Sleep Disorders in Seniors...Early Predictor of Parkinson's Disease?


Recently, I came across some information that I found helpful as it relates to a elderly loved one. My dad's chronic vivid and active nightmares caused me to do a little research. It's definitely an issue that I will discuss with his physician. Consider the following:


Recent scientific research has identified a probable link between REM sleep disorders and degenerative neurological conditions like Parkinson's and memory loss issues. Mayo Clinic researchers have found that people with REM sleep disorders have approximately double the risk of developing cognitive impairment or Parkinson's. The onset of the cognitive impairment is on average about 4 years after first diagnosis of the sleep disorder. This is significant because it may allow physicians to intervene early in the disease process, minimizing brain cell death.


What is an REM sleep disorder? What symptoms are associated with this condition?


When people are in the deep REM (rapid eye movement) sleep stage, their muscles are "paralyzed" so that they do not physically act out their dreams. However, in a person with REM sleep disorder, the muscle paralysis is absent so his/her body is free to move and act out the dream sequence.


This condition is most common in middle aged and elderly people. Men are more often affected than women. In most cases, the behavior comes on gradually and worsens over time. When the disorder appears suddenly, it is typically related to drug or alcohol withdrawal.


People suffering with this condition can experience nightmares in which they are attacked and pursued and in response, scream, cry, kick, punch, thrash and sometimes jump from bed while still asleep. Not all dream sequences involve a frightening experience. My dad, for example, had a fantastic dream where he dove to catch a football and scored the winning touch down in the Super bowl! Unfortunately, he also dove out of bed, knocking over a lamp, crashing into a nightstand and doing a number on his knee. He has also been a "boxer" in his dreams, complete with loud "trash talking" and a fierce punch that almost clipped me when I went to check on him. These stories are little humorous but other experiences have been no joke. The behavior associated with REM sleep disorder can be frightening to experience and upsetting to observe. This intense physical activity while sleeping can lead to injury to self or mate. Upon waking, the individual may remember the dream but not his actions.


Can REM sleep disorder be treated?


The condition can be treated with prescription medication. Low dose benzodiazepine may be prescribed which is believed to suppress the muscle action. Physicians are cautious when using this medication to treat patients who also have signs of dementia or gait disorders. Melatonin has also been prescribed and used with some success as a natural alternative. You will definitely want to have your loved one evaluated by a physician for a proper diagnosis and treatment plan. Your physician will want to follow him closely due to the link between REM sleep disorder and possible serious neurological conditions.

Implement physical safeguards such as placing mattress on floor or place a pad on the floor next to the bed, using padded bedrails, moving the bed away from other furniture or windows and removing unsafe objects from the room. His or her mate should also consider sleeping elsewhere until symptoms resolve.


REM sleep disorder can be a serious condition. Don't chalk up the symptoms to "old age"; seek medical advice. Evaluation and treatment of this condition may alert your loved one's physician to hidden risk factors for Parkinson's disease and other neurological conditions down the road.


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