09-23-05 - More Dreams - More Dreams 9/23/05 1. 2. REM...

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More Dreams 9/23/05 1. REM disorders a. Ability to move during sleep b. Cause: Tumor in locus coeruleus 2. Narcolepsy a. More Symptoms of Narcolepsy i. Sleep paralysis 1. Delayed onset of muscle tonus after waking (perhaps up to a minute) ii. Hypnogogic hallucinations 1. Rapid movement from hallucinations to dreams b. Trends of Narcolepsy i. Genetic inheritance ii. Will onset from puberty to at latest 25 c. Treatment i. Correct diagnosis (takes on average 5 different doctors) ii. Counseling of patient and spouse iii. Good sleep hygiene iv. Medicine (provigil with antidepressants) d. Cause i. Loss of Hcrt neurons which contain the neurotransmitter: hypocretin ii. The mother is sick at some point late in the pregnancy such that it prevents the child from receiving hypocretin transmitters 3. Disorders of Insomnia a. Transient Insomnia i. Situational reactions ii. Environmental conditions iii. Sleep/Wake schedule changes: 1. Shift work rotations 2. Crossing time zones (jet lag) a. Body time is out of synch with real time
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