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Talking and hallucinate all night long. Looking for sleep specialist?

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Practicing since : 2009
Answered : 66 Questions
I am looking for a sleep specialist, not for sleep apnea, but for discovering why I talk and hallucinate all night long, every night. I live in Hesperia, CA, so I can be referred to a doctor in San Bernardino, Riverside, Redlands or Victorville.
Posted Thu, 7 Nov 2013 in Sleep Disorders
Answered by Dr. Sourav Das 49 minutes later
Brief Answer:
Disorder of Arousal (somniloquy) likely diagnosis

Detailed Answer:

Thank you for your query. From your description, it appears that you are suffering from Disorders of Arousal.
It includes Sleep talking (somniloquy), sleep walking (somnambulism), bruxism (teeth clenching), sleep sex, confusional arousals, etc. The common pathophysiology of all these disorders is that there is partial arousal of the brain for brief periods of time (microarousals), which are associated with the above mentioned events. Such microarousals lead to poor quality sleep, non refreshing sleep, day time somnolence, easy fatiguability, headache etc, besides causing poor attention and concentration in the daytime.
These disorders are usually much common in childhood, and the prevalence decreases with increasing age. However, if these persist into adulthood,as appears likely in your case, it should be treated.

I would have advised a Level I polysomnography, to confirm the episodes of microarousals, as well as documenting any associated sleep pathology. Depending upon the pathology involved, I would have customized the treatment.

Yes, a sleep medicine specialist in your area, preferably with a Neurology or Psychiatry background would be the right expert to perform level 1 polysomnography. Unfortunately I cannot be able to provide a referral online. You can talk to your primary treating doctor and ask for a referral to a specialist.

Hope I've been able to satisfy your query. If there are no further queries, please close the discussion and rate the same.

Best of luck,
Dr. Sourav.
Above answer was peer-reviewed by
Follow-up: Talking and hallucinate all night long. Looking for sleep specialist? 15 hours later
I do not feel the "arousal" theory is correct. When I talk, I am teaching a class of 3rd grade students. I will generally sit up in bed and talk/teach. When I hallucinate, I am "talking" to someone I actually see in my room. I do not sleep walk, Just talk/hallucinate all night long. I often wake my husband up by my talking and he nudges me to fall back asleep which I do, for a short period of time, then the talking begins again. Since I am talking, my primary does not think I have anything akin to sleep apnea. I am exhausted every day, all day, but have to teach regardless of my sleepiness. I come home after work and all I want to do is sleep I am so tired. My primary did not refer me to anyone, apparently does not have the "sleep specialist" in her background of training. Being pregnant, I need to be able to sleep now.
Answered by Dr. Sourav Das 6 hours later
Brief Answer:
request primary for a referral to sleep specialist

Detailed Answer:
Dear Ma'am,

Thank you for your feedback, please let me address your concerns. Please let me know if you remember yourself talking in the night, or it is your husband who tells you about the same. Because if you remember most of your nocturnal events, it is more likely to be a REM related behavior abnormality,and if you don't, its most likely an Arousal disorder.

Now, the term disorder of arousal doesn't imply that a person will be fully aroused and aware of whats happening.
Our brain has multiple parts, which control particular functions. Now, in disorders of arousal, there is partial arousal for small duration of time of the brain, with some areas awake,some still asleep. Now,those areas which are awake, will start doing their part (as the area involved with teaching in your case), while the other parts are still asleep, and gives the impression to the brain that it is still asleep, hence, no memory of the event is recorded.
Now, since certain parts of the brain don't get their full share of deep sleep in the night, they become tired, and fail to recover from daily wear and tear. the result is your daytime somnolence, easy fatiguability, difficulty in sustaining attention, irritability etc.
Now, Sleep Apnoea is an entirely different entity, where there is obstruction of respiration, while a person is asleep, usually related to snoring, snorting etc. These cause oxygen desaturation while asleep, and give rise to various cardiac and cerebrovascular risks like stroke etc. Sleep Apnoea is only one of around hundreds of sleep related disorders/ diagnostic entities, athough the most commonly discussed. Awareness about other entities like Arousal disorders, REM behavior abnormality, etc may be less, even among doctors not practising sleep medicine regularly.
I would suggest you to request your primary to refer you to a Sleep medicine specialist with a Neurology or Psychiatry background for Detailed assessment and management of your symptoms urgently as you do need to sleep adequately during your pregnancy.

Hope I've been able to satisfy your query. If there are no further queries, please close the discussion and rate the same.

Best of luck,
Dr. Sourav.
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