy to wake a person with RBD who is acting out a dream. Once awake, he or she is also able to recall clear details of the vivid dream.


The details of this dream match the unusual behavior of an RBD episode. These actions may include any of the following:


  • Shouting
  • Swearing
  • Flailing
  • Grabbing
  • Punching
  • Kicking
  • Jumping
  • Leaping


People with RBD rarely walk, have their eyes open, or leave the room. These are all common signs of sleepwalking. RBD episodes do not involve eating or drinking. They also do not involve sexual activity or going to the bathroom.


RBD episodes occur during rapid-eye-movement (REM) sleep. Normal sleep consists of a series of REM dream episodes. They occur about every 1 ½ to 2 hours each night. This means that an RBD episode tends to first appear at least 1 ½ hours after falling asleep. Episodes may continue to occur until waking up in the morning. Active RBD episodes may appear as many as four times per night. They may also occur as rarely as once per week or per month. RBD does not normally appear during a nap.


An RBD episode often disrupts the sleep of a bed partner. This is how a person with RBD may become aware of the problem. People with RBD are not more aggressive or violent than others when awake. RBD is a medical problem. It is not a psychiatric disorder. People with RBD do not normally have a mental problem.


Who gets it?


RBD most often occurs in men. It can appear at any age. But it most often emerges after men are 50 years old. It is uncommon in women and children. Less than one percent of people have it. It appears more often in the elderly. RBD is also seen more often in people with some neurologic disorders. It occurs at a higher rate in people who have one of the following conditions:


  • Parkinson’s disease (33%)
  • Multiple system atrophy (90%)


People found to have RBD may develop Parkinson’s disease many years later. Those with RBD should watch for symptoms of Parkinson’s such as tremor.


People with RBD are at higher risk for the following sleep disorders:


  • Narcolepsy
  • Periodic limb movement disorder
  • Sleep apnea


RBD can also be related to other factors that increase the intensity of REM sleep. These include the following:


  • Alcohol withdrawal
  • Sleep deprivation
  • Brainstem brain tumors
  • Stroke
  • Use of certain medications


A genetic link for RBD has not yet been identified.


RBD tends to respond to treatment with medications. Clonazepam is often used. However, treatment also requires the following:


  • Bedroom safety precautions
  • Move objects away from the patient’s bedside. This includes night stands, lamps, or other objects that could cause injury.
  • Move the bed away from the window.
  • Place a large object such as a dresser in front of the window.
  • Maintain a normal total sleep time. Sleep deprivation will increase RBD. Monitor for any sleepiness.
  • Avoid certain medications and alcohol. They can cause or increase RBD.
  • Treat any and all other sleep disorders that will disrupt your sleep and increase RBD.
  • Undergo regular monitoring for any neurologic symptoms. This includes tremor or other Parkinson symptoms.