III.
EATING DURING SLEEP.
Individuals
with this often serious disorder may initially experience some
sleepwalking without eating, but then develop a pattern of bizarre
eating in sleep--typically high carbohydrate foods--which are eaten
sloppily in large quantities. The behaviors are frequently nightly
with resulting weight gain and increased risk of diabetes and dental
caries.
Most
have no awareness of the abnormal behavior while it is occurring
and may resist efforts to make them stop eating.
A
minority have histories of eating disorders in wakefulness. It
can be caused by sleeping pills, such as Ambien, and by sedating
antidepressant medications. It sometimes is associated with sleep
apnea. Treatment is available.
IV.
INAPPROPRIATE SEXUAL BEHAVIORS WHILE ASLEEP ("SLEEP SEX").
This
disorder, which occurs with varying degrees of severity, involves
sexual behaviors when fully asleep--either masturbatory or sexual
advances toward the bed partner, sometimes violent in nature.
V.
BITING OF THE TONGUE OR INSIDE OF THE CHEEK IN SLEEP.
Can
be a painful but otherwise harmless irritation -- or, in some cases,
a critically important symptom -- depending on the underlying cause:
-It sometimes
results from toothgrinding (bruxism: described below). In some
instances, it may be an extension in sleep of a nervous habit of
chewing/ clenching of the teeth when awake or drowsy.
-Mechanical
factors may explain its occurrence: for example, a large tongue or
damaged teeth with sharp edges.
-Sleep
apnea may
precipitate this problem -- when patients “catch” their
tongues or cheeks during violent, gasping efforts to breathe.
-It also can
represent the consequence (and occasionally, the only obvious symptom)
of sleep-related
seizures.
VI.
BRUXISM (TOOTHGRINDING, TOOTHCLENCHING).
Bruxism typically
follows transient arousals, too brief to recall, and happens while
the person is drifting back into a sounder sleep. Thus,
anything that can make a person more arousable can aggravate it--such
as:
-Nasal
congestion, from allergies, upper respiratory infections, “sinus
trouble”, etc. -Sleep
apnea -- when the patient arouses repeatedly from inability to
breathe.
-Caffeine,
stimulants, decongestants, diet pills and other medications that fragment
sleep.
-Stress,
as well as a tense, hard-driving personality style. Some individuals
with bruxism have a history of anxiety attacks.
-Other
sleep disorders that provoke repeated arousals, including seizures, can
increase bruxism.
-Chronic
bruxism may gradually damage the teeth and temporomandibular joints
(“TM joints”, “jaw joints”):
accelerating dental occlusion abnormalities (tooth and jaw misalignment):
which in turn may increase bruxism.
Symptoms
vary. Some people have none at all, and their problem
is recognized first by someone else (either a dentist or bedpartner who
finds the grinding noises objectionable). However, other patients
experience pain in the face or TM joints, more generalized headaches,
restless sleep or biting of the tongue or inside of the cheek (see
above).
Treatment must
be tailored to the patient. Underlying sleep disorders
should be evaluated by a sleep medicine specialist, and dental occlusive
problems should be assessed by a dental practitioner who may prescribe
a “bite plate” to protect the teeth from further wear. Avoidance
of aggravating factors that may increase arousals and hence, bruxism,
should be avoided. Good relaxation/ stress management training
proves invaluable in many cases.
VII.
NIGHT SWEATS (SLEEP-RELATED HYPERHIDROSIS).
Vary from mild and
intermittent to nightly, drenching episodes forcing changes in bedclothes. Their significant sometimes correlates with
their severity. Possible causes include:
-Simply
being overcovered, or bedroom too warm.
-Infections
--particularly if chills, shivering, fevers or other infectious symptoms
are present. Taking one’s temperature repeatedly during ‘bad
nights’ may provide clarification.
-Menopause
-- ‘hot flashes’ and increased tendency to sweat at night.
-Sleep
apnea --
a common cause of night sweats, often involving the head and
neck, and related to repeatedly struggling to overcome throat
collapse. Look
for: snoring, restless sleep, arousals with snores/ gasps/ shortness
of breath/ chest discomfort/ headache/ dry throat, worsening with weight
gain, nasal congestion and after consumption of alcohol, or such daytime
complaints as sleepiness, irritability, trouble concentrating and memory
problems. At the same time, realize that some people with sleep
apnea have none of these symptoms.
-Sleep-related
seizures --
particularly if severe.
-Hypoglycemia
(low blood sugar levels) -- if occurring in sleep.
-Other
hormonal/ endocrine disorders and other disorders of the brain
and nervous system -- sometimes are the cause of night sweats. Look
for the common causes first, though, unless you have already been
diagnosed as having another medical or neurological condition that
might explain this symptom.
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