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Wednesday, July 18, 2018

Sleep Anxiety: Yet Another Hidden Symptom

My wife and I are driving down a winding road in my new to me used car. It has replaced my beloved older car, which “died” saving me from an accident. Normally, the ride is a pretty smooth one, but for some reason, I am not able to hug the curves carefully enough, and my car goes careening off the road into a lake.

As it begins to sink, we hurry to keep it afloat. There is no way that I can lose 2 cars in about 4 months, so I must do everything in my power to keep it from sinking to the bottom of the lake. As I do this, I keep pinching myself to see if this situation is real or a dream. I’m pretty sure it isn’t actually happening, but it feels real. Nevertheless, for what I can’t feel in the lack of sensation my pinch creates, the dream is not ending. The car continues to sink, and I can feel the weight of this moment coming after me as it goes on and on.

As time goes on, there is a palpable feeling that my car is definitely sinking, and I'm truly in a world of not-so-good-ed-ness. This is getting scarier and scarier as I try to save my car and pinch myself to see if the madness is real.

Eventually, the dream does end, and I am safe in my bed, but all too completely aware that this is another one of my Parkinson’s dreams playing tricks with me.

If the commercial placement of hallucinations in the life of a Parkinson’s patient is any indication, then people are becoming aware of this side effect in the lives of people with said neurological condition. While it’s not a stretch to think of people with neurological conditions experiencing these issues of things happening that aren’t happening (for instance, ghostlike movement off to a person with PD's sides in an otherwise empty house OR paranoia regarding what family members are “doing” to them), society often blanks out on the way dreams affect Parkinson’s since they tend to be isolated from the slumbering Parkinsonian.

All things considered, why would they know?

If I were to go back to college now, I would love to work on a huge project with Parkinson’s and REM Sleep Behavior Disorder. It would be great to do an independent study where I could look into issues of hallucinations, anxiety, dreams, and visions regarding neurological conditions.

I know what you’re thinking: This dude needs serious help.

But it’s true. I love trying to sift through the dream symbolism and surreal nature of my dreams to decipher what they mean. These include winning big at a casino (compulsive gambling is a rare symptom of Ropinerole and other meds like it), being afraid of my friend driving wildly, ending up at Sandals for a romantic tryst as part of a comedy movie, going to a concert with Pete Yorn rolling around on the ground singing songs that sound more like Sun Kil Moon than him (after seeing Blink 182 and the Offspring collaborate as skateboarders go wild on a halfpipe), waking up and feeling an earthquake shake through my room, flying above a slot canyon on my command, searching for a lighthouse in Britain (which I never get to), and fighting people to the death with makeshift spears, which culminates with me actually punching at my antagonists.

What does all of this mean?

Well, for one, if it involves out of the dream punching, kicking, and scratching, then it means REM Sleep Behavior Disorder is present. This is one of the first signs of having Parkinson’s. One longitudinal study with 29 patients found that almost 40% of those surveyed (a very small amount, mind you) had Parkinson’s diagnoses in a little over a decade. That’s definitely cause for more research.

For two, it means that when we dream, we can feel the anxiety of our lives pushed into dreams, though this isn’t always true. Sometimes, it’s just smoking cessation meds, blood pressure meds, or Parkinson’s meds creating a weird situation in the brain. Insomnia or sleep deprivation can also cause nightmares, but in other cases, anxiety can manifest itself into our unconscious world of sleep problems.

For three, it means that demons are trying to possess said person. In this case, get the patient to a nunnery or monastery, as appropriate! Actually, you’d do better to call Father Karras. He or the Warrens are your only hope.

But since this is reality for a Parkinson’s patient (gotta love our dopamine level fluctuations), it could be a little bit of 1+2. Many of us tend to deal with depression, angst, feelings of meaninglessness, loneliness, loss of independence, communication problems, suicidal ideations, worry, aggression, nihilism, absurdity, crisis of faith, and rejection. Isn’t it obvious that we would feel anxious in both sleep and real life?

Add to this a bizarre cocktail of medicines that could make Timothy Leary stare wide-eyed, and you have a recipe for problems.

This is not always true, but the Mayo Clinic feels that when nightmares keep people from sleeping or wanting to go to sleep because of their intensity and frequency, then they should see a doctor, especially if this intrudes on their daily life. This article at Psychology Today lists a lot of helpful hints on controlling dream problems. These include staying on a schedule, relaxing, and things to avoid (video games and caffeine, for two).

For me, I’m not scared to dream - even when they get surreal or wild. I don’t hurt myself, and my wife is now a bedroom away, so I can’t hurt her anymore. Here, I should clearly note that I would never knowingly hurt my wife, but because of pillow stripping / throwing and scratches in the past, I had to accept this situation. I always say that it’s amazing what we can accept to stay alive, but this punishment was a bummer. Sometimes, a sleeping buddy just wants to touch toes to toes out of a feeling of, “Yeah, I love this person next to me.” It’s not meant to be some bizarre fetish either. It’s just, “I’m connected to you.” Things like that and holding hands, being in the same room, casual “I love you’s,” and hugs / kisses when leaving and coming home are the true intimacies.

 Nevertheless, those dreams… what they can’t take from us or prevent us from doing.

As I’ve written about, recently, I had a CPAP machine prescribed to me for treating sleep apnea. Nevertheless, I would tear it off in a half hour to three hours each night I wore it. I only remember one night that I took it off. Everything else… a mystery.

So far, in my Parkinson’s journey, this is my only treatment refused. There’s no point taking more anxiety / Parkinson’s meds when I’m taking 3 already. I know I’m a health helper person, but sometimes, we have to make a value choice. Do I want another med and its potential side effects so I can try to use the CPAP machine? Will I be OK without the CPAP machine if I choose not to use it?

I guess I'll find out soon.

In the meantime, bring on those dreams.

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