Question:

I am a 37 year old female, and for SEVERAL years, I wake up with the feeling that I have just swallowed something very bad, and i try to get it out of my throat with whatever is by my bed. One time i used a coat hanger. I usually wake up about 2 minutes later, but, by then I have already stuck something (usually sharp) down my throat. It is so weird. And painful. I have always done this since i can remember. Sometimes, it`s a needle that I think i`ve swallowed, or a knife..it`s awful.Can you give me any ideas about this?

Answer:

If I understand your question correctly, you are attempting to get something out of your mouth/throat while still asleep and do not awaken until after this happened. If this is the case, then you may have a possible sleep condition called a parasomnia, which I will discuss below. The alternative interpretation, that you are awakening with a painful throat and then, while awake, try to get something out of your throat, does not suggest a primary sleep disorder, but perhaps a problem with your upper airway or esophagus (food tube). If this second scenario is the correct interpretation of your question, then you would be best served by seeing an Ear, Nose and Throat Specialist to have your throat and upper airway examined.

Parasomnias are a group of disorders characterized by undesirable physical events or experiences that occur during entry into sleep, within sleep or during arousal from sleep. There are a number of different parasomnias, ranging from sleepwalking and sleep terrors to behaviors associated with dreams to a number of other sleep-related behaviors (such as eating during sleep, bedwetting, acting violently etc). The causes of these parasomnias are not entirely known. Many cases of these conditions are idiopathic, meaning we don’t know for sure what causes these behaviors.

The symptoms you describe could suggest possible REM behavior sleep disorder (dream sleep-related disorder). However, there are other sleep disorders that can present with symptoms that mimic REM behavior disorder, including seizures, nonREM parasomnias (non-dream sleep) and even obstructive sleep apnea. As such, before any diagnosis can be made, you will require a thorough history and examination and probably should undergo a sleep study.

REM behavior disorder is an uncommon condition in which individuals lose the muscle paralysis that usually accompanies REM sleep (dream sleep) and thus may act out their dreams. This tends to occur later in the night and most individuals have some recall of what they were doing (though they do not have control over it). Depending on the nature of the dream, this can lead to injurious behavior to the patient, such as from falling out of bed, running into walls or furniture or hitting objects, or their bed partner. Frequently, the nature of the dreams is violent (such as fighting or struggling to get away from someone or something), even in nonviolent individuals, and thus they may be prone to harming themselves or others. Certain factors may help to precipitate episodes, such as being sleep deprived, using alcohol or illicit substances or having an acute illness. It is most commonly seen in middle to older aged men. It can occur in women as well, though this is less common.

I recommend you discuss your problems with your doctor. Evaluation by a Sleep Specialist may be necessary to determine how best to evaluate and treat your problem. In the meantime, you should practice good sleep hygiene practices, some of which include:

1) Maintain a regular wake time, even on days off work and on weekends.

2) Keep a regular schedule. Regular times for meals, medications, chores and other activities help keep the inner clock running smoothly.

3) A relaxing pre-sleep ritual such as a warm bath, light bedtime snack, or 10 minutes of reading may help. Avoid heavy meals before bedtime.

4) Avoid ingestion of caffeine within 6 hours per day.

5) Do not drink alcohol when sleepy. Even a small dose of alcohol can have a significant effect when combined with tiredness and alcohol tends to cause sleep disruption after the first few hours of sleep.

6) Avoid the use of nicotine close to bedtime or during the night.

In addition, you should consider:

1) Removing dangerous, sharp or pointed objects from the room.

2) Adding locks to the windows and doors.

3) Placing heavy drapes in front of windows and glass doors.

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 it.

For more information:

Go to the Sleep Disorders health topic.