I did WHAT last night?

Parasomnias can pose a real danger.

A teenager is found sleeping in a tower crane 130 feet above the ground, having walked across a narrow metal beam to get there. A man gives his roommate a nightly play-by-play of his dreams as they occur. A sleeping man drives across town, chokes his stepfather and stabs his stepmother to death. These are all true stories—examples of extreme parasomnias.

Parasomnias are described as abnormal things that people do while in a sleep state. They can range from talking in your sleep to more risky or violent behaviors such as engaging in sexual acts while sleeping to even homicide. There have been several cases of somnambulism (sleepwalking) where people have thrown themselves out of windows. Somnambulism represents an exceptional state, combining a level of consciousness with organized behaviors and an EEG that resembles sleep.

Consider the case of Kenneth Parks, a 23-year-old married, Toronto man who was under considerable stress due to many factors, not the least of which was his significant gambling addiction and debt. To cover heavy losses, he initially took funds from the family savings, then began to embezzle at work. Hiding these problems from his wife placed severe stress on the marriage. There were also major strains at work in covering up the thefts.1

These stressors began to negatively impact his sleep. Ken reported no sleep at all two days before he was to disclose his gambling to his in-laws. The next night, Ken fell asleep on the couch watching Saturday Night Live, with the next-day’s meeting with the in-laws heavy on his mind.

That was his last memory until he woke up at his in-laws’ house, looking down at his mother-in-law whom he had violently stabbed to death. He has also choked his father-in-law to the point of unconsciousness. Ken had driven nearly 25 kilometers to get there yet had no recollection of any events after falling asleep on the couch.

While in custody and awaiting trial, a lengthy medical history of Ken was constructed, including the fact that he was an extremely deep sleeper, and there was a family history of parasomnias. He had been close with his in-laws and expressed sincere remorse. In addition, there was a lack of evidence of motive or other medical causes, and there was strong laboratory evidence for somnambulism. Ken was acquitted as evidence demonstrated that the murder had occurred while Ken was sleepwalking.

“Often people will talk during sleep and may even walk during sleep and in most cases, their activities are not dangerous. True parasomnias are common, but typically not as severe as the ones mentioned here,” says Dr. Michael Friedman, otolaryngologist and sleep specialist at Chicago ENT.

There are, however, a new set of problems that have arisen due to the frequent use of Ambien. A powerful sleep aid, Ambien is the number one sleep-inducing medication prescribed in the world. Although it usually accomplishes its goal of putting the patient to sleep, very often, it causes patients to do things that they have no memory of. These patients are essentially experiencing parasomnias secondary to the use of Ambien.

Often, they will be found leaving their bedroom and involved in dangerous activities such as driving.

“I had one patient, a police lieutenant, who would at times choke his wife while sleep and have no recollection of it the next day. Ambien can also cause sleep eating and many patients will find food remnants that they have no memory of eating,” said Dr. Friedman.

Dr. Friedman cautions that Ambien is a highly addictive sedative-hypnotic that is used for short-term insomnia and is not intended for long-term use or as a substitute for proper sleep habits. “Ambien is not only vastly over prescribed, but it is also over-dosed, meaning it is prescribed at a strength much stronger than necessary. Also, women do not metabolize Ambien as readily as men and account for 2/3 of Ambien-related ER visits.”

If you experience insomnia or parasomnia, you don’t have to live with it. You should discuss it with you doctor. He or she may refer to a sleep specialist for a sleep study and treatment.

1 Homicidal Somnambulism: A Case Report R. Broughton, tR. Billings, tR. Cartwright, §D. Doucette, tJ. Edmeads, §M. Edwardh, #F. Ervin, tB. Orchard, tR. Hill and G. Turrell