REM parasomnias
REM sleep parasomnias occur when the dream content or muscle paralysis of REM sleep intrude into wakefulness, as in hypnagogic hallucinations and sleep paralysis. Conversely, when the muscle paralysis is absent during REM sleep, dream enactment behavior such as kicking, screaming and punching may be seen as in REM behavior disorder.
Dreams are stories created by our mind while we sleep and our body rests. People with RBD act out their dreams by punching, kicking, screaming and even leaping out of bed. These dreams are vivid, filled with action and may even become violent. Dreams of being attacked by animals, chased by an attacker or being mutilated have been reported. Not all episodes are this violent. Initial spells are usually nonviolent and this condition may remain undetected for years till they become violent and result in injury.
RBD is frequently an early manifestation of a neurodegenerative disorder like Parkinson's disease. It is occasionally precipitated by medications (antidepressants, antipsychotics).
Sometimes underlying sleep apnea can induce violent dreams associated with movements similar to RBD, and is known as pseudo-RBD. Evaluation by a sleep specialist is suggested.
If you see, hear, feel, smell or taste something and are not sure if you are awake or dreaming, you may be having SH, which occur while falling asleep or waking up. While SH occur when are awake. You may see people, hear door knobs open and footsteps or feel bugs crawl on your body.
SH may be complex and associated with sleep paralysis and fear. Occasionally, people have jumped out of bed and injured themselves during these spells.
SH is the intrusion of the dream content of REM sleep into wakefulness.
When should you see a doctor? See below
Sleep paralysis (SP)
If you find yourself unable to move or speak for a few seconds to minutes, while falling asleep or waking up, you may be having SP. Seeing, hearing and feeling things that are not there (sleep hallucinations) may also be present. People have reported a pressure sensation on their chest with a sense of being smothered (as if they will die), or may feel a spinning and floating sensation and have difficulty speaking during these spells.
SP is an intrusion of the muscle paralysis of REM sleep into wakefulness, and is likely to be seen for the first time during adolescence and early 20s.
If daytime sleepiness, sleep hallucinations and cataplexy are also present, SP may be a symptom of Narcolepsy. Recurrent isolated SP may also occur without other symptoms.
SH and SP may be triggered by stress, sleep deprivation, jet lag and panic. While these spells are not life-threatening, they may cause fear and anxiety. If these spells occur occasionally and are not troublesome, following good sleep habits (link to how to get a better night of sleep) should be enough to prevent them. Evaluation by a sleep specialist should be considered:
1) if you have significant daytime sleepiness
2) spells are occurring frequently and disturbing you and your family members.
Nearly 80% of people have occasional nightmares (bad dreams), and 8% of people may have frequent nightmares known as nightmare or dream anxiety disorder.
ND is associated with a fear of going to sleep and worry about having nightmares. You may also experience fear, anxiety, embarrassment, anger, rage or disgust when you wake up from a nightmare. If this occurs frequently, your sleep will be disturbed leading to daytime tiredness.
Dreams and nightmares occur during REM sleep (20-25% of sleep period), which occurs mostly in the final third of the night. Several nightmares with the same story may be seen intermittently during the same night. They may appear very real and become more disturbing before you wake up. People clearly remember details of their nightmares. Disturbing dreams that do not wake you up are not nightmares.
Nightmares can be associated with previous traumatic events as in PTSD (post-traumatic stress disorder). These dreams usually occur earlier in the night. Medications (used to treat depression, hypertension and Parkinson's disease) can also cause nightmares.
When should I see a Sleep Specialist?
If you or your child/family member are having frequent nightmares, causing distress or sleep disturbance, you should visit a doctor trained in Sleep Medicine.
REM behavior disorder (RBD)
Dreams are stories created by our mind while we sleep and our body rests. People with RBD act out their dreams by punching, kicking, screaming and even leaping out of bed. These dreams are vivid, filled with action and may even become violent. Dreams of being attacked by animals, chased by an attacker or being mutilated have been reported. Not all episodes are this violent. Initial spells are usually nonviolent and this condition may remain undetected for years till they become violent and result in injury.
RBD is frequently an early manifestation of a neurodegenerative disorder like Parkinson’s disease. It is occasionally precipitated by medications (antidepressants, antipsychotics).
Sometimes underlying sleep apnea can induce violent dreams associated with movements similar to RBD, and is known as pseudo-RBD. Evaluation by a sleep specialist is suggested.
Sleep hallucinations (SH)
If you see, hear, feel, smell or taste something and are not sure if you are awake or dreaming, you may be having SH, which occur while falling asleep or waking up. While SH occur when are awake. You may see people, hear door knobs open and footsteps or feel bugs crawl on your body.
SH may be complex and associated with sleep paralysis and fear. Occasionally, people have jumped out of bed and injured themselves during these spells.
SH is the intrusion of the dream content of REM sleep into wakefulness.
When should you see a doctor? See below
Sleep paralysis (SP)
If you find yourself unable to move or speak for a few seconds to minutes, while falling asleep or waking up, you may be having SP. Seeing, hearing and feeling things that are not there (sleep hallucinations) may also be present. People have reported a pressure sensation on their chest with a sense of being smothered (as if they will die), or may feel a spinning and floating sensation and have difficulty speaking during these spells.
SP is an intrusion of the muscle paralysis of REM sleep into wakefulness, and is likely to be seen for the first time during adolescence and early 20s.
If daytime sleepiness, sleep hallucinations and cataplexy are also present, SP may be a symptom of Narcolepsy. Recurrent isolated SP may also occur without other symptoms.
When should you see a doctor for SH and SP?
SH and SP may be triggered by stress, sleep deprivation, jet lag and panic. While these spells are not life-threatening, they may cause fear and anxiety. If these spells occur occasionally and are not troublesome, following good sleep habits (link to how to get a better night of sleep) should be enough to prevent them. Evaluation by a sleep specialist should be considered:
1) if you have significant daytime sleepiness
2) spells are occurring frequently and disturbing you and your family members.
Nightmare disorder (ND)
Nearly 80% of people have occasional nightmares (bad dreams), and 8% of people may have frequent nightmares known as nightmare or dream anxiety disorder.
ND is associated with a fear of going to sleep and worry about having nightmares. You may also experience fear, anxiety, embarrassment, anger, rage or disgust when you wake up from a nightmare. If this occurs frequently, your sleep will be disturbed leading to daytime tiredness.
Dreams and nightmares occur during REM sleep (20-25% of sleep period), which occurs mostly in the final third of the night. Several nightmares with the same story may be seen intermittently during the same night. They may appear very real and become more disturbing before you wake up. People clearly remember details of their nightmares. Disturbing dreams that do not wake you up are not nightmares.
Nightmares can be associated with previous traumatic events as in PTSD (post-traumatic stress disorder). These dreams usually occur earlier in the night. Medications (used to treat depression, hypertension and Parkinson’s disease) can also cause nightmares.
