What scares middle-aged men the most


Parasomnias are unusual behaviors that occur just before you fall asleep, while you sleep, or when you wake up.

Children and adults can experience various unconscious behaviors during sleep that they do not remember.

Shortly before falling asleep, almost all people occasionally experience individual, short, involuntary jerks in their arms or in the whole body. Occasionally the legs twitch. Some people experience sleep paralysis (trying to move but being unable to move), brief fleeting images, or thoughts while falling asleep or waking up. Affected people sometimes clench their teeth, grind or have nightmares.

Sleepwalking, banging the head or being startled at night are common in children and can be very stressful for parents. Usually the children do not remember these episodes. Other parasomnias include nightmares, REM sleep behavior disorders, and sleep-related leg cramps.

Nocturnal startling

Scary episodes of sitting up, screaming and lashing out. The eyes are wide open and the heart is racing. Those affected look very scared. The episodes usually occur when people are half awake or when they are awakened directly from the deepest stages of non-REM or NREM sleep, usually in the first few hours of the night.

Nightmares are different from nightmares and can lead to sleepwalking.

Nocturnal startles are common in children. Children should not be woken up as this will frighten them even more. Although the children appear very scared, when they wake up they have no memory of the events or mental images and as a result have no psychological problems. Parents don't have to worry unduly. The episodes usually go away as the children get older.

In adults, being startled at night often indicates mental health problems or alcohol abuse.

With children, reassurance from the parents may be sufficient. If school performance or other activities are impaired, treatment with certain benzodiazepines (such as diazepam, clonazepam, or alprazolam) may be useful in older children. These medicines, used to treat anxiety (anti-anxiety medicines) and to help you sleep better (sedatives), are given 90 minutes before bedtime. They can help children fall asleep and reduce night jerks. However, long-term use of benzodiazepines can lead to drug dependence. Therefore, these drugs are usually only taken for a relatively short period of time (around 3 to 6 weeks).

Adults can benefit from psychotherapy or drug treatment.


Nightmares are vivid, frightening dreams that are followed by suddenly waking up. Children are more likely to have nightmares than adults. Nightmares occur during REM sleep.

They are more common with stress, fever, fatigue and after consuming alcohol.

Treatment for nightmares depends on the underlying problem.

Sleepwalking (somnambulism)

Sleepwalking, a common phenomenon among older children and adolescents, is walking around in a half-asleep state without the person being aware of it. It occurs during the deepest stages of NREM sleep.

The sleepwalker can mumble incessantly and injure himself when he runs into an obstacle. Most do not remember their sleepwalking.

Insufficient sleep and behaviors that do not promote sleep (see the table of changes in behavior to improve sleep) can lead to sleepwalking. For example, coffee consumption, physical activity or exciting films before bed can trigger sleepwalking.

No special treatment is usually needed unless sleepwalking causes injury.

The following general measures can decrease sleepwalking:

  • Sleep-enhancing measures, such as stimulating activities or substances (such as exercise or caffeine), should be avoided before going to bed

  • Install an alarm to wake the sleepwalker when he leaves the bed.

  • Install a door alarm

The following measures will help prevent injury during sleepwalking:

  • Gently guiding the sleepwalker back to bed instead of forcibly waking him up, which may make him restless

  • Remove obstacles and fragile objects that may get in the sleepwalker's way

  • Keep windows closed or lock them

  • Sleeping in a low bed or on a mattress can protect the sleepwalker from falling out of bed

Benzodiazepines, especially clonazepam, are usually helpful when general measures don't work. However, these drugs have significant side effects such as: B. Drowsiness during the day. Long-term use of benzodiazepines can lead to drug dependence.

REM sleep behavior disorder

This disorder includes speaking (often profane) and sometimes aggressive movements during REM sleep, usually in response to a dream.

REM sleep behavior disorders are more common in the elderly. Most people with this disorder have a condition that causes brain tissue degeneration, such as Parkinson's disease, multiple system atrophy, or Lewy body dementia. The risk of developing Alzheimer's disease may be slightly higher. Some people develop Parkinson's disease several years after they are diagnosed with REM sleep behavior disorder.

Unlike being startled at night, people with REM sleep behavior disorders sometimes remember when they woke up the next morning that they had been dreaming vividly.

Aggressive movements include, among others. waving the arms, but also hitting and kicking. The rabid behavior is not intended and is not directed against another person. Those affected can unintentionally injure themselves or their bed partner. This behavior also disturbs sleep and those affected are tired and sleepy during the day.

The diagnosis of REM sleep behavior disorders can often be made based on the symptoms reported by the sufferer or the bed partner. If this is not possible, polysomnography with electromyography (EMG) is usually done.

To check for conditions that cause brain degeneration, doctors do a neurological exam that assesses mental state and brain and nerve function. If a malformation is discovered, computed tomography (CT) or magnetic resonance imaging (MRI) is done.

There is no cure for this disease. However, clonazepam, a benzodiazepine (a sedative), relieves symptoms in most people. A low dose is effective. The drug is usually taken indefinitely. Melatonin can also help relieve symptoms of REM sleep behavior disorder.

The sleeping partner should be warned of the possibility of injury and can sleep in another bed before the medication begins to work. People with REM sleep behavior disorder should remove sharp objects and furniture near the bed.

Sleep-related leg cramps

Often times, middle-aged or elderly people who are otherwise healthy will experience muscle cramps in their calves or feet while sleeping.

The diagnosis of sleep-related leg cramps is usually based on symptoms and after other physical problems or disabilities have been ruled out. No further testing is required.

To prevent cramps, the affected muscles should be stretched for a few minutes before going to sleep. When cramps occur, stretching usually helps quickly and is preferred to drug therapy. Avoiding caffeine and other stimulants can help.

Various drugs (such as quinine, calcium and magnesium supplements, diphenhydramine, benzodiazepines, and mexiletine) have been used and are unlikely to work. In addition, side effects, especially with quinine and mexiletine, can be bothersome.

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