Monday, March 25, 2013

Fear and Sleep

In a recent post [Sleep] I wrote about a Radiolab program on sleep. One thing I remember from that program is that our basic fear of environment affects our sleep at a very basic and deep level. For example, most people have problem going to sleep in a new place, at least the first night or two.

Here is an article from NPR with a strange connection to sleep:
How an unlikely drug helps some children consumed by fear

It talks about a psychiatrist,Demitri Papolos, who is the director of research at the Juvenile Bipolar Research Foundation and a researcher at the Albert Einstein College of Medicine. He's also the author of The Bipolar Child. He defines a subtype of bipolar disorder that he calls the "fear of harm" profile and use ketamine to treat children with this profile [Link to clinical results]. What fascinates me is the idea that sleep disorders are closely tied to this problem. Some quotes from the NPR article:

There are several core characteristics of these children, Papolos says. One is a variety of sleep disturbances including frequent and terrifying nightmares. "They're all about pursuit or abandonment," he says. "Some animal chasing them. A shark biting into their leg, and they feel the blood and the pain."

Another characteristic of kids like George, Papolos says, is an extreme reaction when anyone tries to control their behavior. "They may very well be very aggressive, particularly at home and particularly where there's any limit-setting, because limit-setting is experienced as a threat to them," he says. "They're functioning on a very primitive fight-or-flight level."
When these kids do become violent, it's not premeditated, Papolos says. They're not potential mass killers. They're responding the way an animal might, defending its territory.

There's one more characteristic of the "fear of harm" profile that's not about behavior at all. These children overheat easily, Papolos says, especially at night.
Here is a more technical description of the condition and its ties to sleep disorders and overheating:
Sleep activity patterns and temperature study

I have had some related experiences, although less extreme. For me the world is [used to be?] a frightening place that I always need to watch for possible harm. And I do have the overheating problem at night, especially when I am nervous and anxious about some issues. Nevertheless, I am not convinced that medication is my answer. I think the roots of the problem may be in the early infant years and related parenting/mothering issues. And my guess is that a more psychoanalytic treatment may be appropriate.

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