Hockenbury Discovering Psychology 5th txtbk

158 CHAPTER 4 Consciousness and Its VariationsWarning: May Cause Sleep-Driving andSleep-Eating As the most widely prescribedsleeping pill in the United States, Ambien®was originally marketed as being safer, lessaddictive, and having fewer side effectsthan previous sleeping medications. Butgrowing numbers of patient complaints,published case studies, and news reportsunderscore that Ambien and similar sleepingpills can produce their own uniqueproblems (Najjar, 2007; Sansone, 2008).Ambien users, in particular, have reportedwaking up to find the oven turned on andfood strewn around the kitchen and intheir bed. Other Ambien users havereported driving while asleep, waking uponly after being arrested on the side of theroad (Saul, 2007a, 2007b). Amnesia for performingthese behaviors while asleep iscommon. Because of these risks, the U.S.Food and Drug Administration now requiresmore stringent warnings about usingAmbien and similar sleeping medications(FDA News, 2007; Sanofi-Aventis, 2008).sleep-related eating disorder (SRED)A sleep disorder in which the sleeper willsleepwalk and eat compulsively.REM sleep behavior disorder (RBD)A sleep disorder characterized by the brain’sfailure to suppress voluntary actions duringREM sleep resulting in the sleeper verballyand physically responding to the dreamstory.Sleep-Related Eating Disorder(SRED)Sleepwalking nightly to the kitchen, eatingcompulsively, and then awakening the nextmorning with no memory of having done soare the hallmarks of sleep-related eatingdisorder. SRED affects at least 1 percent ofAmericans, or about 3 to 4 million people.Females are more than twice as likely asmales to sleep-eat. Onset of the sleep-eatingbehavior typically occurs during young adulthoodand is usually preceded by a history ofsleepwalking as a child. Contrary to what youmight expect, SRED is usually not associatedwith a daytime eating disorder (Howell &others, 2009; Winkelman, 2006).Although sweet-tasting foods like candy or cake are most commonly consumed,the sleepwalker can also voraciously eat bizarre items, like raw bacon, dry pancakemix, salt sandwiches, coffee grounds, or cat food sandwiches. Interestingly, alcoholicbeverages are hardly ever consumed during an episode.SRED poses potential dangers to the sleepwalker, including burns and injuriesfrom cooking utensils. However, the sleepwalker can become irritable, agitated,and even aggressive if someone tries to intervene. Reports of consuming nonfooditems include hand cream, buttered cigarettes, and soap slices. Even toxic substances,such as cleaning solutions, can be ingested. Along with being sickened byeating such things, the person may eat foods to which they are allergic, or theymay choke if eating while lying down (Schenck, 2007).REM Sleep Behavior Disorder (RBD)The parasomnias described thus far emerge during NREM stages 3 and 4 slow-wavesleep. In contrast, REM sleep behavior disorder (RBD) represents a failure of thebrain mechanisms that normally suppress voluntary actions during REM sleep. As aresult, the person verbally and physically responds to the unfolding dream story,which they remember in vivid detail upon awakening.The enacted dream story usually revolves around intense fear in response tobeing threatened or attacked by unfamiliar people or animals. In the dream, the persondefensively fights back or tries to escape (Schenck & Mahowald, 2002). Becausethe brain fails to suppress voluntary actions, the person may punch, kick, yell, swear,gesture, jump out of bed, crouch, crawl on the floor, or run. In the process, theymay pummel, grab, or choke their bed partner, charge full force into bedroom furniture,or crash through a window. Serious physical injuries to the dreamer or his orher bed partner may require medical attention, which is often how RBD is first diagnosed(Mahowald & Schenck, 2005).Although it can occur at any age, REM sleep behavior disorder typically occursin males over the age of 60. Approximately 1 out of 200 senior males are affectedby it. Once it emerges, RBD is a chronic condition that gets progressively worse.Onset is usually preceded by a longer history of sleeptalking and twitching or jerkingduring sleep. Chronic REM sleep behavior disorder may be an early symptomof an underlying neurological disorder, such as Parkinson’s disease or Alzheimer’sdisease (Abad & Guilleminault, 2004; Mahowald & Schenck, 2005). Temporaryepisodes of RBD can be triggered by antidepressant medications, excessive caffeineuse, or alcohol withdrawal.Interested students can find more information about sleep disorders by visitingthe American Academy of Sleep Medicine’s Web site, www.SleepEducation.com, orthe National Sleep Foundation’s Web site at www.SleepFoundation.org.