Sleepless in Kalamazoo

Silvia Neme-Mercante and Nancy Foldvary-Schaefer

in A Case a Week: Sleep Disorders from the Cleveland Clinic

Published on behalf of Oxford University Press

Published in print September 2010 | ISBN: 9780195377729
Published online April 2013 | e-ISBN: 9780199322985 | DOI:
Sleepless in Kalamazoo

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Case 46 introduces a 49-year-old woman referred to the sleep clinic by her neurologist for evaluation of abnormal behaviors in sleep, characterized by a sudden arousal from sleep associated with a feeling of anxiety, after which she would roll over and grab the headboard or wall involuntarily. At times, this would evolve to shaking of both arms and legs. She would laugh softly or sigh afterwards and then return to sleep. She was fully aware during spells but would not speak, claiming that intense concentration could lessen their intensity and/or duration. In recent years, more severe spells were associated with urinary incontinence, though she never experienced oral trauma and her husband did not describe convulsive activity, and spells would last 20 to 40 second and occur 2 to 3 nights per week, sometimes repeatedly during the night and worse surrounding menses. While the nighttime episodes scared her, the daytime sleepiness, fatigue, and difficulty with concentration, attention, and cognitive processing the next day were her primary complaint.

Chapter.  2436 words.  Illustrated.

Subjects: Neurology ; Sleep Medicine

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