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Sun 29 Jul 2007

REM Sleep Behavior Disorder (RBD)

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RBD Story VI in my book "Paradox Lost: Midnight In The Battleground of Sleep and Dreams"

ALWAYS APOLOGIZING IN THE MORNING

FEELING THE KICK TWO MONTHS LATERS

HAND WASHING IN A BARREL OF MACARONI AND CHEESE

Introduction by Carlos H. Schenck, M.D.

Carol Mather describes the progression of her husband,s RBD beginning with sleep talking and culminating with Gordon becoming ,so terribly strong in his sleep.0/00 The initial laughter over Gordon,s falling from bed while asleep~,we thought it was a natural thing0/00~eventually gave way to grave concern that some nights he might kill himself. He has even had episodes during daytime naps, which is unusual with RBD.

The most dramatic and life-threatening event resulted in a ,hangman,s fracture,0/00 a high cervical fracture at the C2 level. In the ICU after neurosurgical repair of his neck fracture, Gordon proceeded to enact an RBD dream and was fioricet florida hanging over the edge of the bed, while yelling. Neck fracture number two could have occurred right away, in the hospital. (Gordon clearly Fioricet florida : needed an urgent consultation with a sleep medicine expert at that Fioricet migraine : time, but none was available at that hospital.)

It is important to note Carol,s comments about hearing buy fioricet other wives that ,my husband does this, my husband does that0/00 during sleep. Parasomnias are not uncommon and they can be devastating.

If a man with RBD accidentally kills his wife during sleep while enacting a dream, what would the coroner and district attorney officially conclude after their investigation? An innocent man~a profoundly grieving man~might be sent Fioricet florida - to prison. This possibility should serve a potent impetus to broadly inform the general public, and the medical and legal professionals, as to the serious nature and potentially brutal consequences from untreated RBD and other parasomnias.

REM SLEEP STORIES: RBD

,I FELT THAT KICK ON THE ANKLE FOR TWO MONTHS AFTERWARDS0/00~WIFE

WIFE: Oh heavens, we were Fioricet florida : married in 1942.

MD: Forty-six years of marriage, so you,re heading for the gold.

WIFE: He fioricet florida has slept well.

MD: Fioricet florida : When did you start noticing a problem with dangerous sleep?

WIFE: About five or six years ago. He would talk in his sleep. First it was just talk. And then it gradually got to the point where he was shouting. He would scream, just kind of primitive screams. He was usually mad at somebody or calling somebody names. At first it wasn,t all the time, but lately, for the past year, up until the time he broke his neck, it had been almost every night.

PT: All I know is what she tells me.

WIFE: If I would wake him up and tell him he was dreaming, he would turn over, which he would do very politely.

MD: Would you wake him up by talking to him or shaking him?

WIFE: Talking to him. I did not touch him. I did not touch him at all because when we have been in fioricet florida same bed, he has grabbed me fioricet florida I did not want to bring on any other reaction like that. One time we were at a motel and he grabbed me with both arms~he,s so terribly strong in his sleep~and he just Fioricet florida - held on so tight and I had no idea what he thought about doing or anything. All I could do was try to wake him up so that he would let go, which he did. That time he grabbed my arm, it was sore for a couple of days. Last summer when we were visiting our son in Iowa, we were in the same bed and he kicked me on the ankle, the knee, and the hip. By the time he got the fourth kick in, I was out of bed. I felt that kick on the ankle for two months afterwards.

PT: I have noticed every once in a while, I,ll Fioricet florida, wake up with my feet next to hers, all Fioricet migraine, the way over.

WIFE: He kept falling Fioricet migraine, out of bed and he kept telling me, ,I fell out of bed last night.0/00 We kind of laughed about it, and then one morning I woke up and he said he fioricet florida tackled something, fioricet florida person or a dog. He hit his head on the corner of the dresser and got fioricet florida a cut about four inches, on the skull. That,s when I really started to get very worried about this because I was afraid he was going to really injure himselfSum

PT: ,You,ll kill yourself,0/00 she would tell me. Well I said, ,The hell, no way.0/00

MD: So you did not appreciate how serious it was at first?

PT: No, no.

MD: Your wife was more concerned about it than you?

PT: Much more.

WIFE: Fioricet florida : He would make a lot of noise and I had to just keep constant watch because I didn,t want fioricet florida disturbing other people. When he wouldn,t stop this, I would keep waking him up. He was always very nice about it and he would always apologize, and then Fioricet florida : he,d go right back to sleep. If he started talking right away, I would then realize that I hadn,t really woken Fioricet florida - him. And it would go on until I could get him really awake.

WIFE: Sometimes he will do it during his naps. I have seen him be on the recliner and all of a sudden his legs would start moving and then his hands and arms would start moving. His arms would be a little less slow moving, but his legs would be normal. fioricet florida would get his arms up and would move them and put them up beside his head buy fioricet put them down. He,d make rasping movements. Once this week while he was sleeping in the daytime, he was not making any movements with either his hands or feet, and all of a sudden he went BANG! Like that, his arms just shot out, and it scared Fioricet migraine - me half to death.

PT: Fioricet florida : I can remember that. I was going to do something for a guy and dang well he,d shoot me if I did. So I did it and immediately I had fioricet florida gun and I let him have it.

MD: With a gun?

PT: Or whatever it was, I mean. I didn,t realize what fioricet florida I had used.

MD: Why don,t you describe the time when he broke his neck?

WIFE: Well this was a time that I did not wake up. Maybe he wasn,t talking. I don,t know. It,s usually when he,s talking and buy fioricet noise that I wake up.

PT: I remember a little bit, I had to do something. I stood up like this and I did a dive.

MD: You put your hands together as if you were at a swimming pool and you did a dive?

PT: Yeah. I did a dive right into the dresser. I think it knocked me out for 45 minutes. I remember calling Carol at about quarter to two. About 45 min later I called her again and that,s when she got up.

WIFE: buy fioricet When I got in there Fioricet florida, he told me that he had fioricet florida himself when he had hit his head on the dresser. He was just sitting at the foot of the bed. The bed was very messed up. The covers were all over the place and he said his head hurt very badly. I said, ,Shall we go to the emergency room?0/00 And he said, ,Oh, no, I don,t think it,s that bad.0/00 But he said, ,It is numb up here.0/00

PT: It felt different tan what it Fioricet migraine, ordinarily would feel, even after you hit it against something.

WIFE: He said, ,Let,s fioricet florida OEtill morning and see what happens.0/00 At about 7:00 in the morning, he woke me again and said, ,The pain is very bad. I think we ought to go to the hospital.0/00

PT: I was standing there talking to her fioricet florida all of a sudden it would come down and hit me buy fioricet in the ear and I just feel right straight on my butt.

WIFE: After they admitted him to the hospital, during the night they found him hanging over the end of the bed, yelling.

MD: Had you seen any doctor over the previous years about the talking and shouting and sleep violence?

PT: No.

MD: What did you think was causing it?

PT: I kind of laughed at it and thought it was a natural thing.

MD: A natural thing?

PT: Yeah.

MD: Did you talk to anybody your age about whether they had that kind of thing also?

WIFE: Oh yes. I did to find out Fioricet florida, how some of the other husbands are acting. You would be surprised at the people who are out there saying, ,Yes, my husband does Fioricet florida, this, my husband does that.0/00

PT: There seems to be a lot of it around.

MD: That,s important for us to know about.

WIFE: Yes. I,ve heard some of the things that husbands are doing at night. Roger is falling out of bed all the time, every night.

PT: He,s the guy who brought me here.

MD: Has he fioricet florida coming here himself?

PT: No, but someone else we knowSum

MD: What fioricet florida he do?

WIFE: He sits up in bed and takes telephone calls andSum

PT: He,s a sheep farmer. He grabbed his wife right around the throat and shook the hell out of her.

MD: He Fioricet florida : should come up here, it,s serious! I,m sure people are getting killed or severely injured accidentally, not just the men but also the wives.

PT: That man is terrible at night. When he grabs you around the neck, you know you,ve been grabbed.

WIFE: He,ll take a sheep in each hand like this, you know.

MD: So you thought this Fioricet florida, sleep problem was a natural thing?

WIFE: I thought he was having nightmares, and I would try to see that he didn,t eat bad things, but that didn,t make any difference. Then I tried to get him not to eat right before he went to bed, and that didn,t do anything. After this bad episode, fioricet florida doctor wanted us to go to your sleep center, but our insurance company turned us down, and so the doctor sent in another request and that was turned down. Then I called up here and said, ,I guess we,re going to have to cancel,0/00 because we kept getting turned down for this pre-authorization.

PT: My idea Fioricet migraine, was I think the whole thing with the surgery ran $35,000 buy fioricet if I didn,t get treatment and did it again they,d get another $35,000 shoved at them. I mean, how dumb can you get?

MD: I know, that,s a good point. Well you,re in buy fioricet right place now. Were you ever a sleepwalker as a child?

PT: Not that I know of.

WIFE: Sometimes he is laughing. He had one, he was shouting, ,I see you---you bastard, you quit that.0/00 And I woke him up and said, ,Lord, what,s happening?0/00 And he said, ,well that guy over there insists on washing his hands in that barrel of macaroni and cheese and I,ve been feeding people out of it.0/00 So he did fioricet florida me one that is not really a bad dream.

PT: He was washing his hands out of stuff I had to eat.

MD: What kind of person has your husband been, and is this out of character for the way he is?

WIFE: He,s got a Fioricet florida, real nice personality, gets along well with practically everybody.

MD: In terms of anger, how has he typically shown Fioricet florida, anger? Raising his voice, slamming doors, throwing things around, or being silent?

WIFE: If he,s mad with me, why he just quits talking. buy fioricet then there are times when he gets really upset and he will raise his voice and shout..

MD: But he,s never gotten physical, slamming doorsSum

WIFE: No, he has fioricet florida done anything like that and he has never touched me.

MD: Do you drink alcohol much, have you ever been much of a drinker?

PT: Not at all. I haven,t had almost anything to drink for probably buy fioricet years. Maybe twice a year.

MD: How about coffee, how much caffeine do you take?

PT: Fioricet migraine, None now but I used to take plenty. At one time, I was probably drinking 20-25 cups a day.

MD: When did you cut back?

PT: When I called the doctor and asked him how come my heart was going ,boom-boom,0/00 he fioricet florida to start drinking decaffeinated, and I did.

MD: Do you smoke?

PT: buy fioricet I did.

MD: When did you stop?

PT: When I broke my neck. I never even thought about stopping until six weeks after that Fioricet migraine, and then I thought, ,What the hell, I,ll just quit.0/00

MD: What kind of job did you have and are you retired now?

PT: Yeah, I was a jeweler, a watchmaker, and goldsmith.

WIFE: He just retired two years ago, and then this last year he was working.

PT: One of my competitors called and wanted me to help Fioricet florida : him for six or seven months, so I did.

MD: You,ve had the most severe sleep injury that we,ve personally heard of. We,ve had men break other bones and Fioricet florida : one man actually broke off a spinous process of his neck.

PT: It scared the buy fioricet out of me. For Christmas, she bought me a new feather bed and kept saying, ,Well try it, try it.0/00 And finally I tried and liked it. Now we lowered the bed down so Fioricet florida - everything is on the floor.

MD: You have to protect yourself even after starting the medicine. The medicine should help a lot but it is not foolproof, and you need to be as safe as possible.

WIFE: What do you call this sleep problem?

MD: We call it REM sleep behavior disorder, Fioricet florida : affecting a stage of sleep in which all of us are programmed to be paralyzed ^ that way we don,t act out our dreams and hurt ourselves. For some reason, it,s almost always men in your age group who have lost that protective paralyzing mechanism.

Posted at 5:15PM CDT | permalink