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Wednesday, December 11, 2013
`I See Dead People` Sleep Hallucination
I am getting more and more terrified to go to sleep. I have had insomnia, night terrors and lots of other fun sleep issues (and those I can deal with), but seeing the Dead People are really creeping me out.
I am a sane (IMO), 33 year old married female in good health. Here`s what happens: I am fully asleep and have been for around 90 minutes. Then I discover that there is someone standing next to or at the foot of my bed. My eyes are open. I see my whole bedroom as it is -- if there`s a pile of laundry on the floor, it`s there --I usually have a night light on. The person is standing in my room as I see it with my eyes open. As I am terrified, I scream my lungs out. This is because the person is dead and creepy looking. I`ve had one drowned child, one burn victim, a man who was hit while riding his bike, and several others of unknown causes.
Sometimes I run out of the room. My husband usually turns on the light and talks me calmly into wakefulness. One time, I wasn`t as afraid because the "dead person" was a poor, confused old man...I could see he was stumbled into the laundry hampers along the wall next to my bed and was getting all tangled up. I got out of bed to "help" him. My husband asked me what I was doing and I said, "No, honey this time it`s okay; he needs help." Then it slowly registered that indeed it was another one of my "night incidents."
Even though I become fully awake and aware, I am usually able to go right back to sleep immediately, much to my husband`s chagrin as he has been woken up suddenly by my screaming and now has tons of adreneline running through his body!
My sleep hallucinations are not all dead people. Sometimes there`s an insect or insects, lizards or small furry rodent in the bed. (I am not afraid of insects, lizards or rodents in my wakeful life; I feel comfortable handling them). Sometimes my hubby tells me in the morning that I was telling him to look at the pretty butterflies on the ceiling!
Sometimes the incidents are just night terrors, which I had when I was a toddler and resumed when I turned 13 for some reason. This is where I scream my lungs out. Most of the time I only barely wake up for these, if at all. Only a few times I remember why I am screaming, e.g. a concrete slab is about to fall on top of me. These are not like bad dreams or nightmares; they are like "sudden death" is upon you in an instant. I have accidentally injured myself by leaping out of bed, running down stairs and falling, running into walls, etc.
The night incidents I usually remember are the ones where I become fully awake. A lot of times I don`t remember at all, or I remember hazily once my husband reminds me in the morning. Some mornings he tells me that I was "giggling at something last night" or was quizzing him on his identity! A funny-to-my-family story is that I shouted at my husband "Identify Yourself! What is your social security number? " He said he was my husband and then I said "Where did we first meet? What street did I grow up on?" Hardy-har-har.
Even if I have no recollection in the morning, I can usually tell I had a night incident because I feel way more tired than usual...kind of like a truck ran over me.
I did do a sleep study and of course nothing happened! I do not have sleep apnea.
I just don`t know what to do anymore...it`s really freaking me out and making me feel like there`s something scary-wrong with me. I`m afraid to go to sleep the nights my husband is on call (he`s a doctor) because if I have a night hallucination, it`s more terrifying when he`s not there to comfort me.
Someone *suggested* to me a long time ago that something evil (read: the Devil) is trying to possess me or spirits are trying to contact me and that I am psychic. I dismissed it at the time, but as I get more and more worn down...and it all seems so real...
Please tell that there are medical explanations for all of this. Are there others to whom this happens?
It sounds as though you have a very complex situation on your hands that really requires a thorough evaluation by a Sleep Specialist. The type of behavior you describe, vivid dreams that you may act out, possible hallucinations, sleep talking and sleepwalking, all suggest a possible parasomnia. Other considerations as potential causes of your symptoms might include a seizure disorder, side effects from medications or substance abuse.
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, 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 suggest a possible slow wave sleep-related parasomnia or REM behavior disorder (RBD). The sleepwalking may be a part of or separate from these conditions. However, before any diagnosis can be made, you will require a thorough history and examination and should undergo additional testing (see below).
Slow wave sleep (or deep sleep) disorders often occur early in the night (when most slow wave takes place). It is very difficult to awaken individuals from slow wave sleep and they often have little recall of their behaviors. This seems less like the symptoms you describe. On the other hand, RBD is an uncommon condition in which individuals lose the muscle paralysis that usually accompanies REM sleep and thus may act out their dreams. This tends to occur later in the night (though we often experience our first REM sleep episode about 90 minutes into sleep) and most individuals have some recall of what they were doing. Depending on the nature of the dream, this can lead to injurious behavior to the individual (from falling out of bed, running into walls or furniture or hitting objects) or their bed partner. It is more commonly seen in middle to older aged men, but can occur in women as well.
Sleepwalking, also known as somnambulism, occurs in somewhere around 1-15% of the general population with a peak incidence between the ages of 4 and 8. It tends to resolve with aging. If sleep walking starts in adulthood, it may suggest an underlying psychiatric or psychological disorder, excessive stress or substance abuse. In most cases, sleep walking is not serious and resolves over time. However, some sleep-related conditions can present with sleep walking as their primary symptom, and thus in some cases, additional evaluation and treatment is needed. Obstructive sleep apnea, a seizure disorder and REM behavior disorder all may have sleep walking as part of their presentation. Typically, in benign sleep walking, the individual does not act out violently in their sleep, though aggressive behavior may occur if the sleep walker is confronted with strong stimuli.
In order to determine if there is an identifiable cause for your symptoms, a detailed history and physical examination are needed as well repeat sleep testing. Aside from a possible parasomnia, partial complex seizures need to be excluded. It would be reasonable to be evaluated by a Sleep Specialist with expertise in parasomnias and seizures (perhaps one with a Neurology or Psychiatry background) to make sure the appropriate type of sleep study is performed. In some cases, multiple nights of monitoring with an extended EEG and video recording are needed to make the diagnosis.
In the meantime, here are some general guidelines for helping to protect sleepwalkers:
1) Remove dangerous, sharp or pointed objects from the room.
2) Consider adding locks to the windows and doors.
3) Put heavy drapes in front of windows and glass doors.
4) When sleep walking, family should gently attempt to guide the sleepwalker back to bed without waking them.
5) AVOID strong stimuli - this could cause aggressive behavior.
Once the underlying disorder is determined, then more specific treatments are available that are generally highly effective.
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.
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University