Doctor Curmudgeon® Not Always a Dream!
By Diane Batshaw Eisman, M.D. FAAP Doctor Eisman, is in Family Practice in Aventura, Florida with her partner, Dr. Eugene Eisman, an internist/cardiologist
One of the concepts swirling around in my brain since those days of yore in medical school is parasomnia, the medical term for things that happen while we are actually sleeping.
Somnambulism, a form of parasomnia, has piqued my interest for decades. This term for sleepwalking derives from two Latin words, sommus which means sleep and ambulare which refers to walking.
Thinkers as early as Aristotle and Hippocrates have wondered about this phenomenon.
In the third century BC, the philosopher, Diogenes Laertius was believed to be a sleepwalker. He was said to write and even read while he was completely asleep.
And who can forget the nightly wanderings of Lady Macbeth?
For centuries, it was thought that the sleepwalker was merely enacting his dreams.
From Wikipedia, “Sleepwalking, also known as somnambulism or noctambulism, is a phenomenon of combined sleep and wakefulness.[1] It is classified as a sleep disorder belonging to the parasomnia family.[2] It occurs during slow wave sleep stage, in a state of low consciousness, with performance of activities that are usually performed during a state of full consciousness. These activities can be as benign as talking, sitting up in bed, walking to a bathroom, consuming food, and cleaning, or as hazardous as cooking, driving a motor vehicle,[3][4] violent gestures and grabbing at hallucinated objects.
Dr. Nathaniel Watson, who is the co-director of the University of Washington Medicine Sleep Center, said, “These people are stuck in the nether regions between asleep and awake.”
It is still unclear as to what prompts these nocturnal meanderings. We now know that there are triggers, such as alcohol, stress, some medications and going without sleep for a long time. Genetics plays some part in those who sleep walk. Sleep walking does tend to run in families. If a first degree relative is a sleep walker, one’s likelihood of exhibiting somnambulism is increased.
It seems to be more frequent in children; and they usually “grow out of it.”
Some of these people even eat while they are asleep.
It is common to find that a sleepwalker’s eyes are open, although they appear to be “glazed over.”
Non-rem (REM: rapid eye movement) sleep is the first part of sleeping and this is most often when sleepwalking occurs. This phase can last up to about two hours and is the time when one is easy to awaken. This is the dreamless part of sleep.
Sleep walking that happens during REM sleep is frequently due to acting out a dream. It is now classified as REM Behavior Disorder.
Usually, those who walk in their sleep simply return to bed without even knowing that they have been up and about
Most sleepwalking is harmless. With a sleep walker, the best thing to do is to guide that person as gently as possible back to their bed, and to be sure they are safe.
However there are occasions, when REM Behavior Disorder can be the first indication of dementia or Parkinson’s.
Some scientists have postulated an intriguing idea that sleep walking may be left over from an evolutionary process. When our ancestors lived in caves, it could have been quite advantageous to have our motor centers alert to invasions by predators.
Dr. Sigmund Freud gave a lecture in Vienna in 1907 and expressed his thought that sleepwalking was simply a desire for sex.
But, I must respectfully disagree; because there are times when a dream is just a dream and sleepwalking is just sleepwalking and a cigar is just a cigar.
Dr. Curmudgeon suggests “Bitter Medicine”, Dr. Eugene Eisman’s story of his experiences–from the humorous to the intense—as a young army doctor serving in the Vietnam War.
Bitter Medicine by Eugene H. Eisman, M.D. –on Amazon
Doctor Curmudgeon® is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.
SERMO www.sermo.com “talk real world medicine”
[si-contact-form form=’2′]