People That Believe They are Dead / Cotard’s Delusion

Cotard’s  Delusion is a very rare mental illness where the sufferer does not believe that their body is alive in the way that normal people are alive. There are varying degrees of the illness from the person believing that parts of their body are dead to the person believing that they are dead.

This mental illness was named after the neurologist that first recognized this as a disorder.  Jules Cotard did case studies and research in the 1880’s and called the disease “The Delirium of Negation” which is to say that the sufferers thought of their body in a negative way to the point of believing parts did not exist.

In 1880, the neurologist Jules Cotard described the condition as Le délire des négations (“The Delirium of Negation”), a psychiatric syndrome of varied severity. A mild case is characterized by despair and self-loathing, and a severe case is characterized by intense delusions of negation and chronic psychiatric depression   Wikipedia

Jules_Cotard

Neurologist Jules Cortard

Image from Wikipedia

One of Cortard’s  patients, referred to in his research  Mademoiselle X  was a woman who believed that certain parts of her body did not exist. She did not believe that she needed to eat because she did not have the regular internal organs that normal people have. 

Mademoiselle X believed that she had been cursed to eternal damnation, to walk the earth as a dead person. There was nothing anyone could say to her, to convince her otherwise and in her mind she was a dead person walking the earth, and was destined to continue on that way.

She ended up dying from starvation, as no one was able to convince her to eat any food. 

There is a recorded case of what seems to be Cotard’s Syndrome, that was documented in, prior to the disorder being named after Cotard.

“In 1788, Charles Bonnet reported one of the earliest known cases of Cotard’s Delusion. An elderly woman was preparing a meal when she felt a draft and then became paralyzed on one side of her body. When feeling, movement, and the ability to speak came back to her, she told her daughters to dress her in a shroud and place her in a coffin.

For days she continued to demand that her daughters, friends, and maid treat her like she was dead. They finally gave in, putting her in a shroud and laying her out so they could “mourn” her. Even at the “wake,” the lady continued to fuss with her shroud and complain about its color.

When she finally fell asleep, her family undressed her and put her to bed. After she was treated with a “powder of precious stones and opium,” her delusions went away, only to return every few months. MentalFloss.com

Suffers of Cotard’s Delusion, believe that they are missing certain internal organs or that they do not have a digestive system, blood, or some other internal function. Depending on the person, their reasoning as to why they have lost organs, organs have been taken away, or organs are putrefying varies.

The first stage is called the Germination stage—the symptoms are psychotic depression,  and hypochondria 
Next is the Blooming Stage — the syndrome develops and the delusions of negation cause the person to negate / disassociate / deny that certain parts of their body exist, or that they are alive at all
The last stage, which often ends in death is the Chronic stage—characterized by continued, severe delusions and chronic psychiatric depression.

There have also been cases of Cotard’s delusion that have occurred in people who sustained a traumatic brain injury. In 1996 there was a man who sustained traumatic brain injury from a motorcycle accident and he believed that he had died in the accident.  

Once he was physically recovered, his mother moved with him to South Africa. He told people that he was dead and actually had gone to Hell. He did not believe that he had survived the accident and thought his mother was in spirit form, to escort him and show him around in Hell.

Another incident of this disorder was in New York in 2008. A woman asked her family to take her to the morgue because she had died and believed she should be with the dead people. She reported that her body was beginning to smell like rotting flesh.

Other incidents of this disorder include a woman who went to the ER believing that her internal organs had all melted and that she was almost dead. There was also a man who believed that he was dead and that his daughter’s were also dead.

If you want to read these stories, you can find them at this  LINK for MentalFloss.com

Suffers who do not die from starvation, sometimes commit suicide. They feel that only their body is still walking around and they do not belong here.

“Some people with Cotard’s have reportedly died of starvation, believing they no longer needed to eat. Others have attempted to get rid of their body using acid, which they saw as the only way they could free themselves of being the “walking dead”  New Scientists Health.com

Neurologists theorize that the cause of this disorder may have to do with the part of the brain that recognizes faces, called the fusiform. 

This distorted reality is caused by a malfunction in an area of the brain called the fusiform gyrus, which recognizes faces, and also in the amygdala, an almond-shaped set of neurons that processes your emotions. The combination is a lack of recognition when viewing familiar faces (even the face of the sufferer), leaving the person feeling disconnected with reality.  Scientific American

Overall the research I did shows that this disorder is still a mystery. Some people responded fairly well  to treatment with antidepressants, or anti-psychotic medication. Others were treated with electroconvulsive therapy, which is shock treatment.

Circle with your Hand Triangle with your foot…Hmmmmm

This is fun and it helps to create new neuronal pathways in the brain.

I did do some research about neuronal pathways tonight. I even wrote most of an entire post. But the cold med I took is kicking my DUPA ( that is what my Polish grandma used to say….the word..nothing about kicking it)

I am tried too cancan no longer focus my eyes.

Enjoy this little video. I did and I forsee having a silly contest with my daughter tomorrow, where each person adds a new move.

sorry for any typos

Wishes for peasant dreams

Annie .

“Those People” with Bipolar Disorder ; Stigma and Misconceptions

There is widespread misconception and stigma about bipolar disorder. Many people have the belief that anyone with bipolar disorder is mentally unbalanced, to the point of not being reliable or trustworthy.

People with bipolar disorder often keep their condition to themselves at work and in certain social situations. There is a reasonable risk of people feeling differently about you, once they find out you have bipolar disorder.

In one documentary I watched, many of the people interviewed, confused bipolar with other mental illnesses like schizophrenia and considered people with bipolar to be out of touch with reality.

When people were asked the initial question of what they knew about bipolar disorder, they began to look somewhat uncomfortable in their body language and facial expression. As they described what they thought they knew about bipolar disorder, they had a detached way of talking about it.

They would say things like  “They get happy one minute and then really angry the next, and then happy again. They are completely unpredictable. Anything can cause them to have a sudden angry outburst.”

The thing that I noticed beyond their words, was the way they kind of detached themselves from people with bipolar, by seeming as though  “those bipolar people” are people that they never interact with.

They had the assumption that it would be very apparent to them that the someone was very mentally ill, if they ever were to run into a bipolar person. The people in the interviews thought that bipolar people were very different from everyone else and that they would not just fit in or blend in with everyone else.

I could feel a real sense of detachment and a wanting to be detached from anyone with bipolar disorder, from many of the people in the interview.  It was clear that a lot of people assume that they never interact with any people that have bipolar disorder.

Since the estimated percentage of people with bipolar disorder is between 2 and 3 percent of the population,  it is likely that most people know someone with bipolar disorder, and that they interact with them at some point, during the course of their day to day lives.

I would venture to say that almost no one could pick out the person who has bipolar disorder, if they were to guess based on personalities and behaviors of the people they know.

Bipolar disorder causes suffering to the person that has it, more than to the people around them There is no reason that you would know that your co-worker has bipolar disorder, unless they chose to tell you. The same goes for your classmates, your waitress, your doctor,your pastor and even your family members.

People with bipolar disorder can to be very kind and compassionate to others, and understanding of people who have pain and suffering. One of the best nurses I know has bipolar disorder. She is far more compassionate to the patients than most of the nurses I have worked with.

If there is a very angry, mean person that you know and try to avoid interacting with, that is probably not the person with bipolar disorder in your life.

The unreliable coworker that you are always covering shifts for because they call out, is probably not the person in your life with bipolar either. We are probably the coworker that is saving your ass, when the other person calls out again.

Self Esteem and Mental Illness / Mental Abuse in Childhood

Mental Illness goes hand in hand with having  low self esteem. It is a circle that feeds itself.

The inability to do some of the basic things that other people can do, has an effect on our our self esteem. On the flip side, the low self esteem creates more depression and interferes with the chemistry in the brain.

 Self esteem is “an overall emotional judgement evaluation of his or her self worth.”  Wikidpedia

“It is a judgment of oneself as well as an attitude toward the self. Self-esteem encompasses beliefs (for example, “I am competent,”   “I am worthy”)…” Wikipedia

“… self-esteem is “the experience of being competent to cope with the basic challenges of life and being worthy of happiness… the sum of self-confidence (a feeling of personal capacity) and self-respect (a feeling of personal worth).” Nathaniel  Branden 1969

Dr, Brandon, author of many self esteem books, talks about a person’s belief about their own ability to face challenges. If a person is fully confident in their own ability to deal with challenges , then they have high self esteem.

When we doubt our own ability to effectively tackle the daily challenges of life, we have low self esteem. Depression can be made worse by the fear that we cannot function effectively.

Many people have come from families that want their children to be competent and have the ability to support themselves as adults. The children are encouraged to do well and succeed in school and other activities. The children were rewarded for trying hard, following through and doing well. Thus they developed a pattern of success and feeling good about success.

Some people had dysfunctional childhoods. They did not have a supportive encouragement that built their self esteem. Yjeu were not prepared for dealing with the challenges of life.

Not only was  not rewarded for succeeding, we were undermined. I lived with an alcoholic mother who would wake me up on school nights and interfere with my sleep. In addition to that, even though she had money, she did not keep enough food in the house that I knew how to prepare myself.

She would go out drinking after work and not come home until late at night. Many days I did not have enough to eat to be able to concentrate well in school.

In my perception, it was more of a priority for me to take care of her, than to take care of myself and my schoolwork. I had to take over the childcare and chores that she would not do. As far as helping me with homework or praising me for good grades, that was non-existent.

I have observed that many people with mental illness had parents that were mentally abusive. The constant criticism and lack of respect interfered with the normal development of self esteem.

“Brandon further believed ,”It (self esteem)  exists as a consequence of the implicit judgment that every person has of their ability to face life’s challenges, to understand and solve problems, and their right to achieve happiness, and be given respect.[7]”  Wikipedia

Brandon mentions the “right” to happiness. People that grew up in abusive homes, were taught that they had no right to happiness. The only person that had rights was the abuser.

According to this model by Brandon, a person with high self esteem,  feels that he or she deserves to be respected.

 A person must have experienced  “being respected”, in  order to feel that they  “should be” respected by others or even themselves. When children grow up in an atmosphere of disrespect , they have trouble as an adult having the feeling that anyone will respect them.

The feeling of not deserving respect is a condition of low self esteem.

A constant feeling that people will not respect you , will not like you, and will not value your input, can turn into mental illness. The brain chemistry is configured during childhood to have low self esteem, which causes thinking patterns that are not the same as mentally healthy people.

The brain can be rewired as an adult. We do have the capacity to develop self esteem that we were not accustomed to as children and teenagers. In order to do this, we have to somehow override the programming already set up in our brains, The neurons in our brains are re-trainable to wire differently.

It can take years to fix this problem. First we have to identify that we have a self esteem problem. Then we have to recognize that it goes back to our childhood or perhaps to an abusive adult relationship.

After that we have to decide that we are worthy of feeling good about ourselves and it is just incorrect programming of our minds that has been there for a long time. To overcome the emotional and mental injury of abuse, we need to be proactive for ourselves.

I have been doing some research about re-wiring the brain through some holistic methods. I will post some ideas in upcoming blog posts, For now, just know that you are special and unique. You are worth the focused intention from yourself that is required to become more stable and to feel better about yourself.

All of us who have been through trauma, need some extra help. We all have something to offer to each other in terms of support, encouragement and intelligent ideas for recovery.

Blessing to all

Annie

Lunar Lunacy : The Power of the Full Moon

Werewolves! Vampires! Lunacy!

Seizures? Sleep disturbance? Intermittent Insanity?

All caused by the full moon?

The term “lunacy”  originated in Europe, during the mid 16th century. It comes from the word “lunar” which refers to the moon. During the middle ages, it  was believed that some people suffered from an intermittent insanity, which only occurred when there was a full moon.

The perception was that a higher number of  strange, agitated and violent behaviors occurred during a full moon. People began to fear the full moon and what kinds of unsound, disturbing events might take place.

They blamed the full moon for any unusual events at night, when the full moon was in sight. Epilepsy was not understood at the time. When someone had a seizure people thought it was brought on by demons. If this happened to coincide with a full moon, then of course, the moon was blamed for it.

Lunatic is a very old term meaning insane, reckless and unsound. The term lunacy is a combination of  “lunatic” and “acy”. The suffix “acy” means the “the state or quality of.”    So, in effect, the word  “lunacy” is the “state of  insanity caused  by the full moon.”

“It is the very error of the moon.
She comes more near the earth
than she was wont. And makes
men mad.”

—William Shakespeare, Othello

But is it true? The old belief is still alive and well. People often say and I am sure you have heard  “It must be a full moon.”  This is said in attempt to explain any unusual, seemingly unexplainable happening in the night.

Greek philosopher Aristotle and Roman historian Pliny the Elder suggested that the brain was the “moistest” organ in the body and thereby most susceptible to the pernicious influences of the moon, which triggers the tides.  Scientific American

During Europe, in the middle ages, many people believed that humans could transform into werewolves and vampires during the full moon. This is referred to as the “lunar lunacy effect” or the “Transylvania effect.”

Psychiatrist Arnold Lieber wrote the book The Lunar Effect : Biological Tides and Human Emotions. Lieber hypothesized that the moon had an effect on the water molecules in the nervous system. The disruption of the water molecules would cause certain people to behave strangely.

lunar effect

Popular legend says that there is more violence, more suicides, more accidents and more aggression during a full moon. This is a common belief amongst healthcare workers, policemen and paramedics.

There is a controversy as to whether or not there is a connection between the moon and seizures. The electrochemistry of the brain of patients suffering from seizure disorder may be affected by the moon.

“A separate analysis revealed that for nonepileptic seizures, there was an increase at the full moon, and for epileptic seizures, an increase in the last quarter. We conclude that there is no “full moon” effect on seizures as a whole, although there is a possible effect on nonepileptic seizures.” Pub Med

There has been research done to see whether or not there is any validity to the theory that the moon can affect the water in our bodies. The evidence suggests that this is impossible because the amount of water is too small.

” while lunar gravity does indeed raise tides in the oceans, it does not have any effect  on lakes and even many seas. Those bodies are simply too small to feel the effects—to say nothing of human bodies.” Time Magazine

There is research which indicates that the moon does have an effect on sleep. A study was done by scientist and author, Christian Cajochen at the University of Basel Psychiatric Hospital in Switzerland.

“We found that around full moon, … time to fall asleep increased by 5 min, and EEG-assessed total sleep duration was reduced by 20 min. These changes were associated with a decrease in subjective sleep quality and diminished endogenous melatonin levels.”  Journal Current Biology

As far as violent crime, suicide and problems with patients in psychiatric wards, the evidence in not consistent. The suicide rate does not change during a full moon. There are varying reports about violent crime.

If you like the old tales of werewolves and vampires, as I do, then maybe it is best left to the imagination as to whether or not the moon really can change people’s behavior.

I personally have not seen any difference in dementia residents during a full moon, The most common catalyst to an uproar in the dementia ward, is that the first patient will become aggressive in a room full of other residents,  The behavior of the initiating resident frightens and upsets the other dementia residents. It is like a domino effect.

I personally enjoy the old tales and the myths about the moon. I am going to leave well enough alone and leave it to you. Who knows, maybe there are werewolves when the moon is full…

HowwwL !

Annie

References:

http://www.bbc.com/future/story/20131029-does-a-full-moon-make-people-mad

http://www.sci-news.com/othersciences/anthropology/science-full-moon-disturb-human-sleep-01264.html

http://www.scientificamerican.com/article/lunacy-and-the-full-moon/

http://www.cell.com/current-biology/abstract/S0960-9822(13)00754-9

How the Moon Messes With Your Sleep

http://www.ncbi.nlm.nih.gov/pubmed/15256200

Mental Illness caused by Psychological Damage and Abuse

* this post is in honor of Silvergirl who is a wonderful wounded healer and has an excellent blog on wordpress*

People with mental illness often have psychological damage from being subject to “Situations that Must never Be”.  This is my phrase for any situation which is causing log term damage to a person in any physical or mental way.

These situations that must never be, are many and come in many forms. Any situation of mental abuse or physical abuse of a person should not be. The sad fact is that these situations occur every day. People are suffering in relationships like these as we speak. You might be one of them.

You have chosen to click on this post because the title of it struck a nerve with you. Most likely you have been abused in your lifetime. It may have been during your childhood and / or it may have been as an adult. Many people that were abused as children , end up in abusive relationships as adults.

The psychological damage from living in abuse is extensive and can cause depression, severe anxiety, OCD, PTSD, and other mental illnesses. It is also common that people with other mental disorders such as depersonalization disorder, bipolar disorder, borderline personality disorder , social anxiety and  insomnia have experienced abuse during their lifetimes.

As people with mental illness, we sometimes make choices that are harmful to us that other people would not make. We are so used to things being abnormal and painful that we tend to not notice the red flags of an abusive relationship until it is too late.

The mental illness causes us to end up in codependent , manipulative, abusive relationships. On the flip side, these relationships that cause severe mental suffering break our poor brains and we end up with mental illness that we may not have already had.

Which one comes first? The mental illness, the psychological damage, the abusive relationships? It is hard for us to tell. If you think back through your past , if you can remember, then you will most likely identify abuse against your mental health. 

Situations of trauma cause PTSD. The people who tend to be the most affected are the ones who have had some kind of mental trauma in their past.

There are cases of severe trauma (like military horrors,)  that can cause PTSD , even of the person had a “normal” past. But a lot of the people who endure ptsd that never seems to go away, had some form of abuse prior to that trauma.

It is sometimes difficult to identify abuse from our past/ For some people it is glaringly obvious and for others it has been blocked out by their own brain. The brain wants to protect itself from further trauma and will black out memories and deny us access to them.

People with psychological damage often have more than 1 or 2 mental disorders. Some of us have so many that we feel kind of stupid “showing off our list” to people.

It feels like it will be disbelieved to write out the list such as…

…OCD, insomnia, depersonalization disorder, PTSD,  generalized anxiety disorder, domestic abuse victim, depression,  ACOA, eating disorder,  codependence,  social anxiety and derealization disorder, and avoidant personality disorder.

 See? …Now I feel weird.  My list  looks crazy to me… Really I look at that list and wonder how the hell I get through the day at all…barely by the skin of my teeth sometimes… that is …when i am able to get out of bed…

You are not alone if your list looks as long as mine does. My mental abuse goes back into childhood and I also had abuse as an adult victim of domestic abuse.  Things that occur in life that other people could “suck it up” about and get through, send me into severe post traumatic stress.

Freeing Space in Your Brain for Mental Health / Don’t let Your Living Space Aggravate Mental Illness

“Only the peace and serenity ,  Calmness and grace ,  Of pure and simple, Empty space”

As we are healing our brains and out bodies, we need to open up as much empty space around us as possible. The clutter around us, keeps our brain is a state of disorganization.

We need to throw out anything that has traumatic memories attached to it. Throw out things that have anything to do with our obsessive thoughts. Get rid of the extra things that we don’t need.

We feel obligated to keep things that other people gave us as gifts, but we cannot afford to keep things in our personal space for that reason. A lot of these people are mentally healthier than we are. Why are we protecting their feelings at the risk of our mental well being?

We feel the necessity to keep things , just in case one day, we might need them. If you don’t need them right now, and will not need them within the next year, you are probably not going to need them at all. If you do end up needing it, there will be a better one available by the time you need it.

We feel that we have to keep all photographs and sentimental items  just because other people  do that.  No, you really don’t. If you do not like looking at the picture, then you probably never will. If you want , you can take a picture of it, with your cell and upload to snapfish. That way they will be there but you can let the paper copies go.

Speaking of paper stuff… Get rid of most all of it.

Only keep what you actually  use or  really like to look at . Even paintings and wall hangings should only be in your home, if they make you feel good to look at them.

Look at your items and ask yourself this question…

.” If I did not own this item, would I go out and purchase one?”

If you would not , then you probably do not need it or want it. So. let it go.

The act of getting rid of things can be therapeutic But If  you are triggered by looking through things, then get some help from a friend. Even if someone cannot come over, having someone on the phone can help.

The more open space you create, the more your brain will be able to calm itself and become free.

It is very likely that you have things around you , every day, that are triggers to traumatic memories or negative behavior patterns of your mind. Our brains are tuned in to  objects. There are automatic emotional responses to items that we see.  We should not have any items with bad energy, in our homes.

We need calm, peaceful spaces to rest and sleep. If you have insomnia, it is especially important to remove anxiety causing things from the sleeping area. Our other spaces should be hopeful and full of positive energy. They should only have things in them that we would choose to put in them, if we were starting from an empty room.

Allow yourself enough empty space to be able to move freely in. There is a mind / body connection. If the body is encumbered by things, then the mind will be cluttered and feel closed in.

Keeping old things, just because you have them, is exposing your brain to negative energy.We need to allow our brains to organize themselves differently.

The same things around us for years cannot be healthy and keeps us from moving out from under our mental illness. As you go through things, think of the space rather than the things.

Namaste,

Annie

My Patient with Alzheimer’s disease / dementia is Afraid I will not Find my way Back to Her Again

My sweet lady, I will call her Rosalie, always cries when I leave work for the night. She also gets upset when I leave to go for my dinner break.

I always have known that she likes me there and that she is sad when I leave. But it was not until tonight that I finally realized just why it is so traumatizing for her. Now that I realize it, I can make it better for her.

A visiting nurse came to see Rosalie today. Rosalie took an instant shine to her and  felt very safe with her. The time came for the nurse to leave and poor Rosalie was holding her by her jacket and not letting go. She was crying and begging her to stay.

The nurse and I both tried to reassure Rosalie that she would come back to see her tomorrow. Rosalie said “no she won’t. She has to stay here.”

After the nurse left , I told Rosalie that she would be back tomorrow. Rosalie then said something that has never occurred to me before. She said “No she won’t. How will she find me again? How will she find her way back?”

That is when the realization came over me. Rosalie does not know where she is. She used to have a home and now she does not know how to get back. She does not know where that home is. She could not find it, even if we gave her the car keys and let her go.

She is so lost in time and space that she assumes that everyone else is too. The fact that the nurse happened to find Rosalie today, does not necessarily mean that the nurse can find her tomorrow.

Poor Rosalie feels so lost that she does not think anyone else knows where she is either. She does not understand that other people can find their way home and then back again to find her.

It was a great moment of realization to me. In her world, she is lost. She has no idea how she got to this place where she lives now. As far as she can tell , it is a lost place that no one can find.

Her family does not come to see her, so she must think they are lost and cannot find her too.

So. when she is crying at the end of my shift when I leave, she is truly afraid that I will not be able to find my way back to see her again.

So then, I explained to Rosalie that the nurse and I were good with finding our way home and back to her again. I told her that the nurse had found her way here today on purpose and could find her way home.

I explained to her that I had found my way to see her many times. It was not an accident that I ended up here. I assured her that I know how to get to where she is and that I would never lose my way to her.

This seemed to help.  From now on, I will remind her that I know how to get to where she is.

I will not lose her. I love her very much and will find my way back to her every time.

It reminds me that we all live in different realities. Our experiences form our perceptions and our feelings.

When we try to understand people by looking at their situation from our reality, we cannot truly have full compassion for them.

In order to understand, we have to listen and see that their world is different from ours. That includes the world they perceive in their mind. It is the only reality they know.

People who have been abused, people with PTSD, people with mental disabilities and people who are very poor have a very different reality than others.

It is true for many situations including people who have sick children, people who live with chronic pain, eating disorders, alcoholism and addiction.

In order to have true compassion we have to know that others see and feel things differently than we do.

Namaste,

Annie

How Stella and Bob Still Stayed Close During Bob’s Late Stage Dementia – Alzheimer’s Disease / A True story of How Love Endures

Stella and Bob had been married for 63 years when I met them. I was the home health aide for Bob.

His care had become too much for Stella to do alone. It was too difficult physically, mentally and emotionally for her.

Bob had late stage Alzheimer’s Disease, Dementia, and he could no longer walk, use the bathroom, feed himself, or communicate well.

Stella felt depressed a lot of the time. Their relationship was no longer the same. He could not communicate with her like he used to. He could not comfort her or help her anymore.

She missed him, the way he used to be. He was still there in body, but part of him was gone and still continuing to get worse. She was losing him bit by bit every day.

Bob himself was depressed and angry a lot of the time. His anger was mostly directed toward the home health aides but sometimes spilled over onto Stella.

Bob had late stage dementia and he could no longer walk, use the bathroom, feed himself, or communicate well.

Stella loved Bob very much. She wanted to understand him even when he could not say what he needed or wanted. She would lean over him in the bed, and ask him what he needed. She would hold his hands and stroke his head to calm him.

He would get so frustrated that he could not put his words together but she spoke to him with kindness, in a calm tone of voice.

In the evenings, I would help her clean him and out him in his pajamas. They had 2 twin beds because he had to be in a hospital bed.

The beds were apart during the day, in order for the aides to have access to Bob, to perform care that was required.

At bedtime, Stella would help me to push the two beds together. She asked me to push them as close together as I could, so that they were touching.

She said, “He is my husband. I want him next to me in the bed. I want to be able to reach over and touch him. ”

She explained to me that during the nights, he would wake up and call out because he was afraid. He was disoriented and did not understand where he was or what was going to happen to him.

“I always hear him when he awakens, and I reach over and touch him to comfort him. I want to be close enough to him at night to be able to do that.”

So, every night , I pushed the beds together.

There is more to health care than just caring for the physical needs of the patient. There are emotional and mental needs of the patient and the family that are equally important.

*Note The facts in this story are true. The names were changed to protect the privacy of Stella and Bob. Stella was 88 at the time of my association with her. Bob was 92.*

Sleep Apnea – Tiredness, Fatigue and Memory Impairment

Sleep Apnea affects 4 % of Americans. About 1 out of 4 middle aged men in America suffer from Sleep Apnea.  Studies suggest that memory impairments can occur from disrupted sleep.

In Sleep Apnea, the sleep cycles are disrupted by periods of difficult breathing. In a new study by  Dr. Andrew Varga,  at the NYU Langone Medical Center in New York City, subjects had impairments in their spatial memory from disrupted REM sleep cycles.

After a night of improper REM sleep, the subjects had difficulty remembering the placement of items and what they did with things the day before.

The REM stage of sleep is the Rapid Eye Movement stage. This is the deep sleep where we have dreams. The REM stage of sleep is critical for the body to repair any tissue damage from the day, such as muscle microtears. It also has to do with processing memories.

A person with disrupted REM sleep may forget where they placed the car keys the day before and have trouble remembering where they parked their car. Another consequence of  incomplete REM cycles is inability to focus and pay attention.

There are 2 different types of Sleep Apnea. They are Obstructive Sleep Apnea and Central Sleep Apnea. The causes for the 2 types are different but both of them cause difficulty breathing during sleep and periods of waking up in the middle of  sleep cycles.

Obstructive Sleep Apnea has to do with the airway becoming obstructed.  The muscles in the throat becoming too relaxed and causing a narrowing of the airway. The brain will become aware of low oxygen levels and force you awake to reposition yourself.

Usually people do not remember these brief periods of waking. Every time someone wakes up for a few seconds, it disrupts the sleep stage they are in.

The brain and the rest of the body are not able to finish what they are supposed to do, during that cycle. There are certain repairs and regeneration of tissue that naturally occur during REM sleep.

The 2nd type is less common. Central Sleep Apnea is caused by a problem in the brain.  The brain is supposed to send signals to the lungs to breath.

The brain of  person with Central Sleep Apnea, fails to continuously send the signals properly. The lungs will simply stop doing their job.  The body and the brain will fail to get the necessary level of oxygen, which will cause the person to wake up.

Again, with this type of Sleep Apnea, the person will awaken just long enough to be able to breath properly again. Someone with Central Sleep Apnea may wake up with  shortness of breath.

Men are twice s likely to get sleep apnea. It is most common in men 60 or more. Being overweight contributes to your risk as well as having a family history of Sleep Apnea.  Certain medications are possible contributing factors, such as excessive use of muscle relaxers.

Central Sleep Apnea can occur with people that have heart disease or have had a stroke. It can also be a co-morbidity with neurological disease like ALS.

People that have Sleep Apnea can have  morning headaches and depression. Some people have an increased frequency of urination.

If you have extreme tiredness and sleepiness during the day along with any of the other symptoms I mentioned, you may want to see your doctor.  There are treatments that would reduce your symptoms.

They also could check you for other types of sleep disorders and medical conditions that could be causing the constant fatigue and tiredness.  There are mental illnesses such as depression that can cause some of these symptoms as well as other physical disorders.

Namaste,

Annie

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