Can You Diagnose This Sleep Disorder?
Author:
Joseph A. Diamond, MD
Mount Sinai West/St. Luke's
A 56-year-old man presents to your office with concern for multiple injuries at night. He has a medical history significant for hypertension that is well-controlled with amlodipine; depression, for which he is taking bupropion; chronic constipation; and a fall 6 months ago that had resulted in a rib fracture, which had been medically managed. During the current visit, he is accompanied by his partner, who reports that the man “seems as though he’s fighting people and yelling in his sleep.” This has resulted in multiple contusions and minor lacerations to the patient’s body, particularly his extremities, but no further serious injuries.
He once tried to hit his partner while screaming, “I’ll get you all!” but was able to be awakened and redirected. After this incident, the patient was alert, in no apparent distress, and reported, “I was boxing some aliens in my dream.” There is no reported snoring or witnessed apneas. He rarely has problems falling asleep; around times of large deals for his business, he has difficulty falling asleep because of “finances being on my mind.” He has 3 healthy children and a brother who is being treated for hallucinations. His parents died of old age, with some “shakiness” in his father shortly before his death, which was attributed to his being frail. There are no other known medical problems.
Joseph A. Diamond, MD, DABPN, DABSM, is an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai; Neurology Clerkship Site Director at Mount Sinai West/St. Luke's; and Neurohospitalist at Mount Sinai West/St. Luke's in New York, New York.
Which neurologic condition commonly develops 10 years after this diagnosis?
Joseph A. Diamond, MD, DABPN, DABSM, is an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai; Neurology Clerkship Site Director at Mount Sinai West/St. Luke's; and Neurohospitalist at Mount Sinai West/St. Luke's in New York, New York.