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Friday, December 6, 2013
Sleep talking (conversational)
I quickly became accustomed to the fact that my wife has always spoken aloud or in a whisper while sleeping. She would always deny any knowledge of the occurrence and would become extremely agitated if I made mention such a thing actually happening. Several months ago, she began to speak in a breathy whisper while sleeping and i thought it might be interesting to see if i could engage her with dialog. She began to speak back and forth almost as fluid as normal speach levels, etc. These "conversations" would be intermittently interrupted only when she would apparrently "wake - up" and accuse me of "whispering" in my sleep and disturbing her to the point where she would become very angry and offensive then immediatley fall back into sleep and continue the previous conversation without missing a beat. These whispery conversations now occurr during the waking hours and when i hear her speaking to what i assume is her self, i ask the question " I`m sorry, did you say something?? She becomes very angry and asks me if i have lost my mind and denies any such thing. As this frustrated me - i began to respond to her and speak to her in this secret language of white noise, and she would almost always respond. With all of this said, my question is: Is the medical case history of a condition similar to the I have described?
Sleep talking, also known as somniloquy, is not an uncommon problem, especially in children. While we don't know exactly how common talking in sleep is, it is estimated to occur in about half of all children and in about 5% of adults. Sleep talking can range from infrequent quiet sounds to full spoken sentences to singing and shouting. Often, the speech cannot be understood and may sound like mutterings or gibberish. The cause of talking in sleep is not entirely known. Most of the time, the cause of this sleep behavior can not be linked to any identifiable underlying problem or disease. And in most cases, the problem is not serious and may resolve over time or with age. However, in some cases, it has been found to be associated with other sleep-related disorders, such as sleep walking, REM behavior disorder (an unusual disorder in which individuals tend to act out their dreams while asleep), sleep-related epilepsy, post-traumatic stress disorder, sleep apnea, and the nighttime sleep eating syndrome. In addition, in adults who begin sleep talking in adulthood (did not do this as a child), there may be a higher rate of psychiatric disorders, though most adults who talk in their sleep do not have these problems.
If I understand your question correctly, you are suggesting that your wife is now speaking during the daytime in a similar fashion to her sleep talking episodes and is either unaware of it or not doing it intentionally. This poses the interesting question as to whether behaviors in sleep can carry over into daytime / wake time behaviors. This is not unheard of in some conditions, such as narcolepsy, where dream sleep (REM sleep) phenomena can carry over into awake time. A classic example of this is cataplexy, a symptom of narcolepsy, where individuals suddenly lose muscle tone (as happens when dreaming) when excited or upset. However, after a review of the available literature, I am unable to find any examples of sleep talking behavior that carries over into awake time.
The nature of the problems raised in your question could suggest an underlying psychological issue that may need further evaluation. To determine if there is an identifiable cause for your spouse's problem, a thorough history and physical examination are needed. A referral to a Sleep Specialist by your primary care physician may be necessary to help sort out whether further testing is needed. Once a history and physical examination have been performed, the Sleep Specialist will decide if additional evaluation by a sleep study or other testing is necessary. This may be required to determine the presence or the absence of some of the conditions mentioned above. Specific treatments for each condition are available and will depend upon the results of the evaluation, though as mentioned, most cases of sleep talking do not require any treatment.
In the meantime, it might be a good idea not to "converse" with your wife while she is sleeping. I suspect that she might be embarrassed by these episodes and her angry response may be arising, at least in part, from this. If you would like additional information regarding sleep and sleep disorders, you can obtain it on the American Academy of Sleep Medicine website. This website also contains a list of Sleep Centers across the country so you can locate one near you if need be. Good luck and here's to better sleep!
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University