Posted by Mark H. on March 31, 2000, at 21:24:31
In reply to psycotic episodes while in rem sleep, posted by katieb on March 31, 2000, at 15:11:36
Sleepwalking is not a psychosis, although the behaviors associated with sleepwalking can be very strange indeed. As you probably know, there was a famous case in Canada where a man with a sleep disorder who had been recently severely sleep deprived arose in the middle of the night, drove several miles to his in-laws and entered their house, started beating his father-in-law, and when his mother-in-law tried to fend him off with a kitchen knife, he took it away from her and stabbed her to death. He finally awoke several miles down the road with severe cuts on his hands, and immediately drove to the nearest police station, stating frankly that he feared he had just killed someone, although he had no memory of anything after going to bed. After much testing and research, the jury believed his story and found him not guilty.
My favorite documented case of odd sleepwalking behavior involved a woman who would get up in the middle of the night, go to the refrigerator, spread mayonnaise on two pieces of white bread, and then empty her dirty ashtray onto the bread and devour a cigarette-butt sandwich. Yuck!
Clonazepam may be useful in helping REM behavior not to break through into physical movement. It is used in the treatment of Periodic Limb Movement Syndrome and REM disorders. It is available as a generic, probably won't leave you too drowsy the next day, and -- perhaps most importantly -- is easier to stop taking (that is, it's less addictive) than most of the other benzodiazepines (Valium-related tranquilizers). In fact, my psychiatrist uses it to help people get off of more addictive substances.
Self-hypnosis may also be useful -- suggesting to yourself repeatedly before going to sleep that you will not get up and sleepwalk during the night.
Getting enough rest is extremely important. All of the REM movement related sleep disorders seem to be exacerbated by sleep deprivation. If I have to pull an all-nighter at the office to get a proposal out, the next night my wife says I'm flopping all over the bed (although I may experience a perfectly peaceful night's sleep).
Some sleepwalkers choose to leash themselves to the bed to limit how far they can physically go. This might not help your husband much, however, if he is sleeping next to you.
I recently counseled a couple (as a total non-professional layperson with no qualifications whatsoever except my own experience with such things and a bit of reading -- the usual disclaimer) to seek a thorough sleep study, to get professional advice on medications that might be useful (including clonazepam), for the violent person to get anger management training (on the hope that it would eventually affect his subconscious mind as well), and for his spouse to sleep with a Myotron or other electronic stun-gun so she could temporarily put her husband down if he attacked her again in his sleep. In their case, he choked her and dragged her down the hall, and he didn't wake up until he was handcuffed and sitting in the back of a police car.
When violence is involved with sleepwalking, you really do want to involve your doctor as soon as possible -- but the good news is that it is NOT a psychosis or indication of mental illness, medication may help, the condition will probably change or go away over time, and a good sleep lab and specialist can probably help you before you do any serious harm to your husband or yourself.
Please let me know the results of your sleep study and the treatment your doctor recommends, since I have been answering about 2 inquiries similar to yours a month, and the more I learn the more information I can pass on to other sufferers.
I will be on retreat next week, but I'll be back on Monday April 10. In the meantime, you'll find the Psycho-Babble community extremely supportive and informative.
Very best wishes!
poster:Mark H.
thread:28569
URL: http://www.dr-bob.org/babble/20000321/msgs/28603.html