- SURE, I HAVE HIT ANITA PRETTY HARD BEFORE.
- AND ONE NIGHT, IT WAS JUST WHAM, WHAM, ONE AFTER THE
OTHER, RIGHT IN THE TEMPLES.
AND THAT NIGHT, I DID SEE STARS.
- SOMETIMES I'D CHOKE HER.
SOMETIMES I'D KICK HER.
- WITH MY ARM, HE WAS BENDING IT BACKWARDS LIKE HE WAS
GONNA SNAP IT.
AND THAT HURTS.
- OF COURSE, YOU WAKE UP APOLOGETIC AND ALL THAT,
BUT IT'S ALREADY DONE.
IT'S DAMAGE.
YOU'VE HIT YOUR WIFE, AND THEN YOU HAVE THE MEMORY OF IT.
- WE THINK THAT DREAM ENACTMENT BEHAVIOR, OR REM SLEEP
BEHAVIOR DISORDER, IS A LESION CAUSED BY THE PATHOLOGY
OF PARKINSON'S DISEASE DEEP IN THE BRAIN STEM.
IN THIS AREA, NORMALLY WHEN YOU DREAM, THIS CENTER WILL
SHUT OFF YOUR SPINAL CORD, BASICALLY, SO THAT IF YOU DREAM
ABOUT RUNNING AWAY FROM A TIGER, YOU WON'T ACTUALLY RUN
AWAY FROM A TIGER.
YOU'LL JUST DREAM THAT YOU DO.
WHEREAS IN THESE PATIENTS, THAT SORT OF OFF SWITCH GETS
KNOCKED OUT BY THE PARKINSON'S PATHOLOGY, AND SO NOW THEY
WILL QUITE LITERALLY RUN AWAY FROM A TIGER AND SORT OF RUN
OUT OF BED OR, YOU KNOW, KICK THEIR BED PARTNER.
- THE PROBLEMS I'VE HAD WITH MY SLEEP AND THE PARKINSON'S,
AT FIRST, WE THOUGHT IT WAS PTSD BECAUSE I WOULD ACT OUT
A LOT OF MY DREAMS, STARTING IN THE LATE EIGHTIES.
I FINALLY WENT TO A VET CLINIC IN FRESNO FOR THE DREAMS.
- YEARS AGO, WHEN WE THOUGHT IT WAS JUST THE PTSD, WE DID GO TO
SUPPORT GROUPS, BUT THEY NEVER TALKED ABOUT IT, LIKE,
WHAT YOU CAN DO TO HELP WITH THE NIGHTMARES.
- THE DREAMS IMPACTED MY LIFE IN THE WAY OF THEY WOULDN'T
ALLOW ME TO GET ANY REST, AND I'D WAKE UP
WITH TREMENDOUS ANXIETY.
THEY WERE SO REAL THAT IT WOULD JUST LEAVE ME DEVASTATED
THE NEXT DAY.
SO AFTER A COUPLE OF DAYS OF THAT, YOU'RE PRETTY NUMB
AND PRETTY HARD TO DEAL WITH.
- IN THE VA POPULATION, IT'S REALLY TRICKY BECAUSE WE
SEE A LOT OF PATIENTS WITH POSTTRAUMATIC STRESS DISORDER,
AND OBVIOUSLY IN OUR CLINIC, WE SEE A LOT OF PATIENTS
WITH PARKINSON'S DISEASE.
IT CAN BE REALLY HARD BECAUSE PATIENTS AND THEIR BED
PARTNERS ARE USED TO A LIFETIME OF NIGHTMARES FROM PTSD.
BUT MOST OF THE TIME IF WE ASK, THEY'LL SORT OF DELINEATE
ACTUALLY SOMETHING SORT OF DIFFERENT ABOUT THE NATURE
OF THEIR NIGHTMARES NOW.
BUT YOU REALLY HAVE TO ASK THOSE PROBING QUESTIONS TO
SORT OF TEASE THAT OUT.
- I WOULD ACTUALLY EVEN HAVE FANS IN MY ROOM WHERE I COULD
FEEL THEM WALK IN FRONT OF THE FANS AND STOP THE AIR,
AND ALMOST LIKE A HALLUCINATION, YOU KNOW.
YOU'RE AT THE POINT WHERE YOU'RE AWAKE, OR AT LEAST I
FEEL LIKE I'M AWAKE TO THE POINT WHERE YOU BELIEVE IT.
YOU WAKE UP MAD.
AND I WOULD FEEL THEM WALK IN FRONT OF THE FANS AND THEN GET
RIGHT IN MY FACE, AND THAT'S WHEN I'D COME UP SWINGING.
- WHATEVER CAUSED YOUR PTSD OR WHATEVER THE THEME
OF THE DREAMS THAT YOU RELIVE ARE MAY SORT OF INFLUENCE THE
DREAMS IN REM SLEEP BEHAVIOR DISORDER, WHEREAS IF YOU
DIDN'T HAVE PTSD, YOU MIGHT BE DREAMING ABOUT SORT
OF THE GARDEN-VARIETY STUFF THAT YOU AND I MIGHT
DREAM ABOUT.
- EVEN THOUGH PARKINSON'S IS A HIDEOUS DISEASE, KNOWING THAT
YOU HAD IT WAS KIND OF A RELIEF.
THEN I KNEW WHAT I HAD TO DEAL WITH.
- CONSERVATIVE THERAPIES FOR REM SLEEP BEHAVIOR DISORDER
INCLUDE MAKING SURE YOUR NIGHTSTAND IS NOT RIGHT NEXT
TO YOUR BED, YOU DON'T HAVE SHARP CORNERS, YOU DON'T HAVE
LAMPS WHERE YOU'RE GONNA BASH THE LAMP WITH YOUR HANDS.
A LOT OF TIMES, WE'LL ACTUALLY RECOMMEND THAT PEOPLE PUT
THEIR MATTRESS ON THE FLOOR.
- OUR BED IS ABOUT 3 FEET UP OFF THE FLOOR, SO NOT
PROTECTING YOURSELF, NOT BEING AWAKE ENOUGH TO PROTECT
YOURSELF, THAT HURTS PRETTY GOOD HITTING THE FLOOR.
- THE SECOND STEP IS OFTEN TO INSTITUTE SOME MEDICATIONS TO
TREAT REM SLEEP BEHAVIOR DISORDER.
IN THE CASE OF MR. WIENER, WE USE CLONAZEPAM, WHICH IS
THE MOST COMMONLY ADVOCATED MEDICINE FOR USE OF TREATMENT
OF REM SLEEP BEHAVIOR DISORDER, AND WE STARTED
AT A VERY LOW DOSE.
- THE DRUG FOR THE NIGHTMARES, I TAKE ON A REGULAR BASIS.
THAT'S HOW IT WORKS, IS YOU TAKE IT ON A--YOU DON'T KNOW
WHEN YOU'RE GONNA HAVE THE DREAMS, AND IF YOU WAIT UNTIL
AFTER YOU'VE HAD DREAM, WELL, IT'S TOO LATE.
I TAKE IT EVERY NIGHT, AND I TAKE IT ABOUT AN HOUR
BEFORE I GO TO BED.
I FEEL THAT IT HELPS ME GO TO SLEEP A LITTLE EASIER, AND IT
GETS ME ALL THE WAY THROUGH THE NIGHT WITHOUT
HAVING A DREAM.
- I'M ABLE TO RELAX MORE.
HE RELAXES MORE, OBVIOUSLY, AND THERE'S LESS NIGHTMARES,
LESS MOVEMENT.
- LIKE A LOT OF PATIENTS, HE NOTICED A DRAMATIC
DIFFERENCE ON THE VERY FIRST NIGHT.
AND ONE OF THE NICE THINGS ABOUT TREATING DREAM ENACTMENT
BEHAVIOR OR REM SLEEP BEHAVIOR DISORDER IS THAT THE EFFECTS
OF THE MEDICATION ARE IMMEDIATE, AND SO PATIENTS
WILL LITERALLY TELL YOU THEY WENT FROM HAVING DREAM
ENACTMENT ACTIVITY EVERY NIGHT TO NOT AT ALL IF YOU HAVE HIT
A THERAPEUTIC DOSE.
- IT WAS KIND OF A MIRACLE DRUG.
I DIDN'T THINK SOMETHING LIKE THAT WOULD EXIST.
AND I TOLD DR. GLASS, WHICH IS KIND OF FUNNY, I TOLD DR. GLASS
ABOUT THE REVELATION OF NO MORE DREAMS, AND HE SAID,
"OF COURSE. THAT'S WHAT THE DRUG IS FOR."
- IF YOU OR SOMEONE YOU LOVE HAS PARKINSON'S DISEASE
AND HAS SLEEP PROBLEMS, IT'S IMPORTANT TO BRING THOSE
TO THE ATTENTION OF YOUR DOCTOR BECAUSE IN MANY CASES, WE CAN
MAKE THOSE SLEEP PROBLEMS SIGNIFICANTLY BETTER AND THUS
IMPROVE THE QUALITY OF YOUR LIFE AND YOUR PARTNER'S LIFE.
- THE STAFF AT THE CLINIC IS FANTASTIC.
I'LL HAVE TO SAY, YOU NEVER WALK OUT OF HERE
WITH A BAD FEELING.
JUST EVERY TIME WE SEE THEM, IT'S A LITTLE MORE OF A HELP
AND AN ANSWER OR HELPING US GETTING THROUGH THIS, BUT YOU
LEAVE WITH A BETTER FEELING.
- MY SLEEP NOW IS ALMOST NIGHTMARE FREE.
AND IT ISN'T THAT THE DRUGS DRUG YOU UP TO THE POINT THAT
YOU HAVE TO GO TO SLEEP.
IT'S AMAZING.
IT JUST KIND OF ELIMINATED THE DREAMS.
AND THE NEXT DAY, I WAKE UP AND I'M REFRESHED AND REALLY
HAVEN'T HAD THOSE ANXIETY ATTACKS SINCE I STARTED TO
TAKE THE MEDICATION.
IT'S MADE LIFE WORTH LIVING.