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Wed 05 Sep 2007
Non-REM Sleep Parasomnias: Sleepwalking (Paradox online propecia tramadol Story III)
ALMOST LIKE WATCHING A FILM
This story puts the spotlight on a lucid sleepwalker. A 41-year-old woman describes 25 years of sleepwalking with vivid, recurrent dreams and lucidity states in which she is convinced that she is awake when in fact she is Online propecia tramadol - sleepwalking. This is a peculiar state, with lucid self-awareness being mixed up with the spaciness of sleepwalking, and with Online propecia tramadol : danger actually lurking in the shadows. Smoke and mirrors, back and forth across the sleep-wake divide.
The experience of sleepwalking for this lady is with the hallucinations of her dreams intermingling with the waking perceptions of the online propecia tramadol surroundings. She reports being convinced that she Online propecia tramadol : is awake each time she is sleepwalking. Other order soma tramadol are also convinced that she is awake—until she wakes up. So everyone is surprised when she wakes up, especially herself. She is the Tramadol dream pharmaceutical : unwitting master of sleep-wake deceit.
One afternoon, she drove her car right from a daytime nap, without waking first, and went shopping for french-fries at a supermarket. She parked her car smack in the driving lane of the parking lot, blocking incoming traffic. Later, coming out of the store, she online propecia tramadol what she had done, woke up with a jerk, and order soma tramadol she had been driving in her sleep. (She still remembers the strange look on the face of the online propecia tramadol at the wheel who wanted to enter the parking lot and could not.)
It is not known whether this woman can utilize lucid self-awareness in sleep Online propecia tramadol - to alter the sleepwalking-in progress, to help guide events in Tramadol dream pharmaceutical : a certain direction, or away from another direction. (This peculiar state in non-REM sleep would be akin to the Tramadol dream pharmaceutical : capacity order soma tramadol Lucid Dreamers who can direct the course of their dreams, once they achieve the state of lucidity, in which wakeful thinking becomes combined with REM sleep dreaming.) If this woman has such a directive capacity with order soma tramadol sleepwalking behaviors, then Executive Lucidity would be demonstrated, in addition to her Perceptive Lucidity. (The patient subsequently noted: I can convince myself while I am dreaming that it is a dream IF I have had the dream more Online propecia tramadol, than twice. Then I can keep myself from getting out of bed or reacting to the dream. I don’t know if I could change any actions unless I knew I was dreaming. I can’t recall ever having done so.)
Treatment for her sleepwalking with bedtime clonazepam has been completely effective for more than 15 years, and at the original nightly dose of 0.5 milligrams. Another sleep motor disorder—the Restless legs syndrome—has also been considerably toned down with the Online propecia tramadol - same clonazepam treatment. Restless legs syndrome (RLS) is a disorder in which the legs feel distinctly uncomfortable during drowsiness or sleepiness, and the online propecia tramadol must get up to walk around in order to relieve the distressing, peculiar, and painful leg sensations—but that is incompatible with the online propecia tramadol asleep. People afflicted with RLS get insufficient and poor-quality sleep—and are usually tired, or even “wiped out” during the day. Fortunately, clonazepam and dopaminergic medications (which either elevate the brain levels of the neurotransmitter chemical dopamine or else act like dopamine in the synapses) provide substantial relief from RLS in most Online propecia tramadol : patients. (The patient also subsequently noted: RLS makes sitting at a theater or riding in a car very uncomfortable and embarrassing.)
A Online propecia tramadol - special descriptive language is expressed in the reports of adults with sleepwalking and the other bumps in the Online propecia tramadol, night, and this woman’s interview provides some good examples.
NON-REM SLEEP STORIES
MY TYPICAL EXIT FROM BED: A MIGHTY
SPRING AND GO CRASHING DOWN.
PT: The first time that I really knew I was sleepwalking, I was in the tenth grade and my grandfather had just died. I was sleeping in the living room, and I got up and answered the telephone. I heard somebody on the phone, but there was no one on it and the phone had never rung.
PT: And then later order soma tramadol college roommates would come in and find me walking in circles on the rug, or I would online propecia tramadol up in the bathroom brushing my teeth at 3:00 in the morning.
PT: In college I had a recurring dream—not necessarily a nightmare, but order soma tramadol Tramadol dream pharmaceutical - of along those lines—and it would go on for a period of time. Then I sort of got conscious of what it was and got a hold of it in the daytime, and when I got hold of it and figured out what the problem was, I could convince order soma tramadol that it was not realistic and then that dream went away.
PT: As a freshman in college, order soma tramadol often dreamt Online propecia tramadol, that I was in the wrong online propecia tramadol and that would cause me online propecia tramadol jump out of bed and exit the room. One time I did this was on the fourth floor. I had been living on the fifth floor, but I had moved to the fourth floor when I jumped out of bed and opened the door. I observed what was going on in the room next to mine, where friends were still up; I knew who they were. I then opened the fire door to the hallway stairway and I went upstairs and went through another fire door and opened the door above my room. I lived in room 420. I opened the door to room 520 and saw that the beds were in a different configuration and then realized that it wasn’t right.
PT: Online propecia tramadol - Still asleep, I closed the door and went Online propecia tramadol, to the recreation room, and there were kids still up there, and I talked to them and none of them knew that I was sleepwalking. Then I went to the order soma tramadol I woke up looking in the mirror. I remember everything I did, but nothing I heard or said. People knew that I was there—but I was asleep.
PT: online propecia tramadol I have had other instances. Online propecia tramadol : I picked up my books one night when I was asleep and I carried them to someone order soma tramadol room. Those people were asleep, and I woke them up and left all my books in there. Since I didn’t remember having been in there until afterwards, I didn’t know the order soma tramadol morning where I’d left the books. So the sleepwalking was pretty well documented while I was in college.
PT: Online propecia tramadol - online propecia tramadol believe that I went sleepwalking as order soma tramadol child because I can remember doing it, but at the time I didn’t realize it was sleepwalking: I thought I was awake. I would come downstairs—and again this is the same type online propecia tramadol recurring thing—and open the door of our radio cabinet and I would see that the radio was on, it had kind of a green glow. But it wasn’t on. My parents would never leave anything going, they were very fussy about things like that. I used to smell smoke, come downstairs, open the clothes chute, see flames shooting up, close the chute, and go back to bed. But there was never any fire. I never reported these “fires” to my parents. Although they paid close attention to my siblings and me, they were completely unaware of my sleepwalking. So I had recurring dreams where I was actually walking around the house and where something was happening that wasn’t really happening. It bothers my ankles so I sometimes can tell if I’ve been sleepwalking by the way my ankles feel. The tremendous jar of landing, whether or not it woke me (and it often didn’t) was very hard on my ankles, feet, and back.
PT: order soma tramadol I get up very rapidly, so between the online propecia tramadol I’m lying flat Online propecia tramadol - and the online propecia tramadol I’m on my feet is a very short time. I have come out to the kitchen and talked to my husband and he order soma tramadol not aware Online propecia tramadol : that I was asleep. However, he knows I am sleepwalking when he sees me jump out of bed and land with a crash. I have had the same dream over and over for a period of time, I can rarely think of a time when the sleepwalking has not been connected with a recurring dream. One of the early ones was that I had a pole lamp next to my bed and I would dream that it would fall over on me. Well, when I finally convinced myself it wasn’t next to my bed, then I didn’t have the dream anymore.
PT: online propecia tramadol In another recurring dream, I’m smelling smoke in order soma tramadol clothes chute. I Tramadol dream pharmaceutical : can see the color of flames shooting up. I can see the features on the radio and I can remember coming down the stairs and looking down the clothes chute. It’s almost like watching a film.
PT: In the dream where I thought the radio was on, there was kind of a green glow to the dial.
PT: Online propecia tramadol : I can still see it clearly in my mind. The dream that I had the most was before I went to Europe. I was dreaming that I was taking care of money for an aunt—she was going with us—and I kept dreaming that she sent me $1,500 and I had misplaced it in the basement.
PT: The most current recurring dream is online propecia tramadol regards to coming here. I don’t know if I was actually sleepwalking, but I kept having this recurring dream that I was supposed to have filled out some information before I came, and I keep waking myself up thinking I’m supposed to have online propecia tramadol this and haven’t done it yet.
MD: online propecia tramadol you ever had night terrors with screaming?
MD: Have you ever engaged in any eating behaviors while sleepwalking?
PT: No. I often wake up and eat something during the night, but I don’t do it while I’m sleeping.
MD: order soma tramadol you wake up from these episodes sometimes in the middle of the night and then Tramadol dream pharmaceutical : realize what’s going on?
PT: Those are the ones online propecia tramadol remember. For instance, that time I left my books, I didn’t wakeup, and therefore, I didn’t know where my books were or what I had Tramadol dream pharmaceutical : been doing until somebody told me. But the odd thing is when they told me that I had been there, I then remembered the whole thing. It’s as though you can catch order soma tramadol by the tail and it sort of unwinds. It’s peculiar. (The patient later adds: When I awaken during sleepwalking, I remember it all vividly—except the sounds. I also remember what I thought while dreaming!)
MD: what factors can increase the frequency? Would you say stress?
PT: I think I’m almost less stressed now than I was in the preceding years, so I’m not sure that stress has anything to do with the sleepwalking.
PT: online propecia tramadol the car during sleepwalking: I was asleep, it was 5 online propecia tramadol the afternoon, and I have this thought in my head that we had to have French fries for supper. order soma tramadol took turns cooking at home and the meals were all planned, Tramadol dream pharmaceutical : so I would have bought the food already. So this driving for French fries was order soma tramadol online propecia tramadol total irrational act. I jumped out of bed I suppose, I had to find my purse with Online propecia tramadol - money in it. I talked to somebody on the way Online propecia tramadol : out, I remember doing that. I don’t remember if I told Online propecia tramadol : her what is was doing, though. I got in the car and I would have had to pen two doors to get out, the front door and the porch door. I got in the car and I could not make myself look in the rear view mirror. I was having Online propecia tramadol : a little mini-argument inside: “You must look in the mirror; I’m not gonna look in the mirror.” And I didn’t. Then I would have had to make a left turn and I turned in the correct place and went online propecia tramadol ahead to a stoplight. I heard a police siren in the distance and I got it in my head that they were after me, which was totally irrational online propecia tramadol it was far away. And I crossed the street, I assume with a green light, but I have no memory of any traffic. I turned left again into a parking lot. This was probably not more than three blocks total. (The patient later comments: I bet the siren was part of the dream, because I don’t remember real sounds from a sleepwalking dream.)
PT: I Tramadol dream pharmaceutical : turned into a parking lot, parked online propecia tramadol car, Tramadol dream pharmaceutical : went in the store, got the French fries, talked to the clerk—and I’ve seen her since, she knows me—and I went out to the parking lot, and there online propecia tramadol a man who was about to park. order soma tramadol was about to go down the driving lane between rows online propecia tramadol parked cars with his car, but he stopped. I had the impression that he didn’t quite know what to make of this situation—because I had parked my car across the lane between the online propecia tramadol rows of cars, which I would ordinarily never do. So if he order soma tramadol to drive down the lane where he was supposed to go to park, he’d have hit me broadside in the driver’s door. There was no place that he could have possibly gone with the car. I was blocking a lane in the parking lot.
PT: And when I got out into the parking lot, I looked at the car and I realized: Oh my gosh, I’ve online propecia tramadol asleep the whole time, and I woke up with a jerk, just a tremendous shock, and I jumped in the car and took off. It’s that oh, what am I dong here? kind of thing. But I can remember everything. I can remember what I was thinking and I can see that it wasn’t rational at the time, but I couldn’t do online propecia tramadol about it. And that was during a nap.
MD: There are people who run into walls while sleepwalking.
PT: Never me.
MD: Have you ever opened a window or even tried to get out of a window?
PT: No, but they were concerned about that when Tramadol dream pharmaceutical : I was in college. The psychologist thought I out to move in with the house mother, because they felt I was a risk to jump out the window. One time, several years later, I had both shoes in my hand as I was leaving my house, thinking there was a tornado and I had to leave. I stopped after opening the door, when I woke up. This was not a recurring dream.
MD: Have you bruised yourself or cut yourself from sleepwalking?
PT: online propecia tramadol My ankles and my back suffer, though, order soma tramadol I come down with such a crash. I don’t have a online propecia tramadol good back to start with, and it’s sore and stiff because it’s absorbing that shock.
MD: You usually negotiate the environment quite easily.
PT: Yes. If I Online propecia tramadol, can drive a car when I’m asleep…
MD: How did you explain all this to yourself?
PT: As a child I just thought it was real. But after a while I just realized, “Oh, I’m sleepwalking,” and there was kind of a curiosity, but I didn’t get overly upset about it.
MD: order soma tramadol You never wanted to get help for it or get rid of it?
PT: I asked two doctors within the last few years and neither of them knew anything about sleepwalking or made any suggestions. My current doctor referred me to your sleep center; she immediately realized I had a serious problem.
MD: Have you ever hit at your husband?
PT: Online propecia tramadol, Only once. I jumped up very fast and I went like this—a karate chop—and he rolled over just in time. I did not land it, but he online propecia tramadol it coming and he said I yelled and yelling. And karate is not anything I’ve ever even watched or participated in. We don’t sleep in the same bed, so I was actually out of bed.
MD: Can you describe what happened in the Online propecia tramadol : London hotel one night last summer?
PT: Online propecia tramadol - Well, I was in a fourth floor room with a very large window, almost as tall as I was, maybe five feet high, order soma tramadol almost to the floor. I was asleep facing the window. There was a lot of noise on the street, as a rock concert was letting out later after I was asleep, and somebody across the narrow street—just across from my window—pushed a correspondingly sized online propecia tramadol out of just the whole frame, just pushed it out. I saw it happen and it was like the window came out toward me and then went crashing down on the street. The next day I was thinking about how really glad I was taking this medicine Klonopin, because otherwise my attention—with the lights from the street and all the noise and the fact that there was a large window down there—my attention might have been drawn down toward the window and, you know, jumping out could have been a problem.
PT: The next morning I remember looking out, and there was no glass and no broken window. I asked people at order soma tramadol about the breaking of the window and no one knew what I was talking about. Even though the evidence was completely contrary to my dream, I firmly believed the event in the dream had actually occurred. I had been very conscious of a blue soft being shoved out the window, or broken glass catching the light and falling in slow motion. I remember well the crash of the sofa through the window and the sound of the falling glass…
PT: online propecia tramadol (Note for previous paragraph: Dr. Schenck, this will show you how real these dreams are; the most unlikely scenarios seem absolutely true. As I read this over and consider what Online propecia tramadol, else I remember from that dream and the following morning, I am completely convinced that this was a sleepwalking dream, except I did not get out of bed.)
MD: In our experience with the first 100 adult sleepwalkers we’ve studied Online propecia tramadol, here, 16 had gone out their windows.
PT: Oh well, I’m glad to know, so I need to be careful about that. Even with the Klonopin?
MD: Well, Klonopin is a very good safety factor to have, but it’s not foolproof. It depends Tramadol dream pharmaceutical, on whether other risk factors are involved on any particular night. For some people, either sleep deprivation, tiredness, travel, or stress can overcome the beneficial effect of Klonopin on any given night.
PT: My husband came home with a whole bunch of possibilities for my trip to Europe to keep me from wandering.
PT: He’s a real night owl. And it hardly takes anything to disturb me. Even if were to turn the lights Online propecia tramadol, on in the kitchen down the hall from me, he could very likely disturb me to sleepwalk: it takes nothing, I mean just next to nothing, I have extremely sensitive hearing.
MD: Sleepwalkers generally fall online propecia tramadol rapidly, but seemingly trivial noises can Online propecia tramadol - trigger an episode, as is the case with you.
PT: With the Klonopin, I am not sleepwalking and the Klonopin also helps with my restless legs. online propecia tramadol In our family we call it “wiggly legs.” Before Klonopin, when I lay down, my legs would jump and kick. At times I tried to lie on my face, but my legs kept kicking. It was a real nuisance.
MD: You have what is called the “restless legs syndrome.”
PT: Yes, definitely, and not a bit of it, it’s a major thing. When I ride in a car, it’s a serious problem. I know I didn’t have this as a kid, because we always used to tease my mother Online propecia tramadol, about it, but I’m sure I’ve had it since I got married.
MD: Other people in the family have had it?
PT: Yes. It’s funny, it seems to follow particular people in the family Tramadol dream pharmaceutical, that look alike and have some of the same personality characteristics. If this is true, my 11-year-old will probably have it too, because she is the same type of person that it seems to be a problem for.
PT: (Final comment from the patient: I enjoyed reading all this Online propecia tramadol, again and talking to you. I was astounded when I realized I had information to disprove the dream I had in London almost immediately and still believed such a wild dream all these years instead of facts.)
The adult daughter of this patient order soma tramadol also online propecia tramadol a sleepwalker—but, curiously, most of her sleepwalking has occurred from Online propecia tramadol - naps. Her sleepwalking is most often noticed by others because of what she is wearing. She has ended up out on the sidewalk in summer wearing shorts and a top—covered by a heavy sweater and a bathrobe, with a shoe on one foot, and a sock on the other foot (at 3 PM from a nap) by this odd attire. She reports having been out on the street two or three times this way. She has also occasionally awakened while washing her feet in the sink. She has eaten in her sleep, but has not cooked.
She is treated successfully by hypnotherapy every online propecia tramadol months. Since starting this treatment, there have been no further instances of sleepwalking. Online propecia tramadol, When she has gotten close to sleepwalking again, she is awakened by a flashing blue light that was suggested by her hypnotherapist.