Sleep violence seen--and felt--in Parkinson's disease.

[Margaret Tuchman <mtuchman@xxxxxxxxxxxxx>]

Perhaps we are dreaming about the NIH & Dr. Varmus???

The Lancet,Volume 349, Number 9059 - Saturday 19 April 1997=20

Sleep violence seen--and felt--in Parkinson's disease.

Sleep violence "largely goes unrecognised and unsought after" in patients
with Parkinson's disease, even though in many cases it is also "very
treatable", said Cynthia Comella (Rush Medical College, Chicago, IL, USA) at
the annual American Academy of Neurology meeting (Boston, MA, USA; April
12=AD19).


Comella and her team investigated the frequency of nocturnal sleep-related
violence and REM sleep behaviour disorder (RBD) in 37 men and 24 women with
idiopathic Parkinson's disease. Patients and caregivers separately assessed
the patients' sleep quality, history of sleep disturbances prior to the
onset of disease, and occurrence of sleep-related movements associated with
injury to self or to the caregiver.=20

Seven men and two women (15%) were diagnosed with RBD. Their caregivers
reported nocturnal running, pushing, kicking, and thrashing. If awakened
during an episode, none of the patients were aware of making violent
movements, but all reported aggressive dreams. Nine non-RBD men, but no
women, also had episodes of sleep violence.=20

"Caregivers often won't tell you if they are punched, kicked, or choked at
night unless you ask", Comella said. "Clinicians should make these questions
part of a specific interview. Recognising the cause and initiating treatment
may prevent injury and improve the relationship between patient and
caregiver." RBD is "very responsive" to low doses of clonazepam, noted
Comella. A larger study to determine whether clonazepam "eliminates all
episodes of sleep violence in Parkinson's patients" is planned, she added.=
=20
Marilynn Larkin
Margaret Tuchman (55yrs, Dx 1980)- NJ-08540
mtuchman@xxxxxxxxxxxxx