Why acting out dreams as if they were real could be an early sign of Parkinson’s

Why acting out dreams as if they were real could be an early sign of Parkinson’s
Why acting out dreams as if they were real could be an early sign of Parkinson’s
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Wes Mills has a very peculiar nighttime ritual, which surprised and amused his wife when the two began living together a decade ago: he moved a lot during the night. sleepas if it were a actor acting out his dreams, with all the drama. He once ran in bed to escape an attacker. Another time, he motioned for a small raccoon to eat from his hand. Yet another time, he came up with strategies with other inmates during a prison riot.

“I laughed and called him The WesShow,” says Eileen Mills, 49, of Taos, New Mexico.

But today she doesn’t find it funny anymore.

Wes Mills, a contemporary artist with works at the Whitney and MoMA, hasn’t been able to hold a pencil in over a year. His tremor started on one side of his body and now affects both. In January, at age 63, he was diagnosed with Parkinson’s.

Researchers say that these movements that look like an actor acting out a dream may indicate health problems, one of the most serious and common being the future onset of Parkinson’s disease. Wes Mills began acting out dreams more than ten years before his first tremor appeared.

Other common problems that can lead to dream enactment are obstructive sleep apnea and the post-traumatic stress disorder (PTSD).

Moving like an actor in your dreams could be a symptom of a health problem. Photograph: Andrey Popov/Adobe Stock

People who act like actors in their dreams often should consult a doctor and undergo a sleep study to find out the reason for your behavior, experts say.

When transitioning into rapid eye movement (REM) sleep, when dreams occur, the body typically enters a state of almost total paralysis to prevent dream enactment. But some people – approximately 1% of people over 50 years old – lose this paralysis.

This chronic problem, known as REM sleep behavioral disorder (or RBD)appears more often in middle-aged men, researchers found.

“The brain stem has two connected nuclei that generate the protective paralysis of REM sleep. When one of them, or its connection pathway, is damaged, it releases muscle tone,” says Carlos Schenck, psychiatrist at the Minnesota Sleep Disorders Center. “Then people end up acting out their dreams.”

In 1986, Schenck and his colleagues first identified RBD in four men and one woman, all over the age of 60. Most had a long history of hurting themselves or their bedmates with aggressive behavior while sleeping. One patient had tried to strangle his wife while dreaming that she was fighting a bear, another had knocked over furniture during a dream in which he was a football player. The researchers observed that RBD is different from sleepwalkingwhich originates from non-REM sleep.

Dream enactment behavior has also been documented in severe obstructive sleep apnea, as it causes people to abruptly stop breathing for brief periods during sleep and even partially awaken. Because these breathing stops are more common and severe in REM sleep, people sometimes act out scenes from their dreams, mimicking the symptoms of RBD, Schenck said.

About 39 million adults in the United States have obstructive sleep apnea, according to the National Council on Aging, but it’s unknown how many of these adults act as actors in their dreams.

Similarly, people with PTSD may show signs of reliving the trauma through dream enactment. Approximately 70% of PTSD patients report sleep disturbances and up to 70% have recurring nightmares. But there are no data on the prevalence of dream enactment behavior in PTSD, Schenck said.

For people with RBD, the risk of Parkinson’s is astonishingly high. Individuals over the age of 50 with idiopathic RBD – which occurs spontaneously, without other health complaints or recent medication changes – are likely 130 times bigger of developing Parkinson’s disease compared to someone who does not have the problem.

“There’s nothing like it. Eighty percent of people who have this problem develop Parkinson’s disease 15 to 20 years later,” says Ronald Postuma, director of neurology at the McGill University Health Center.

The RBD is ten times better than any other clinical marker – for example, abnormal motor examination or loss of smell – at predicting the possible onset of Parkinson’s. RBD is also strongly associated with other synucleinopathies, a group of diseases that includes dementia with Lewy bodies and multiple system atrophy.

The brains of people with idiopathic RBD have enough misfolded alpha-synuclein to affect REM sleep, but the harmful protein has not spread throughout the brain, experts say.

More rarely, RBD can be caused by a stroke, a tumor, or medications such as certain antidepressants.

The RBD presents a unique opportunity for researchers to study early Parkinson’s disease as well as its progression It is preventive therapies. Michele Hu, professor of clinical neuroscience at the University of Oxford, is leading a randomized placebo-controlled trial in patients with RBD that tests whether a drug can reduce brain inflammation, an early hallmark of Parkinson’s.

“We know that lifestyle modifications like exercise also slow the progression of Parkinson’s, so there are even more reasons why they are likely to be effective in RBD,” Hu said. “And that’s what I tell every patient we diagnose with RBD.”

People with RBD diagnosed through a sleep study can enroll in the RBD registry established by the North American Consortium for Prodromal Synucleinopathy (NAPS), which aims to develop treatments to prevent or delay the onset of neurodegenerative diseases. associated with RBD.

The Michael J. Fox Foundation is also looking for people who act out their dreams to participate in the Parkinson’s Progression Markers Initiative (PPMI) to identify biological markers of Parkinson’s risk, onset, and progression.

“You have to plan your life accordingly — retirement planning, financial planning, taking those family trips you’ve been putting off,” says Schenck. “I think that diagnosis is very useful in terms of life planningit is not just to generate sadness and misfortune”.

Eileen Mills has been trying to find a balance between living in the moment — like going for walks with her husband and dog — and making necessary preparations based on his diagnosis, like long-term insurance. And Wes Mills still loves creating art. He focuses on the things he can do, like carving and carving wood.

“When it became clear that he could no longer hold a pencil, he didn’t miss a beat. He started working with other materials right away,” said Eileen. “Wes is the most extraordinary human being I know, truly.”

Meeri Kim is a science writer with a PhD in physics from the University of Pennsylvania. / TRANSLATION OF RENATO PRELORENTZOU

The article is in Portuguese

Tags: acting dreams real early sign Parkinsons

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