This patient is a female in her early 30s. Her medical history is unremarkable f
ID: 3456653 • Letter: T
Question
This patient is a female in her early 30s. Her medical history is unremarkable for any major problems or diseases. She indicates that she has no sleep problems of which she is aware, although she did sleepwalk as a child, but not beyond age 10. She falls asleep readily, does not believe she snores, and generally awakens feeling refreshed. She has no bed partner to provide confirmation of her sleep behaviors. She seeks help because of two recent incidents. In the first incident, she awoke at 3:30 a.m. to find herself on the roof of her house, apparently having climbed a ladder to get there. She stated that during the day she had been concerned about a tree branch that was rubbing on her roof but had forgotten about it that night. When she awoke on the roof, she thought she had just dreamed about climbing a ladder and inspecting the tree branch. The second incident occurred five weeks later. The patients reported having a good day and falling asleep readily. She awoke at 4:00 a.m. sitting under a ite tree in a nearby park and drinking a glass of wine. Upon awakening in the park, she thought she had been dreaming about being on a picnic with her boyfriend.
Explanation / Answer
Sleep walking also known as somnambulism, is a sleep disorder. The symptoms above are clearly that of a sleep disorder mentioned in the DSM-V. Sleep walking is a sleep disorder which takes place during the slow wave stage of the sleep cycle. The sleep cycle has five stages, the fifth stage being Rapid Eye Movement (REM) . It approximately takes about 90 minutes to complete a sleep cycle. The third stage (Non-REM) of sleep cycle is characterized by theta waves. It is during the third stage of sleep cycle, dreams are enacted for real. The patient in the above case thought she was dreaming, however, she was enacting her dream for real. Sleep walking can be very dangerous and life-threatening. A person may not realize that it is a dream until they wake up and come to their senses. Sleep walking cannot be cured, however, preventive measures of a safer sleeping environment should be taken care of.
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