When sleep becomes a person’s worst nightmare!

At the end of a long, hard day, many of us relish the comfort of our beds. We snuggle under the covers and with a satisfying sigh, welcome the sweet onset of sleep. But for some people, sleep is not such a pleasant experience. Here’s three conditions likely to turn sleep into someone’s worst nightmare:

1) Sleep paralysis

Waking up and not being able to move or speak is a terrifying prospect. But for some people, this nightmare can actually be a reality. People who suffer from sleep paralysis may experience periods, either as they wake up or when they are falling asleep, when they feel conscious but are unable to move a muscle, sometimes for up to a few minutes. During this time, the individual may also experience a crushing sensation in their chest or disturbing hallucinations.

Despite being described in various ways throughout history, the term “sleep paralysis” was first coined in 1928 and is believed to be caused by a disturbance in a person’s normal sleep pattern. Briefly, our sleep occurs in approximately 90 minute cycles consisting of two stages: the non-rapid eye movement (NREM) stage, which makes up about 75–80% of our sleep, and the REM stage. It is while we are in REM sleep that we experience our most vivid dreams. During this sleep-stage, our brain also sends signals to our muscles inhibiting movement. People with sleep paralysis tend to wake during REM sleep, therefore finding they cannot move or speak as their muscles are still paralysed. As a consequence, this disorder is often associated with risk factors that affect one’s sleep (e.g. stress and narcolepsy) and treatment tends to focus on addressing the related conditions.

2) REM behaviour disorder

In contrast to sleep paralysis, REM behaviour disorder is characterised a by a lack of muscle inhibition while a person is in the REM stage of sleep. Consequently, people with REM behaviour disorder tend to act out their dreams physically and verbally (e.g. kicking out, screaming, etc.). This can be both distressing and potentially dangerous to themselves and any poor souls sharing a bed with them. In fact, 35–65% of people with this condition report having caused injury to themselves or their bed partner. As one may expect, diagnosis of REM behaviour disorder often follows as a result of such injuries.

REM behaviour disorder usually occurs in people over 50 years old, and may be a risk factor of disorders associated with neurological decline (e.g. Parkinson’s disease). At present, treatments for the condition focus on symptom control using medication (e.g. clonazepam) and ensuring one’s sleep environment is safe.

3) Sleep apnea

Sleep apnea is a potentially serious, and highly distressing, condition where someone will intermittently stop breathing repeatedly while they sleep. This is often accompanied by heavy snoring and disrupted sleep resulting in excessive daytime tiredness. There are two types of sleep apnea: obstructive sleep apnea which, as the name suggests, occurs when a person’s airway becomes blocked due to the muscles and soft tissue collapsing during sleep; and central sleep apnea, a rare form of the condition, where the brain fails to signal to the muscles telling them to breathe. If left untreated, both forms of sleep apnea can lead to serious medical conditions, such as high blood pressure (hypertension), low oxygen blood levels (hypoxemia) and stroke.

Diagnosis of sleep apnea is primarily based on measuring the number of times a person stops breathing per hour (≥15 or ≥5 in combination with other symptoms e.g. excessive daytime tiredness) while they sleep. Doctors will also look for the presence of risk factors, such as obesity and high blood pressure, as indicators of the condition. Sleep apnea is usually a lifelong condition but can be managed in a number of ways from making lifestyle changes (e.g. losing weight or sleep on one’s side) to using a therapy called continuous positive airway pressure (CPAP), a mask linked to a ventilator which applies mild air pressure to keep the airways open.

Despite the obvious differences between these three conditions, sleep paralysis, REM behaviour disorder and sleep apnea all have one thing in common – they make going to sleep distressing, and sometimes harmful, for those living with them. So don’t take for granted a good night’s rest; for people with these sleep disorders, sleep may be a nightmare waiting to happen.

Post by: Megan Barrett