Now narcolepsy is really hard though because they're very tired during the day, they're sleepy during the day and it's managed mostly with medications. So we use medications to help them sleep better at night and to stay away during the day. But there are behavioral things you can do also by changing diet, exercise, having an actual nap schedule.
There's confusional arousals, there are states in deeper sleep that can happen where people will go and they'll disappear and they'll take on some other persona. They'll commit some crime, but it's all when they are in a very deep stage of sleep. So you really need to have a very thorough evaluation.
Narcolepsy is a disorder that affects many different areas of life. So in typical patients with narcolepsy, they have something called "excessive daytime sleepiness." So, they're very sleepy during the day. Yet, at night, they're still sleepy, but their sleep is very broken.
Some patients will report that they have sleep paralysis. If we see sleep paralysis alone and nothing else, we don't really think all that much of it, but if we see other symptoms, then it might be a red flag for something else that's going on.
There are some that are - REM Behavior Disorder, we'll see some court documented cases. And they really need to have a thorough evaluation with a sleep specialist.
Sleep paralysis is something that is actually very common. Many people have it, I've had it myself. And what happens is, when you're in that REM stage of sleep, your brain is very active. You're dreaming your most during that stage, you're mind, your eyes are moving, there's a lot going on. It's like fireworks going on in your brain.
We think is happening in the brain, the way I like to think about it is, it's almost like, you're brain is going through all these stages of sleep and it's developing in children so fast that it's almost like you're shifting gears in a car. And at some point, you actually stall out a little bit, and that's kind of what happens during a night terror.
Now there's some night terrors that happen in adults. And if it starts as an adult and you've never had them before, then there might be other things that are happening; it might be anxiety, depression, stress. And that's when you might have more of a thorough psychological evaluation.
Night terrors are very different from nightmares. A lot of people will think they're the same, but they're really not. Night terrors - you want to look at the time of night when you're having the problem. Night Terrors happen in deep sleep. Nightmares tend to happen in a lighter REM sleep.
Night terrors are in deep sleep, and they're more common in kids, as are nightmares, but what happens in a night terror is like a flash - we think a flash of some image or something happens in the brain. We don't really quite know what. And it usually ends up with the child screaming almost like screaming bloody murder. It's very scary for the parents or whoever else is around.
When it comes to the reason why we have nightmares, we're still debating that. It's a new area of research, nightmares. And the way I like to think about it is, our brain - we have stress during the day and our brain needs to learn to process this stress.
There are people who have repetitive nightmares. And what happens is their brain is trying to process the stress and help their brain actually deal with what happens if this stress happens again, so their brain's preparing them to deal with it in case the stress happens again, but it's so scary that they awaken from it.
There's some debate as to whether you need to awaken from them because there are some patients who are actually starting to say, "I had these horrible nightmares, but I never woke up from them." But they can still recall them when they get up in the morning. So there's still some debate in the field.
So you have it, you awaken from it and you can recall, in detail, what just happened, that's a nightmare. So it's very different from a dream where you generally don't wake up from it and you don't have this dysphoric emotion.
Nightmares are distinctly different from dreams in the way that people feel them and experience them. So a lot of people think that a nightmare is something where something is chasing them and you have to wake up screaming. Yes, that's one of the more common nightmares that we see is the person chasing someone or they're being chased.
Really, a nightmare just really has to evoke some sort of, we call it, dysphoric emotion or something uncomfortable. You could be sad, you could be unhappy; you could be scared, anxious. But traditionally, the definition is you have to awaken from this nightmare.
So it's like your brain has a large filing cabinet and it's opening up each drawer and it's taking in various images and memories from the day, consolidating what it needs to and puts in whatever file. And then if there's something that doesn't fit in any of the files and doesn't really belong, you'll forget about it. So it's a way of really getting a succinct way of storing things in your brain.
There are some people who believe that dreams really are just kind of a throwaway thing. They are just a way of your brain processing what's happening during the day, but there's really no meaning to them; a lot of imagery of just flashes of what happened.
There are other people that think that dreams actually do serve a purpose. But what that purpose is, we're not really sure. So some people believe that it actually does have some psychological representation of what's going on in the day, but there's no need to sit and really analyze it.
If there's a lot of fear that's going on, if there's a lot of anxiety, it's manifesting itself in your nocturnal world so that analyzing it can help open up basically thoughts about what you need to do during the day. So a lot of people who subscribe to the psychoanalysis, the Jungian thought will really focus a lot on dreams, the meaning, and how it can be used to help you during the day.
For some people they say, it's about wish fulfillment, it's about the things you are never able to do in your day you are actually fulfilling at night. There are other people who will say that it's actually telling you something.
So the older models, when you look at Freudian, when you look at Jungian thought, and there's still people who really - who really use the Jungian thought of dream analysis, is really that you would analyze the dreams. The dreams are there for a purpose.
Honestly, what we use a lot is melatonin. So we use lower dosages of melatonin, taking it at different times, depending upon where we are traveling and that can really help adjust the body's rhythm to wherever you are going.
Jet lag depends on which direction you're going and it can be a little complicated, but there are a few different treatments. So one would be if you're going somewhere - sorry it's hard to think about it.
If you're going somewhere East from here, generally what you want to do is you want to try to have your bed time earlier and earlier so what we'll do is I'll have someone adjust for a week or two by going to be 15 minutes earlier and getting up 15 minutes earlier every night. So that can be a really simple thing.
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