Question:
I am a 30-year-old, lifelong sleepwalker. I had a sleep study in 1997 after
I pinned my wife to the bed and told her that she needed to take her
medications. (I was a medical student doing psychiatry at the time.) I was
diagnosed with REM sleep behavior disorder (RBD) and put on 0.5 mg
clonazepam. The clonazepam decreases the frequency and severity of events
(which occur almost nightly without the medication, more when I'm stressed).
My question: Do I really have this disease. I was looking for more recent
literature on the subject so I could find a better drug than clonazepam
(which causes me to be tired during the day and makes me not give a crap
about important things) when I found this article:
http://www.emedicine.com/NEURO/topic524.htm
I also found this article (linked from above article):
Olson EJ, Boeve BF, Silber MH: Rapid eye movement sleep behaviour disorder:
demographic, clinical and laboratory findings in 93 cases. Brain 2000; 123:
331-339
It seems that in all 93 cases, the youngest person to have RBD was 36 years
old. It also seems that these people don't have a history of childhood
sleepwalking. I definitely experience complex behaviors with my episodes
and I can often remember what I was dreaming.
Anyone have similar experiences out there?
Answer:
Dr. Dement, in _The Promise of SLEEP_, says that REM Behavior Disorder
usually shows up after age 50, but that he'd seen in patients as young
as nine. He doesn't mention a sleep walking connection, but does say
that sleep walking occurs during non-REM sleep. It's entirely possible
that you could have two sleep disorders, each at a different part of
your sleep cycle.
0.5 is not that high of a dose, which I am taking for another disorder. If
you want tired try remeron that is a tough one.
My doctor wants me to use it for 3 nights and 2 days off, but he thinks I
will have to use it longterm.
Also as a warning, I think that I recall that long term use of this drug
requires that the liver be checked from time to time.
You could find a psychristist who might know of similar drugs that you could
try that might make you less tired but not sure if you would get the same
effects.
This condition is pretty easy to spot in that a normal person during rem
does not move. I saw a couple of shows on tv about this, one person jumped
out of a window.
BTW, for the last couple of nights, I have taken 1 mg instead of 0.5 mg of
the clonazepam, and my wife and I both feel much more rested. I still
talked a little, but nothing close to what I have been doing. I still worry
about drowsiness during the day and feeling indifferent about important
things, but my safety and my wife's safety are supremely important.
