A 23-year-old female student presented with a five-year history of abnormal sleep in which she would sit up or stand up for brief periods in the early morning,talk loudly for a couple of minutes and then lie back down...A 23-year-old female student presented with a five-year history of abnormal sleep in which she would sit up or stand up for brief periods in the early morning,talk loudly for a couple of minutes and then lie back down.When woken by family members she would remember vivid dreams and nightmares.In one episode she had a fall that resulted in a subdural hematoma.On presentation at the psychiatric hospital she had a normal mental status exam except for being mildly depressed and anxious about the chronic fatigue from poor sleep.Overnight polysomnography(PSG) showed multiple waking periods each night,poor sleep efficiency and a lack of normal muscle paralysis during REM sleep.The patient was diagnosed with REM Sleep Behavior Disorder and treated with 1 mg clonazepam nightly.Her sleep improved dramatically and remained better at a six-month follow-up,but repeat PSG exam found that the lack of muscle paralysis during REM sleep remained.展开更多
文摘A 23-year-old female student presented with a five-year history of abnormal sleep in which she would sit up or stand up for brief periods in the early morning,talk loudly for a couple of minutes and then lie back down.When woken by family members she would remember vivid dreams and nightmares.In one episode she had a fall that resulted in a subdural hematoma.On presentation at the psychiatric hospital she had a normal mental status exam except for being mildly depressed and anxious about the chronic fatigue from poor sleep.Overnight polysomnography(PSG) showed multiple waking periods each night,poor sleep efficiency and a lack of normal muscle paralysis during REM sleep.The patient was diagnosed with REM Sleep Behavior Disorder and treated with 1 mg clonazepam nightly.Her sleep improved dramatically and remained better at a six-month follow-up,but repeat PSG exam found that the lack of muscle paralysis during REM sleep remained.
