Monday, March 25, 2013

Dreams and Lewy Body Disease

I’ve always been a dreamer and often awaken in the night puzzling over what remote area of my brain produced those mini-motion pictures. My dreams are often a mystery, especially when I wake up with vivid images of my nighttime adventures.

We all dream, but some people cannot remember their dreams when they awaken. I tend to remember mine and find myself inspired, disturbed, or downright puzzled. I kept a dream journal for a long time as a means to jumpstart my writing. I am amazed at how many ideas I can glean from my dreams.

Just a few of the images I remember from last night: (1) I dreamed my house was connected to my work and a former employee had removed my cat’s litter box and let her outside. (2) I had gone to the dentist (whose office was at a mall) and forgot to remove the clothing protector when I left, but managed to accidentally put on two fancy scarves that didn’t belong to me. (3) My sister and I hopped on a trolley to return to the mall to get my coat and return the scarves.

Does any of that make sense? In a strange way, most of it does relate vaguely to something that happened the day before. Think about Dorothy and the Wizard of Oz. Her dream from the bump to her head was a fascinating distortion of the events leading up to the tornado.

Did you know that studies before 1950 showed that most people dreamed in black and white? That began to change during the sixties, and now about eighty-eight percent of us dream in color. Nearly ninety-six percent younger than twenty-five dream in color. This change is believed to be the result of the changeover from black and white film to color media. It really makes sense if you think about it.

One of the theories behind dreaming is that dreams are our way of consolidating our memories and attempting to make sense of them. We dream during the REM (rapid eye movement) stage. While our eyes move, normally, the rest of our body is paralyzed. In our family, several of us have, or have had, paralyzing nightmares. During this event, we are trying to wake from a bad dream and realize that although the mind is awake, the body cannot move. It is a disconcerting feeling, to say the least.

On CBS This Morning, Dr. James Galvin talked about a study from Mayo Clinic about dreams and the connection to dementia. This study showed that if you act out your dreams by kicking, shouting, punching, or thrashing about, you are at higher risk of developing dementia. In fact, the study shows this is the strongest predictor of developing Lewy Body disease.

Approximately 1.3 million people in the United States have Lewy Body disease. Both men and women develop the disease, but it is more common in men. Lewy Body disease is under diagnosed because of symptoms it shares with Alzheimer’s and Parkinson’s, but subtle differences help physicians make a diagnosis. Now, added to other differences, acting out dreams may be another indicator of the disease.

Lewy Body disease is best treated with a comprehensive approach by a team of specialists. Cholinesterase inhibitors, such as Aricept, work well on Lewy Body disease. In fact, it is believed the cholinesterase inhibitors are more effective on this disease than on Alzheimer’s. The movement disorders associated with Lewy Body is treated with Parkinson’s medication. Antipsychotic drugs should not be used for hallucinations because they react differently on persons with Lewy Body disease. These drugs worsen symptoms in fifty percent of those using them, and can cause a fatal reaction called neuroleptic malignant syndrome (NMS).

Of course, one of the problems with Lewy Body disease is REM Sleep Behavior Disorder. This is often treated with melatonin or clonazepam.

It is important to remember that if you move around and act out your dreams, it does not mean that you have Lewy Body disease or that you will develop it. If you develop signs of dementia, it is something to mention to your team of physicians during testing to determine the cause of your cognitive problems.

The connection between sleep and function the following day is strong. A lack of sleep or disturbed sleep affects our thinking process. Now, acting out during sleep means a person is five times more likely to develop Lewy Body dementia than those who sleep quietly during dreams.

Sleep is essential to our health and wellbeing. The REM stage of sleep is when our minds can take us places we will only reach through dreams.

Copyright © 2013 by L.S. Fisher    
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