Sleepwalk with Me: Comedian's sleep disorder experience comes to film

Mike Birbiglia’s sleep disorder has been the basis for a book and one-man show. Now the comedian’s REM sleep behavior disorder is featured in film. Sleepwalk with Me made its premiere at the 2012 Sundance Film Festival in Park City, Utah.

The movie is presented in association with WBEZ Public Radio's This American Life. Birbiglia has appeared as a semi-regular contributor to This American Life. Its host, Ira Glass, is a producer for the movie.

Birbiglia plays a New York stand-up comedian with girlfriend issues and a sleep disorder. Birbiglia’s real-life REM sleep behavior disorder causes his body to physically act out dreams. He limits the frequency of these episodes by taking clonazepam, a drug used to treat seizures by activating parts of the brain to produce a calming effect. He also sleeps in a makeshift cocoon – wearing a sleeping bag up to his neck and mittens so he can’t open it and get up.



Sleepwalk with Me also pays homage to sleep medicine. William C. Dement, MD, PhD, can be heard narrating his own audiobook as Birbiglia falls asleep while driving. Dement in 1975 launched the American Sleep Disorders Association, now known as the American Academy of Sleep Medicine. He also served as its president for the first 12 years.

No word if the film has found a distributor. But the book is available for purchase and segments with Birbiglia on NPR are available at This American Life and Fresh Air. More about Mike Birbiglia’s story can be found in the Sleep Education Blog. Or go to the AASM’s patient education website for additional information on parasomnias, like sleepwalking and REM sleep behavior disorder.

Image: Sleepwalk With Me Publicity Photo

Researchers Probe Family for Sleepwalking Gene

What’s passed down from your parents, grandparents and ancestors can impact the way you sleep. In some cases, genetics can be beneficial. For instance the short-sleep gene allows people to better cope with sleep loss. Other families have less helpful genes, like vulnerability to insomnia caused by depression. And rarest of all, a few families in the world carry the ticking time bomb of a gene that causes fatal familial insomnia – a degenerative condition that blurs the boundaries between sleep and wakefulness, eventually ending in death.

Somewhere in America, a group of researchers from Washington University School of Medicine have discovered a family with four generations of sleepwalkers. Nine out of 22 members of the family have been sleepwalkers. And they may hold the key to finding the cause - and potentially a cure - for sleepwalking.

So far the researchers have been able to identify the chromosomal location that contains the family’s sleepwalking gene. Further research is needed to identify the exact gene.

It’s been long known that sleepwalking is a highly heritable condition. Sleepwalking and other parasomnias such as sleep talking and bedwetting are not uncommon in childhood. About 10 percent of children sleepwalk compared to only 2 percent of adults.

It appears researchers are closer to learning why that 2 percent still sleepwalk.

Image by Xava du

Did Sleep Deprivation Lead to Attack on U.S. Rep. Gabrielle Giffords?

Politicians and pundits continue to argue whether vitriolic partisan politics inspired the shooting of U.S. Rep. Gabrielle Giffords on Saturday. Another factor that may have pushed alleged gunman Jared Lee Loughner to go on a killing spree that left six dead and 14 injured remains left out of the discussion.

Bizarre online ramblings allegedly posted by Loughner reveal he may have had insomnia prior to the Arizona attack. He writes:

“All humans are in need of sleep.
Jared Loughner is a human.
Hence, Jared Loughner is in need of sleep.”

Other passages in the YouTube rant mention sleepwalking and so-called conscious dreaming about the government. It’s unclear whether his message is intended to be literal, symbolic or just the incoherent ramblings of someone with serious mental health problems. Former classmates indicate it may be the latter.

And it all could have started with insomnia. Young adults with long-term sleep deprivation have an increased risk for mental illness, a study published last year in the journal SLEEP reported. A history of depression, anxiety or general emotional distress further raises the risk.

So was the shooting a product of partisan speech with violent undertones? Was it long-term insomnia? Or was the alleged gunman simply seriously disturbed? Chances are we will find out more in the coming months.

Sleepwalking into adolescence: parasomnias tend to persist past childhood

Childhood parasomnias like sleepwalking or bedwetting don’t necessarily stop at adolescence. The remission rates for these pediatric problems are actually quite low heading into the teenage years.

The research abstract (#251), presented as a poster today at SLEEP 2010, compared parasomnias incidents rates for children ages 6 to 11 over the course of less than five years.

The children’s parents completed comprehensive sleep habits surveys at the beginning and end points of the study.

Results show the remission rate for children with sleepwalking was only 1.9 percent after five years. Remission rates remained low for bedwetting (5.2 percent), sleep terrors (4.8 percent) and sleep talking (3.5).

Sleep talking was the most common parasomnia for adolescents. 22.3 percent of parents reported their child talked in his or her sleep. 15.2 percent of those cases were new.

The incidence rate was 2.6 percent for new cases of sleep terrors, and less than one percent for both bedwetting and sleepwalking.

Learn more about sleepwalking. bedwetting and nightmares at sleepeducation.com

Sleepwalking disorder at center of Colorado Springs teen murder case

The disorder that causes people to act out their dreams continues to grab media attention this month. A 13-year-old Colorado Springs boy is in court for a deadly attack on family members. His mother says he appeared to be possessed. His lawyers claims he did it all in his sleep.

On year ago, police say Daniel Gudino shot and killed his 9-year-old brother, then shot his mother in the shoulder and stabbed her multiple times. This week, a judge is hearing arguments to decide if he will be tried as an adult.

Thursday, a child psychiatrist took the stand as a defense witness. He claimed Gudino had a rare parasomnia. He says the boy thought he was shooting at shadowy ghosts inside his house. He referred to a history of sleepwalking, including an incident two years ago.

Parasomnia is a classification of sleep disorders. All parasomnias involve undesirable events during sleep.

The description given by the doctor is partly in line with the symptoms of the parasomnia REM sleep behavioral disorder. RBD causes people to act out vivid dreams in their sleep, sometimes violently.

REM sleep behavioral disorder can be progressive, starting out with mild activity, eventually becoming more violent. Only about .5 percent of people have symptoms of RBD. Most are older men.

Sleepwalking disorder might be a stronger possibility because it usually occurs early in life. Sleepwalkers may get violent, trying to escape from a threat they dreamed. Their eyes are usually open and have a confused “glassy” look. Someone with these symptoms could be mistaken for being possessed, as the suspect’s mother described her son.

Whether the boy has any disorder at all is still up for debate.

The prosecution claims his actions were far too complicated to happen in his sleep. Before he shot his brother, they say he used toothpicks to pick the lock on a gun cabinet, and then he loaded a .22 caliber rifle.

Look for further updates on this case on the AASM Twitter account: www.twitter.com/aasmorg.

“Ambien Zombies”, sleepwalking fears and facts

Last night, Fox News Boston aired the special report “Is Ambien creating a nation of zombies?” The segment called attention to dangerous or even deadly sleepwalking episodes linked to the prescription sleep drug Ambien.



While these incidents are a reminder that side effects can occur, millions of people regularly take Ambien and other prescription hypnotics without experiencing any problems.

You can minimize the risk if you take Ambien exactly as prescribed by your doctor, moments before bedtime. Never increase dosage or begin taking additional medications without consulting your doctor. And don’t use alcohol before or after taking Ambien. Allow for a full nights sleep when you take the drug.

The FDA warns in its Medication Guide for Ambien, “You may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night.”

The AASM recognizes Ambien as a safe short-term treatment for insomnia. For severe or chronic cases we recommend seeing a board-certified sleep specialist for further treatment options, such as cognitive behavioral therapy. To find a sleep specialist contact an AASM-accredited sleep center near you.

Find out more about Ambien and other sleep medications.

Or follow us on Twitter: twitter.com/aasmorg.

Movie “In My Sleep” is a Sleepwalking Thriller

Coke’s recent “Sleepwalker” ad had a whimsical, humorous tone. In contrast, the new movie “In My Sleep” examines the darker side of sleepwalking.

The movie’s tagline is, “Sleepwalking can be deadly.” And the film is rated PG-13 for sexual content, violence and bloody images.



The plot was inspired by real sleepwalking stories, first-time director Allen Wolf said in a press kit. He also wrote and produced the movie.

“I had read many stories about people who had done all kinds of horrifying things while they were sleepwalking,” Wolf said. “The idea that someone could do virtually anything while sleepwalking and have no conscious memory of it was fascinating to me.

“I thought that most of us could relate to feeling like a part of our lives is out of control. I wanted to take that to the next level – what if you lost control of yourself when you were sleeping? That idea drew me to the story.”

In terms of its medical accuracy, the movie appears to be a little loose with the details. The main character is diagnosed with “parasomnia, a rare sleep disorder.”

“Parasomnia” is actually a classification of a dozen specific sleep disorders. Some of them are rare, but others are quite common. All of them involve undesired behaviors during sleep.

Nightmare disorder. Sleepwalking. Sleep terrors. Confusional arousals. Sleep paralysis. Hallucinations. Sleep-related eating disorder. These are some examples of parasomnias.

But in general, the movie is right: Sleepwalking can be a dangerous problem. Some people with REM sleep behavior disorder take sleepwalking to the extreme. They act out vivid, action-packed dreams while remaining asleep. They may shout, punch, kick, run and even jump out a window.

Other people may sleepwalk as a side effect of taking a sleeping pill. In 2007 the FDA requested that a warning about the risk of “complex sleep-related behaviors” be added to the product labeling of all sedative hypnotics.

You can get help for a parasomnia at an AASM-accredited sleep center near you. The AASM offers these Guidelines for Taking Sleep Medications.

Read more about parasomnias. The 2005 documentary “Sleep Runners” tells the true stories of people who suffer from parasomnias.

Twitter: Sleep & Tweets

You can learn a lot about a person in 140 characters or less. You can learn a lot about their sleep too.Twitter let’s you answer the question, “What’s happening?” The Web site at www.sleepingtime.org has responded by asking, “When do they sleep?”

The one-click site simply asks you to provide the username of a person who is on Twitter. Then in a second the site’s algorithm will analyze the timing of hundreds of that user’s tweets.

It will identify the time of day when the user is least active on Twitter. From this activity analysis it calculates the hours when the person is more likely to sleep.

The site was developed by Amit Agarwal, a personal technology columnist in India. He writes the Digital Inspiration blog and is on Twitter as @labnol.

So when does Amit sleep? According to sleepingtime, he typically gets about seven hours of shut-eye from 1 a.m. to 8 a.m. in the New Delhi time zone.

Amit also used the site to compile estimated sleep times for some “Tech Superstars.” For example, sleepingtime determined that Bill Gates is more likely to get eight hours of sleep from midnight to 8 a.m.

Last year the Sleep Education blog reported that there can be little time for White House staffers to sleep. What does sleepingtime say?

It reports that @whitehouse is more likely to sleep for eight hours from 11 p.m. to 7 a.m. And @barackobama is more likely to sleep for seven hours between 1 a.m. and 8 a.m.

So it’s not an exact science. But if you use Twitter regularly, the site can give you a quick snapshot of your typical “sleep window.”

After all, you can’t tweet in your sleep. Or can you?

Episodes of sleepwalking can involve routine behaviors such as making phone calls. Last year a case report even described a woman who sent some strange e-mails while she was asleep.

But sleeptweeting? It’s possible. And it’s another good reason to keep your cell phone away from your bed at night.

Coca-Cola’s Sleepwalker Super Bowl Ad

Coca-Cola scored during last night’s Super Bowl with its “Sleepwalker” ad. It was in the Top 5 of the most popular ads according to the USA Today Ad Meter focus groups.

That may not put the ad in the same elite category as classics like Coke’s ad with Pittsburgh Steeler “Mean” Joe Greene.



But a good showing on advertising’s biggest night has to be considered a success.

In “Sleepwalker,” a sleeping man rises and goes on a sleepwalking safari across the African savanna. He unwittingly survives the perils of the African night to quench his thirst with a bottle of Coke.



The whimsical ad has a playful, humorous tone. But sleepwalking really can be a dangerous problem.

A sleepwalker may climb out a window or walk outside. On rare occasions a sleepwalker may get in the car and go for a drive.

And some sleepwalkers go to the fridge for much more than a Coke. People with sleep related eating disorder have episodes of compulsive binge eating while they are only partially awake.

Other people with REM sleep behavior disorder take sleepwalking to the extreme. They act out vivid, action-packed dreams while remaining asleep. They may shout, punch, kick, run and even jump out a window.

These are examples of a group of sleep disorders called "parasomnias." They all involve undesired behaviors during sleep.

Read more about parasomnias such as sleepwalking. Get tips for preventing parasomnias on SleepEducation.com.

Contact an AASM-accredited sleep disorders center for help with an ongoing sleep problem.

Sleepwalking, Sleep Terrors & Dreams

A new study shows that episodes of sleepwalking and sleep terrors may be related to short, unpleasant, dreamlike mental activity. The study suggests that people with these sleep disorders may be acting out dreamlike thoughts. The results were published yesterday in the journal Sleep.

The French study involved 43 people with severe sleepwalking or sleep terrors. Their age ranged from 11 years to 72 years. They were compared with 25 healthy controls. Sleep was monitored during an overnight sleep study.

Participants also were interviewed. They were asked, “What was going through your mind at the very moment of the episodes, whenever the night?”

Thirty-eight people were able to reliably answer questions about their mental content during the sleepwalking and sleep terrors episodes. These recollections covered a lifetime span.

Results show that 71 percent of people reported at least one incident of dreamlike mental content associated with an episode of sleepwalking or sleep terrors. The action in the dreamlike thoughts corresponded with the observed behavior.

A total of 106 reports of dreamlike mental activity were collected. The mental content was brief; 95 percent of the reports involved a single visual scene.

These dreamlike thoughts were frequently unpleasant. About 84 percent involved apprehension, fear or terror; and 54 percent involved misfortune. In 24 percent of the reports the dreamer was the victim of aggression.

People with sleepwalking and sleep terrors reported more severe daytime sleepiness. They also had four times as many arousals from slow-wave sleep.

The authors noted that dreaming typically is associated with the sleep stage of rapid eye movement sleep. REM sleep dreams tend to be long, complex and vivid.

Complex mental activity has been reported in non-REM sleep during slow-wave sleep. But are these dreamlike thoughts really dreams? The authors reported that this question is still debated.

So what does this dreamlike mental activity represent? The authors suggested that it could be the final part of a longer dream. The rest of the dream may be forgotten after waking up. Or it could be a short mental creation that is formed before or just at the time of arousal.

Learn more about parasomnias such as sleepwalking and sleep terrors. Get tips for preventing parasomnias on SleepEducation.com. Compare the common features of four parasomnias.

Image by Xava du

To Sleep, Perchance to Dream: Or Stroll or Snack...

Former "American Idol" judge Paula Abdul told Fox News that while they were living together, her former co-star Kara DioGuardi suffered from sleep eating and sleepwalking.

Sleepwalking is typically seen as a childhood problem. While it is more common in children (as many as 17 percent of children sleepwalk), up to four percent of adults sleepwalk as well.

Sleepwalking, also known as somnambulism, tends to occur during slow-wave sleep, or when you aren’t dreaming. It is difficult to wake a sleepwalker. Sometimes they wake themselves. Other times they go back to bed, not knowing they ever got up.

Most people naturally outgrow sleepwalking. Those who wake up and find themselves in dangerous or embarrassing situations, however, may need treatment.

Sometimes sleepwalking is harmless. You may wake up somewhere other than your bed and wonder how you got there. It can also be dangerous. Children can fall down stairs and adults might even try to drive!

DioGuardi’s problem, sleep related eating disorder, is unusual. But like other eating disorders, it is much more common in women than in men.

People with SRED often prepare and eat food with no recollection of doing so. They may gain weight. Eventually they can even develop type 2 diabetes.

Sleep eating tends to occur in people with histories of alcoholism, drug abuse and other sleep disorders. People with high levels of stress and anxiety may also find themselves snacking in their sleep.

DioGuardi admits that in the past she had an eating disorder and has received professional help to overcome it.

Visit an AASM-accredited sleep disorders center if you suffer from sleepwalking or have an ongoing sleep problem.

Understanding Child Parasomnias

Child parasomnias are sleep disorders that can put a scare into parents. Episodes can involve unusual and undesirable actions.

Nightmares may be the most familiar parasomnia. Others include sleepwalking and sleep terrors.

The good news is that these disorders tend to be common and harmless in children. In many cases the child will have no memory of the event.

But some children may have a more severe problem with a parasomnia. You should contact an AASM-accredited sleep center if a sleep problem greatly disturbs your child.

It may be hard to distinguish some parasomnias from one another. They can have similar features.

This chart will help you compare four common child parasomnias. Get tips for parents from the AASM.

When Dreams Come Alive: “Bizkit the Sleep Walking Dog”

By now you may be one of the millions of people who have seen “Bizkit the Sleep Walking Dog.” The dog is the latest YouTube sensation.

What can we learn from Bizkit?

Well, the video is pretty good evidence that dogs have dreams. In fact, YouTube is littered with similar videos. They all show sleeping dogs in various states of twitching, whimpering and moving. But few of them can match Bizkit’s full-throttle “sleep sprint.”

Of course, we may never know for sure that dogs dream like we do. They can’t exactly tell us about their dreams after they wake up. Unless your dog is Scooby Doo or Astro, that conversation is unlikely to happen.




But there is something even more important that we can learn from Bizkit. The dog’s behavior is an example of what can happen when dreams come alive.

Normally the brain paralyzes most of our muscles during the stage of rapid eye movement (REM) sleep. This prevents us from jumping out of bed and acting out our dreams.

Cats and dogs have a sleep stage that is similar to REM sleep. Sometimes it is called “paradoxical sleep.” This is the paradox: The animal appears to be asleep; but brain waves and eye movements look like the animal is awake.

Studies have found movement disorders during sleep in cats and dogs, as well as a disorder of REM sleep in a cat. Early studies also found that cats with lesions in certain brain areas would display complex behaviors during sleep. While sleeping they might even search for and attack an imaginary prey.

This animal research led to the discovery that some people have REM sleep behavior disorder (RBD). They act out vivid, action-packed dreams while remaining asleep.

People with RBD may shout, punch, kick, run and even jump out a window. Usually their eyes remain closed during the episode. Once they are awake they often report having a dream that describes their unusual actions.

Injuries may result from an RBD episode. Both the dreamer and a bed partner are at risk of being hurt. This is why it is important to seek medical help at an AASM-accredited sleep center if you suspect that you or a loved one may suffer from RBD.

As for Bizkit, the dog’s behavior looks a lot like RBD. It wouldn’t be the first time; a 2004 study reported on the diagnosis of RBD in a dog.

In fact Bizkit may be the latest in a line of famous dogs with RBD. It has been suggested that dogs in the movies “Cinderella,” “Lady and the Tramp,” and “The Fox and the Hound” all may have had RBD.

When Dreams Come Alive: REM Sleep Behavior Disorder

Dreams that come to life are the stuff of fantasy novels and horror movies. But it’s also a reality for people who suffer from REM sleep behavior disorder.

People who have RBD act out vivid dreams as they sleep. The dreams tend to be action-packed. The dreamer may punch, kick, jump or get out of bed and run. All of this occurs while he or she is still asleep.

The disorder may sound funny. But injuries are common. Cuts, bruises or broken bones may occur to the dreamer or to a bedpartner.

Why does RBD occur? Normally your brain paralyzes most muscles during the stage of rapid eye movement (REM) sleep. This is the stage of sleep when you have most dreams and nightmares. RBD occurs when the brain fails to tell the muscles to remain still.

RBD is similar to sleepwalking. But a sleepwalker tends to be confused upon waking up. Once awake, a person with RBD usually has clear recall of a vivid dream.

Sleepwalkers also are more likely to get up calmly, have their eyes open and walk out of the room. RBD actions tend to be more intense and dramatic.

RBD was identified and reported in the journal Sleep in 1986. Sixteen years later a follow-up report was published by the same research team. People with RBD are at risk for developing Parkinson’s disease.

RBD appears to be rare, affecting less than one percent of people. It is more common in older men. A new study followed 93 people with RBD. Participants had an average age of 65.4 years; 80 percent were men.

But stand-up comedian Mike Birbiglia is evidence that RBD can strike when you are younger. During his routines he often shares true stories of his RBD episodes. He is even starring in an off-Broadway show called Sleepwalk with Me.

Laughter is good medicine; but people with RBD should seek medical help. Contact an AASM-accredited sleep disorders center if you act out your dreams while you sleep.

The Curious Case of the Sleep E-mailer

Add e-mailing to the long list of behaviors that can occur during an episode of sleepwalking.

The journal Sleep Medicine has an article “in press” that will appear in an upcoming issue. It describes the case of a woman who sent some strange e-mails while she was asleep.

Sleepwalking can involve routine or unusual behaviors. Examples include making phone calls, walking outside or eating. But this is the first reported case of sleep e-mailing.

The New York Times reports that the woman was taking Ambien for her insomnia. The sleep e-mailing occurred after she decided on her own to increase her dose.

Like any other drug, sleep medications may cause some side effects. These side effects can include sleepwalking, sleep eating and other complex sleep behaviors. Some people also may experience memory problems.

The AASM Tips for Taking Sleep Medications note that you should follow your doctor’s instructions when taking a sleeping pill. Never increase the dose on your own. You also should only take the sleeping pill for as many days or weeks as your doctor tells you.

The Times article also reports that a new feature from Google could help protect sleepwalkers from sending embarrassing e-mails. It’s called Mail Goggles.

When enabled, it stops you from sending late-night e-mails on weekends. Before a message is sent, you have to solve a few math problems. The intent is to force you to stop and consider if you really want to send the message.

The math problems are fairly simple. But for a sleepwalker, it might be enough to prevent you from sending a strange e-mail to a co-worker or friend.

Update 03/02/09: The article appears in the February 2009 issue (volume 10, issue 2) of Sleep Medicine.