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Sleep Eating, Sleep Sex, Tongue Biting, Bruxism, and Night Sweats

THE SLEEP SITE

BRINGING SECRETS OF THE NIGHT TO THE LIGHT OF DAY...

Understanding the symptoms of sleep disorders.

ABNORMAL BEHAVIORS IN SLEEP.
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Introduction.
Analyzing the problem.
-Sleepwalking, screaming, arousals with panic & frantic, agitated behaviors.
-Abnormal body movements during sleep.
-Eating during sleep.
-Inappropriate sexual activity during sleep ("sleep sex") .
-Biting of the tongue or inside of the cheek during sleep.
-Bruxism (toothgrinding; toothclenching).
-Night sweats (sleep-related hyperhidrosis).
-Headaches related to sleep.
-Enuresis (bed wetting) and frequent urination at night (nocturia).
-Abnormal heart rhythms during sleep.
-Choking, shortness of breath and chest pains occurring during sleep.
-Sleep paralysis.

ABNORMAL BEHAVIORS IN SLEEP - 3.


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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Columbus, Ohio, Central Ohio, hospitalssleep, wake, insomnia, sleepiness 

COLUMBUS COMMUNITY HEALTH
REGIONAL SLEEP DISORDERS CENTER
Accredited by the American Academy of Sleep Medicine.

Robert W. Clark, M.D., Medical Director
1430 South High Street, Columbus OH 43207

Tel: [614] 443-7800
Fax: [614] 443-6960

e-mail: flamenco@netexp.net 

 © Copyright 2006 Robert W. Clark M.D. Inc.