Sleep Soundly Every Night, Feel Fantastic Every Day (26 page)

  
Circadian issue, such as shiftwork

  
Sleep apnea

  
Periodic leg movement

  
RLS

  
Pharmaceutical factors (prescription and over-the-counter)

Adult night terrors often respond to treatments to rectify causes of poor quality or quantity of sleep. If testing reveals no cause, and the condition becomes frequent and potentially dangerous, then clonazepam is recommended. The antidepressant paroxetine may also be effective.

Q.
 
I was diagnosed with bipolar disorder a year ago and was put on lithium. I have done very well on it. I live alone and frequently find myself waking up in a room other than my bedroom. Could this be because of the medication? I did not do this before.

A.
 
Yes. Although lithium is an excellent medication, there is an increased incidence of sleepwalking noted in those who take it. I would bring this up with your prescribing health care provider. You may need to be switched to a different medication.

Q.
 
Is it true that sleepwalking is hereditary? My dad was a sleepwalker and now my son is sleepwalking.

A.
 
Yes, many studies show genetics are involved in sleepwalking. We think that heredity may predispose one to sleepwalking, but there are other factors such as lack of sleep or a sleep disorder such as sleep apnea that may precipitate them.

Q.
 
Can people drive in their sleep?

A.
 
Yes they can. In fact it has been reported in Ambien users more often than with any other sleep aid. However, it can occur even in the absence of medications. It is a form of sleepwalking called sleep driving. There is a dissociation of the higher cortical brain centers from the motor centers in the brainstem.

Q.
 
My wife is 33 years old. She sleepwalks several times a week. This has been going on for several years. Isn't this supposed to be a disorder of children? Is there anything I should do?

A.
 
Interestingly, 2% of adults sleepwalk. Less than 1% of these adult sleepwalkers do it frequently. If they do, as in your wife's case, there may be one of several contributing factors. First of all, is she getting enough sleep? Sleep deprivation can be a leading cause of sleepwalking. Is she
under undue stress? This can also contribute to frequent sleepwalking. Finally, does she snore or have to get up in the middle of the night because her legs bother her? Sleep apnea and RLS are major contributors to sleepwalking in adults. With appropriate treatment, in most cases the sleepwalking goes away. I would recommend you discuss this matter with your health care professional.

 

 

Nothing is improbable until it moves into past tense.

—GEORGE ADE

Some bed partners might be thrilled when one initiates fondling and snuggling. If you are the partner on the receiving end, however, you could find it disconcerting when you realize your partner is asleep. Sex while sleeping? Is it possible?

Lew, aged 52, fondled and kissed his wife Kris, and then attempted intercourse … all in his sleep. This sudden behavior after 15 years of marriage was surprising to Kris, and even offensive when she realized he did not remember the episode the next morning. When she woke him during the event, he remembered nothing. Lew had never done this before.

Stories like Lew's describe a sleeping disorder called sleep sex, which causes people to act out sexual behaviors during sleep. Dr. Colin Shapiro named this sleep disorder sexsomnia in 2003, but reports have been rare to date. Two doctors, Schenck and Mahowald, published the outcomes of 31 cases found as a result of their survey of
medical literature. This brought the topic of sleep sex out of the closet and to the attention of both medical doctors as well as the public through popular news articles.

One specific case presented in the book
Case Studies in Sleep Neurology: Common and Uncommon Presentations
shows how different or bizarre these nocturnal events seem if you experience them without further understanding or help. In this case, a married couple of 10 years went to a sleep disorders clinic to discuss the wife's nighttime behavior. The wife reported sleepwalking as a child that almost abated in her teen years, then occurred once or twice in a decade. But after the onset of hepatitis, she had regular episodes of night behaviors that included waking in a restless condition and scolding her husband. These verbal harangues could last as long as an hour. On other occasions, she sleepwalked aimlessly, moved furniture around, and initiated sexual intercourse. Though her daytime personality was that of a respectful, kind woman, and she didn't remember the behaviors, she did believe her husband's accounts of the events.

Can you imagine their sleepless nights? Can you feel the husband's fear grip his gut, knowing any verbal assault could expand into a long, irate monologue on yet another night?

You probably have not heard of sexsomnia because those who experience sleep sex are too embarrassed to discuss odd sex behaviors with a family physician. Yet, sexsomnia events occur nightly, and those who experience them suffer from fear, fatigue, unclear thinking, and low-grade chronic stress. Are you one of these people? Will you get help?

The American Academy of Sleep Medicine officially recognized sexsomnia as a sleep disorder in 2005, and later the International Classification of Sleep Disorders also listed
sleep sex as a disorder. Like sleepwalking and night terrors, sexsomnia is a parasomnia, an undesirable complex behavior associated with or arising from sleep that occurs during non-rapid eye movement (non-REM) sleep. The higher brain centers, such as the frontal lobes and prefrontal cortex, remain in a sleep state but the brain stem, which governs motor movement for basic functions like walking, eating, and sexual activity, remains active. The limbic system—the brain structures for emotion, emotional memory, gratification, and motivation—are wildly alive during sexsomnia episodes.

The official list of sexsomnia behaviors includes:

  
Sexual talk and vocalizations, like moaning or groaning

  
Body movements such as oral sex, thrusting against or penetrating the anus or vagina, and full intercourse