Sleepless in America

Healthy rest, problem sleep, and the dreams and nightmares therein.

John Cline, Ph.D., works at the Sleep Disorders Centers of Connecticut and Waterbury Hospital Regional Sleep Lab. He also teaches psychiatry at Yale University. See full bio

June 1, 2008, Sleep

Comments on "Things that Go Bump in the Night"

Things that Go Bump in the Night

By John Cline, Ph.D. on June 1, 2008 in Sleepless in America

Cornelia Collins awoke to an incessant rain of blows. As she fully awakened she saw that her husband was distressed, frightened, and lashing out. Read More

Awake but dreaming

Submitted by Becky on June 2, 2008 - 9:38am.

I often have sensations of being awake but yet still in a dream-like state. I believe I am actually looking at things in my bedroom as they exist, but I am unable to move and have confusing thoughts. It is a petrifying experience. I feel like hours pass as I struggle to get out of bed, my sub-concious shouting at my conscious to wake up. In reality, the problem probably only lasts for a few minutes. My ex-husband used to tell me he would sometimes see me laying with my eyes wide open, but not able to communicate with him, as if I was still sleeping. What is this? Is there anything I can do about it? It seems to happen about twice or three times a month.

Awake but dreaming

Submitted by John Cline on June 2, 2008 - 2:37pm.

Becky,

What you are describing is most consistent with sleep paralysis, another parasomnia. It can occur as a separate parasomnia or may be a symptom of another sleep disorder, narcolepsy. Sleep paralysis is a state dissociation in which aspects of REM stage sleep persist into wakefulness. The body remains paralyzed even as the senses blend dream imagery with external stimuli such as objects in the bedroom. It is known as recurrent isolated sleep paralysis when it occurs in the absence of narcolepsy. Of note, repsiration is usually unaffected, consciousness is maintianed and people have full recall of the event - which can be quite frightening. Episodes last from seconds to minutes. It usually ends spontaneously and can be more quickly terminated with stimulation such as someone touching or speaking to the person or by making intense efforts to move. Episodes are more likely to occur during times of stress, sleep deprivation or if there is an irregular sleep-wake schedule. As this may be a symptom of a different disorder accurate diagnosis is important. Since the episodes are occuring with some frequency and are upsetting, discussion of this with your primary care physician with referral to a sleep specialist if needed is recommended.

John Cline

Thanks

Submitted by Becky on June 3, 2008 - 7:51am.

Thank you for your insight. I will discuss my symptoms with my doctor.

sleep fighting and swearing

Submitted by Anna on June 22, 2008 - 3:17pm.

Hi!
My boyfriend of 4 years (living together for 3 yrs) has had nightmares where he seems to be fighting, but he doesn't wake up. I know that most people are "paralyzed" while sleeping, but my boyfriend starts pounding on the headboard, nightstand, lamp, or pillow...but not me, thankfully. But he has grabbed me and when I wake him he says he was trying to protect me. He talks out loud, usually very clearly, with lots of anger and swearing, not at all the way he is during the day. Sometimes it's happened once a week or once a month. But in the last couple of weeks, it's interfering with my sleep because it's happening 6 or 8 times a night, which I usually don't do because he has the outbursts that last 5-15 seconds and then he falls right back asleep. He doesn't remember any of it, unless I wake him up. He's 53 and overweight, but hasn't had problems with sleep apnea. He snores occassionally, but not too often. It happens right when he falls asleep, right before he's ready to wake up, and all times in between. He doesn't drink alcohol or take medications. I wonder if this is RBD and what can be done about it?
Thanks,
Anna

RBD

Submitted by John Cline on June 23, 2008 - 5:05am.

Anna,

The symptoms you describe could definitely indicate RBD. Being male and over 50 are both risk factors for RBD. Additional rule outs include other parasomnias, such as confusional arousals, and possible nocturnal seizures. Being male, overweight and having a history of snoring all indicate possible obstructive sleep apnea. Sleep apnea is not always evident to the bed partner and could result in symptoms such as you describe. As a first step I would recommend that you take measures to assure your safety such as sleeping in a different bed until a diagnosis is established and treatment effectively implemented. Serious self injury is also a significant concern with RBD. The next step is a consultation with his primary care physician. If he is agreeable, given privacy concerns, it would be highly desirable for you to be present for the consultation so that you could fully describe the behaviors you have observed. Most likely a referral to a sleep specialist will follow with further evaluation including possible polysomnography. Depending on the results of the consultation and if polysomnograpy is ordered, it will probably include video recording so that the sleep specialist can observe any behaviors that occur during the night and may also require an expanded (seizure) montage for the EEG. Given the safety considerations mentioned above and given that RBD (if this is RBD) may be associated with other disorders, consultation with his primary care physician as soon as possible is indicated.

Best,

John

sos

Submitted by frustrated in utah on August 27, 2009 - 11:21am.

hi,
im 26 male and married. i have beem strugling with parasomnia RBD the majority of my life; ive had it since i was a kid and it has impacted my life or the quality of it greatly;as an example 2 weeks after i married my wife i had an episode and tried to smother her with a pillow because i thought she was a giant bee.
ive been through the batery of sleep tests twice only too be told that im a rare case and that there isnt anything else too be done.i also have been diagnosed with a very mild case of sleep apnea and my quality of sleep is so bad that my doctor(a pulmonary specialists)believed i was narcoleptic: tests later showed that i dont meet all the qualifications required to prove a diagnoses.the usual med to aleaviat the Condition (clonazapan)doesn't work and im Conserned that im take a more powerful medicine to help keep me awake/able to focus during the day in provigal and new provigal.
i dont know were to go from here and im very Conserned about parkasons and that i will pass it on two my kids.
any info, guidance or suggestions you can give would be very much appreciated.