Sleep Problems

For most of us, closing our eyes at the end of the day means drifting off into peaceful slumber. But for some people with sleep problems, the action’s just beginning. Find out what surprising things you might be doing in your sleep. Some behaviors may seem laughable, but can be quite serious...

You think your dreams are weird?

You might be doing even odder things when asleep – like eating, walking and talking.

Some nocturnal behaviors are merely annoying, but others are dangerous.

We asked sleep experts to explain 6 unusual bedtime behaviors and when you should seek help for sleeping disorders.

1. Sleepwalking (Somnabulism)
Until about ages 10-12, sleepwalking is common and normal, says Kathy Gromer, M.D., at the Minnesota Sleep Institute.

So how does it happen?

“When we fall asleep, we have many buttons that go off – eye muscles, hearing, limb muscles,” she says.With somnabulism, some get “stuck” when waking and don’t come on. For example, the body may have turned on the eyes and ears, but not the brain, she says.When someone sleepwalks, they might quietly walk around their room. Or they might run or attempt to "escape."

Typically, the sleepwalker's eyes are open with a glassy stare as he roams the house. If you question him, he'll be slow to respond or not respond at all. When you get him back to bed without waking him up, he usually won't recall the event.Older children may wake up more easily at the end of a sleepwalking episode.

It’s not uncommon in kids, and parents usually monitor their children’s activities and keep them safe. In adulthood, however, it can be dangerous if no one’s around to prevent nocturnal wandering.

One of Dr. Gromer’s patients once drove to the supermarket, discovered it was closed and walked home.The next morning, a friend found the woman’s car in the store’s parking lot, unlocked, with her purse on the front seat.The patient didn’t remember her nocturnal outing because she was in a state of partial arousal, half asleep and half awake.

Sleep disorder solution: If you sleepwalk, safety-proof your home, Dr. Gromer advises.

• Lock sliding doors and put car keys out of easy reach.
• Install 2-3 locks on the front door. “By the time the sleeper gets to the third lock, she’ll probably wake up,” she says.
• Eliminate triggers that interfere with a sound night’s sleep, such as too much caffeine, loud TV and sleep apnea. Also, sleeping pills or alcohol may trigger sleepwalking in some people, says Max Hirshkowitz, Ph.D., author of Sleep Disorders for Dummies (For Dummies).
• An alarm on the bedroom door may work, he says. If it doesn’t wake you, someone else might hear it and get you back in bed.

If these steps don’t stop the sleep disorder, see a sleep specialist, who may recommend relaxation techniques or antidepressants.

Causes

Several things can lead to sleepwalking.It can run in the family. Identical twins are more likely to sleepwalk. If you have a parent, brother, or sister who sleepwalks, you're 10 times more likely to do so than someone from a family with no sleepwalkers.

You might also have the disorder if you're:

• Sleep deprived
• On a chaotic sleep schedule
• Stressed
• Drunk
• Taking drugs such as sedative-hypnotics (which promote relaxation or sleep), neuroleptics (used to treat psychosis), stimulants (which boost activity).

Medical conditions that have been linked to sleepwalking include:

• Heart rhythm problems
• Fever
• Heartburn
• Nighttime astma
• Nighttime seizures
• Obstructive sleep apnea (a condition in which you briefly stop breathing during sleep)
• Restless leg Syndrome
• Psychiatric disorders, for example, posttraumatic stress disorder, panic attacks, or dissociative states, such as multiple personality disorder.

2. Sleep Eating (Nocturnal Sleep-Related Eating Disorder)

Are you waking up with crumbs in your bed or on the previously clean kitchen counter?

You could be sleep eating.

This sleeping disorder is caused by the same brain malfunctions as sleepwalking, but the sleeper focuses on food.Often, sleep-eaters chow down on wacky stuff, “like cardboard, or cereal with ice cream,” Dr. Gromer says.That’s why it’s dangerous.

Hirshkowitz says his patients have set kitchens on fire trying to make a meal in a semi-awake state, or consumed chemicals (from cleaning products, for example) because the refrigerator was locked to prevent nighttime binges.

Both men and women are vulnerable to these disorders, but they are more common among women. A little over of the general population are thought to have NES. Close to 5% suffer from NS-RED. The number of people affected by these disorders increases up to 17% in those with other eating disorders. Many of these individuals diet during the day, which may leave them hungry and vulnerable to binge eating at night, when their control is weakened by sleep. In some cases, people with sleep-related eating disorders have histories of alcoholism, drug abuse, and other sleep disorders.

Sleep disorder solution: Avoid partial-arousal triggers and put away dangerous items, like medication, cleaning products and knives (that might harm sleep-eaters making food).And don’t lock the fridge. It’sbetter to eat real food, not cleansers, Hirshkowitz points out.

3. Acting Out Dreams (REM Sleep Behavior Disorder)

If you wake up and realize you’ve been battering a pillow, nightstand or bedroom wall, you could have REM Sleep Behavior Disorder (RBD), a condition that researchers don’t yet fully understand.

Here’s how it works: When we’re in deep, rapid-eye-movement (REM) sleep, we’re temporarily paralyzed.Only heart and breathing muscles are active.But people with RBD twitch in that state, which means they have muscles working when they shouldn’t.“They often have very violent dreams… of chasing criminals or trying to beat someone up,” Dr. Gromer says.As a result, they act out on furniture – or worse, a slumbering partner. And the “sleeper” doesn’t wake until they’ve hurt their bedmate.Both men and women are affected, she says. And it’s more common in younger women and older men, although researchers don’t know why.

Sleep disorder solution: RBD is easy to treat with medication.

“A dose of clonazepam [a psychoactive drug commonly used to control seizures and panic disorders] will do the trick,” Dr. Gromer says.Also, pad bedroom furniture and remove sharp objects to avoid injuries, says Hirshkowitz.

4. Talking in Your Sleep (Somniloquy)

You’ve probably heard someone mumble while they’re sleeping – or maybe you’ve been accused of it yourself.

Sleep-talking usually occurs between wakefulness and sleep, or when going from one stage to another.A high fever can cause it too.What you’re saying doesn’t usually relate to your dreams.

In fact, when you’re dreaming, it’s the least likely time you’ll talk, because of the deep paralysis that occurs, Hirshkowitz says.Can nightly chatter harm you?“Only if you’re saying something you shouldn’t be,” Hirshkowitz says, laughing.Worry only if nocturnal chatter leaves you so sleep-deprived that you can’t function during the day, he adds.Sleep disorder solution: Anxiety and stress play a role, Hirshkowitz says. A doctor or therapist can help reduce both.When fever’s the cause, treating it should stop the talking.