Category Archives: Neurological Disorders

Dream Enactment

There is a sleep disorder characterized by people acting out their dreams known as Rem Behavior Disorder (RBD). Typically, the dreams that are being acted out are violent in nature. Interestingly, these patients are usually very nonviolent. Having this disorder can lead to severe harm, either to the person who has the disorder or to their bed partner. Some patients with RBD have stated that they think they are going “crazy”. Frequently bed partners will have to leave the bedroom for their own safety. Normally, all of our muscles, except the diaphragm and the eye muscles become paralyzed during dream sleep. This prevents us from acting out our dreams. RBD is characterized by a paradoxical ability to move during dream sleep. It is more commonly seen in older men but can occur in either sex at any age. RBD has been associated with alcohol withdrawal, and seen with use of many of the antidepressants now used. 40% of the time it is a predictor of future neurodegenerative diseases such as Parkinson’s disease or Multiple Sclerosis.

RBD can be diagnosed in a sleep lab and is quite treatable. If you or a loved one have symptoms of RBD, i.e., usually negative ones which involve kicking, screaming, punching, grabbing, and even jumping out of bed, it would be wise to seek help.

Restless Legs Syndrome

Restless Legs Syndrome (RLS) is a common disorder. It occurs between 3 and 15% of the population. It is more common in women and increases with age. However, it can occur in children and has been mistaken for “growing pains” in the past. RLS is characterized by an overwhelming desire and need to move one’s extremities, usually the legs, in response to an uncomfortable sensation. The movement brings on temporary relief. It is most prone to occur at night and is a major cause of Insomnia, making it difficult to fall asleep or stay asleep. RLS may be genetic in which 94% of patients have a family history of the disorder. It has also been associated with low iron and low B12 levels as well as chronic renal disease, Parkinson ’s disease, Fibromyalgia, and pregnancy. It has also been cited as a major factor in Depression and ADD (Attention Deficit Disorder). RLS is treatable, so it is important to bring it to the attention of your health care provider. When low levels of iron and B12 are present it may be reversible. In those who do not have such a cause there are several, excellent new medications available. There is no reason to suffer with this affliction anymore.

Pulmonary Disease and Sleep

Most people do not realize the effect of sleep on breathing at night. People with breathing disorders such as COPD (Chronic Obstructive Pulmonary Disease) and Pulmonary Fibrosis, may have borderline normal levels of oxygen during the day, however, with the onset of sleep, everything changes. The amount of air that your lungs normally hold decreases. The resistance to air flowing in and out of the lungs increases and profound drops in oxygen levels in the body may occur. In addition, with sleep, our corrective responses to these changes are significantly blunted. Sleep Apnea is commonly seen in patients with COPD and extraordinarily common in patients with Pulmonary Fibrosis. The coexistence of Sleep Apnea and these diseases is called the “Overlap Syndrome”. It portends a much worse prognosis and increases the severity of the diseases. Therefore, if you or a loved one have a respiratory disorder accompanied by snoring, excessive sleepiness during the day, moodiness or trouble concentrating, you should be seen by your medical provider or by a sleep specialist to check the possibility of having sleep apnea. Treatment for sleep apnea will positively impact the underlying pulmonary disorder.