Nightmares and Parkinson's Risk: Be Aware of the Warning Signs of REM Sleep Behavior Disorder

Nightmares and Parkinson's Risk: Be Aware of the Warning Signs of REM Sleep Behavior DisorderIs my husband sick? Liu asked with worry etched on her face, her sunglasses acting as a shield for the bruises she was trying to hide. Lately, life had become tough for Liu

Nightmares and Parkinson's Risk: Be Aware of the Warning Signs of REM Sleep Behavior Disorder

Is my husband sick? Liu asked with worry etched on her face, her sunglasses acting as a shield for the bruises she was trying to hide. Lately, life had become tough for Liu. Her husband was frequently having nightmares, accompanied by punching, kicking, and yelling. Not only was she woken up every night, but she was often beaten and had bruises all over her face and body. After enduring this for a while, Liu could no longer bear it and took her husband to the hospital. After examination, her husband was diagnosed with primary Parkinson's disease, which caused REM sleep behavior disorder, leading to the frequent nightmares. Fortunately, after systematic treatment, her husband's nightmares were significantly improved, and Liu could finally get a good night's sleep.

Liu's experience is not an isolated case. Rapid eye movement sleep behavior disorder, also known as sleepwalking, is a common type of sleep disorder characterized by acting out dreams in real life, such as punching, kicking, and yelling. In recent years, research has revealed that REM sleep behavior disorder is not only a manifestation of sleep disorders but could also be a precursor to Parkinson's disease.

I. REM Sleep Behavior Disorder: An Invisible Precursor to Parkinson's Disease

Normally, sleep is divided into two stages: non-rapid eye movement sleep and rapid eye movement sleep. During REM sleep, we dream, and muscle tension disappears, preventing us from acting out our dreams. However, in people with REM sleep behavior disorder, muscle tension does not disappear during sleep, leading to acting out or acting in dreams. This means that whatever they are doing in their dreams, they will do in real life, typically involving violent, unpleasant, or emotionally charged scenes.

The latest guidelines from the International Movement Disorders Society have classified REM sleep behavior disorder as a precursor to Parkinson's disease. Studies have found that 5 to 14 years after the onset of REM sleep behavior disorder, approximately 35% to 92% of patients develop neurodegenerative diseases, including Parkinson's, Lewy body dementia, and multiple system atrophy. Among Parkinson's patients diagnosed in clinical settings, approximately 60% have experienced REM sleep behavior disorder.

Researchers from the University of Birmingham in the UK published a study in the Lancet, analyzing 3,818 men living alone in the United States. During a 12-year follow-up period, 91 cases of Parkinson's disease were diagnosed. Analysis revealed that older adults who frequently had nightmares had a two-fold risk of being diagnosed with Parkinson's compared to those who seldom had nightmares. Older adults who develop Parkinson's may experience nightmares a few years before the onset of tremors, stiffness, and slow movements.

II. Repeated Dreams: A Possible SOS from Your Body

Sleep is an indispensable physiological need for humans, crucial for brain function recovery and repair. However, many people in modern society suffer from sleep problems, with many experiencing repeated dreams after falling asleep, feeling as if they haven't slept at all. Repeated dreams could be an SOS signal from your body, demanding attention.

1. Dreaming of Drowning/Suffocation: This manifestation could indicate sleep apnea, where the airway is blocked during sleep, leading to hypoxia and dreams of drowning or suffocation. Such patients often snore loudly and experience sudden pauses in breathing during sleep. Sleep apnea is associated with hypertension, coronary heart disease, heart failure, and even sudden death in sleep.

2. Dreaming of an Organ Being Hit: Frequently dreaming of an organ being hit or stabbed with a knife during sleep, experiencing a dull pain upon awakening, could indicate an organic lesion in the organ. For example, patients with brain tumors or neurological diseases often dream of having their head hit.

3. Dreaming of Being Chased/Falling: Constantly dreaming of being chased by criminals or wild animals, unable to run, accompanied by a racing heart and palpitations upon awakening, could be related to coronary artery insufficiency. Frequent dreams of falling could be related to hidden heart disease or problems with the blood vessels near the heart.

4. Dreaming of Unsteady Walking: Patients with angina pectoris or myocardial ischemia often dream of unsteady walking, body tilting, or a sense of suffocation while sleeping.

5. Dreaming of Floods: Patients with liver or kidney disease often dream of floods and struggling in the water during sleep.

III. Strange Occurrences During Sleep: A Possible Sign of Approaching Cancer

Sleep and cancer are intricately intertwined. Previously, a study published in the journal Nature by ETH Zurich and the University of Basel revealed that cancer cells are most active during human sleep. When cancer cells become active, the body may exhibit some anomalies, such as:

1. Frequent Dry Cough: When lying down at night, the vagus nerve around the bronchi becomes more active due to the pressure from the tumor, causing significant irritation to the bronchi and leading to severe coughing. Uncontrollable long-term coughing can cause the mucosa in the trachea to rupture and bleed, resulting in coughing up blood.

2. Persistent Pain: Persistent abnormal pain that doesn't subside after rest or becomes more intense at night, with intermittent "bursting pain," could indicate bone metastasis. For instance, lung cancer metastasizing to the bone often causes spinal pain, while leukemia or thyroid cancer metastasizing to the bone may cause pain in the front of the shoulder or sternum.

3. Hot Flushes and Night Sweats: Night sweats are a possible systemic symptom caused by tumors, commonly observed in leukemia and lymphoma patients. This usually occurs at night during sleep and can soak through clothing. If accompanied by weight loss, it's crucial to be highly vigilant for potential cancer.

4. Increased Nighttime Urination: Frequent nighttime urination, despite not drinking much water, could be related to benign prostatic hyperplasia, urinary tract infection, or kidney dysfunction. However, after ruling out these benign conditions, it's important to be cautious about potential prostate cancer, bladder cancer, multiple myeloma, and ovarian cancer.

The body's manifestations during sleep can often serve as a "weather vane" for health. If any abnormalities are detected, it's advisable to seek medical attention promptly, avoiding procrastination.

References:

[1] "Warning Signs of Parkinson's - REM Sleep Behavior Disorder (RBD)". Wuhan Central Hospital, Department of Neurology, 2023-10-21

[2] "Illness in the Body, Sleep Knows First! These 5 Dreams May Be "Warnings" of Big Illness, Don't Blame Your Body for Not Reminding You!". Beijing Television, I Am a Doctor, official Weibo, 2023-08-12

[3] "14 Cancer Signals You Must Know". Health News, 2021-12-31

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