Parasomnias Often Under-Recognized, Misunderstood
Research points way to new treatments for sleepwalking, sleep sex, and other parasomnias.
Acting Out Dreams continued...
Taking the research a step further, other scientists have
implicated the same faulty brain chemistry in both disorders. In a recent study
of 13 people with the condition and 27 healthy individuals, Mayo Clinic
researchers found REM sleep behavior disorder is associated with low stores of
dopamine -- the same neurotransmitter known to be deficient in Parkinson
disease. The greater the loss of dopamine in the brain, the more severe the
symptoms, the researchers reported in the journal Neurology.
Other researchers have done brain imaging scans of people with
REM sleep behavior disorder. They found abnormalities in the region of the
midbrain where Parkinson's originates -- even in patients who did not yet have
signs of neurological problems.
Though the work is still early, it suggests that REM sleep
behavior disorder can be the first symptom of Parkinson's disease, Mahowald
says. "If we can develop a drug that protects against Parkinson's, this
will be very important."
Sleep Sex, Sleep Eating
Less well known and more recently recognized are sleep sex and
sleep eating disorder. "They have some characteristics of each of the other
[parasomnias], but don't quite fit the mold," Shapiro says.
Shapiro and Guilleminault have each published research
describing 11 patients with symptoms of sexsomnia that ranged from loud,
disruptive moaning to sexual assault. Regardless of how unusual or violent the
behavior, Guilleminault says his patients had no memory of the events the next
He notes that often, people who engage in
sleep sex have a history of sleepwalking, REM behavior disorders, apnea,
bed-wetting, or other sleep-related problems, to name a few. Some even have
"That's a big find," Guilleminault
says. "It suggests we can treat the seizures and eliminate the
Shapiro urges people to have an open
dialogue about any abnormal sexual behavior during sleep with their doctors.
"Just recognizing that sexsomnia is a sleep disorder is a step in the right
direction," he says. "Now that we know it is possible and doctors start
to ask the right questions, we will start to learn more about
The medical community has also been slow to
recognize sleep eating as a medical condition, says Lea Montgomery, RN, MS, an
instructor at Texas Christian University Harris School of Nursing in Fort
Worth, who has written review articles on the disorder. "I had one woman
frantic to get help; she had been sleep eating for 13 years. She tried to get
help but wasn't taken seriously."
Sleep eaters get up to nosh as many as 12
times a night, Montgomery tells WebMD. "It's messy, primitive eating --
butter right out of the butter dish, salt out of the saltshaker -- not what
they would normally eat during the day," she says.