How Sleep Affects Relationships, Page Two

How Sleep Affects Relationships...Mark Amundsen
Page Two

Nightmares, REM Sleep Behavior Disorder, Night Terrors
Nightmares are disturbing, but usually only to the person dreaming. During REM sleep, we are immobilized by muscle atonia, so there’s usually no physical action involved. (Nightmares can be caused by medications or stress; see your doctor if you experience recurring nightmares.) Some people, however, are not paralyzed during REM sleep and may act out in frightening ways. This is called REM sleep behavior disorder (RBD), and it can be upsetting — even dangerous.

“You might dream of running in the Super Bowl, dive out of bed and break your wrist,” says Ronald Kotler, M.D., medical director at the Pennsylvania Hospital Sleep Disorders Center and coauthor of 365 Ways to Get a Good Night’s Sleep. The Cleveland Clinic says that most sufferers of RBD are men 50 and older, but it can happen to younger people, including women. Kotler recommends first isolating the sufferer to prevent physical harm: “Put the mattress on the floor and keep sharp objects away — these are protective measures.” He
Nightmares can be caused by medications or stress.
adds that clonazepam (Klonopin), a drug used to treat seizure and panic disorders, is extremely effective in treating RBD. “The bad news is that 50% of RBD patients go on to develop Parkinson’s disease,” warns Kotler.

Night terrors differ from nightmares and RBD in that they don’t take place during REM sleep; although the sufferer seems terrified, he or she is usually not dreaming. Children 4-12 get night terrors most frequently, but 2.2% of adults in the 15-64 age range also get them. And according to the Cleveland Clinic, strong emotional tension and/or the use of alcohol can increase the incidence of night terrors among adults.

Night Sweats
According to Kotler, “Night sweats are part of menopause; they signal the end of the reproductive years.” For anyone suffering from excess sweating at night, Kotler recommends practicing good sleep hygiene. Wear light or no clothing to bed — like an oversized Nike Dri-Fit tennis shirt, which wicks away moisture. Use a fan to lower the bedroom temperature. Women suffering from menopausal night sweats can try a short-term course of hormone replacement therapy. However, Kotler says, night sweats can also be linked to other conditions, such as obstructive sleep apnea, an overactive thyroid, lymphoma, gastroesophageal reflux and even tuberculosis. If you’re waking up in drenched sheets, talk to your doctor.

Bruxism — grinding one’s teeth — hurts your teeth and jaw muscles and it sounds like you’re chewing on something. The American Dental Association (ADA) says bruxism is “caused not just by stress and anxiety, but by sleep disorders, an abnormal bite or teeth that are missing or crooked. Symptoms include a dull headache or a sore jaw.” The ADA recommends asking your dentist for a mouth guard to prevent painful, loose, or fractured teeth as a result of grinding and to help you identify and treat the cause.

Mindell says that sleepwalking “is dramatically more common in children, but can occur in up to 4% of adults” and warns that a sleepwalker “can be combative and agitated if awakened.” If you find yourself with a somnambulist, try to lead the person gently away from harm and back to bed. The Mayo Clinic states that sleepwalking in adults may be caused by mental disorders, drugs, alcohol, or medical conditions, like partial complex seizures. If it recurs, is accompanied by other symptoms, or includes dangerous activities — driving, cooking, etc. — see your doctor.

Restless Legs Syndrome and Periodic Limb Movement Disorder
“Restless legs syndrome, or RLS,” says Kotler, “is the irresistible urge to move your legs, get up, and walk around; it’s a creepy, crawly sensation within the legs.” It happens mostly in the evening and in confined spaces, such as a movie theater. “Iron deficiency, pregnancy, or kidney dialysis can cause RLS,” says Kotler. “Taking supplements can resolve the problem if it’s an iron deficiency. Women lose iron during menstruation, and young women are at the greatest risk.” A doctor can measure your iron levels with a blood test. If you are taking medication that causes RLS (including some antidepressants), your doctor can isolate the cause. According to Kotler, some medications that are highly effective in treating RLS
PLMD is usually diagnosed during a sleep study using electromyogram monitoring.
include Requip (ropinirole) and Mirapex (pramipexole): “In some patients, they need more than one class or type of medication.” Other remedies include a soaking in a warm bath, massage and avoiding both caffeine and excessive exercise before bed.

Periodic limb movement disorder (PLMD) is similar but unrelated to RLS and causes muscle constrictions about every 30 seconds. “PLMD is usually diagnosed during a sleep study using electromyogram monitoring,” notes Kotler, saying that PLMD is generally treated with the same drugs as RLS. “Many people with PLMD don’t have RLS, but people with RLS often have PLMD.”

Talking in Your Sleep
As the Romantics said, “I hear the secrets that you keep/When you’re talking in your sleep.” Or, more likely, your partner heard you mutter something unintelligible. According to the NSF, “Sleep talking can involve complicated dialogues or monologues, complete gibberish or mumbling. The good news is that, for most people, it is a rare and short-lived occurrence. Anyone can experience sleep talking, but the condition is more common in males and children.” It can be pretty embarrassing if you’re speaking coherently. But the NSF doesn’t advise treatment unless it’s causing other problems: “If it is severe or persists over a long period of time, talk to your physician or health care provider about the problem. There may be an underlying medical explanation for your sleep talking (e.g., an undiagnosed sleep disorder or debilitating anxiety or stress).”

Narcolepsy is, in fact, an actual neurological problem “caused by the brain’s inability to regulate sleep-wake cycles normally,” according to the NSF. Daytime sleepiness is narcolepsy’s most obvious symptom. Others include repeated awakenings at night, sudden, temporary paralysis and hallucinations. Do we even need to tell you to see your doctor if you’re experiencing this?

“Sleep sex — or sexsomnia — is a sleep disorder characterized by non-rapid eye movement, causing people to commit sexual acts while they are asleep,” say experts from Sleep Forensics Associates, a medical-legal consulting firm in Minneapolis, MN. According to Mindell, “sexsomnia — having sex while asleep, fondling a partner while asleep — can be a bit like forced sex. It’s very upsetting for both partners.” A man with a history of sleepwalking was tried in Toronto in 2005 when he fell asleep intoxicated next to a woman on a sofa next and sexually assaulted her in his sleep.

Sexsomnia is a parasomnia, which makes it a sleep disorder like eating during sleep wherein the sleeper is not awake or aware during the acts being committed. It’s rare, but for people prone to it, it can be brought on by excessive alcohol consumption or sleep deprivation. Treatment with benzodiazepines, such as Xanax, has a high success rate in preventing parasomnias. If something like this does happen, doctors, counselors, policemen, courts of law and lawyers may follow shortly thereafter. If you think you might suffer from any parasomnias, don’t wait until something strange occurs to get help.

How to Get a Good Night’s Sleep
The NSF offers the following tips for restful sleep, especially if a partner’s sharing the bed with you:

1. Maintain a regularly scheduled time for going to bed and rising, including on weekends.
2. Establish a regular, relaxing bedtime routine, such as soaking in a bath or hot tub, then reading a book or listening to soothing music.
3. Create a sleep-conducive environment that is dark, quiet, comfortable and cool.
4. Sleep on a comfortable mattress and pillows.
5. Use your bedroom only for sleeping and intimacy.
6. Finish eating at least 2-3 hours before your regular bedtime.
7. Exercise regularly, but complete your workout at least a few hours before bedtime.
8. Avoid caffeine (coffee, tea, soft drinks, chocolate) near bedtime.
9. Avoid nicotine (cigarettes, tobacco products) late in the day as it can negatively impact sleep quality.
10. Avoid drinking alcohol just before going to bed.

Visit the NSF’s Web site for more information.

Mark Amundsen is a writer and editor in New York who never gets enough sleep.
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