Is this sleep paralysis?

[lynette]

My husband is 55 years old and has had experiences since childhood during sleep which I thought might be sleep paralysis. Last night he had another episode which I found very frightening and now I'm not sure what it might be.
My husband is 55 years old and has had experiences since childhood during sleep, which I thought, might be sleep paralysis. Last night he had another episode, which I found very frightening and now I'm not sure what it might be.

After he has fallen asleep he begins to awaken or dreams he is awakening. He is aware of sounds around him in the room and he can actually see what is in front of him as he lies in bed, but he feels like he is in the grip of something he must struggle against. He can't fall asleep again nor can he pull out of the paralyzing feeling unless he or someone else can move an arm or leg. If that happens he is then immediately released from the grip.

Last night I was awakened by what felt like him trembling all over and making sounds like muffled screams. When I grabbed him arm he came out of it and told me he had been trying to get my attention to rescue him as this time he wasn't able to break out on his own.  These episodes happened infrequently as a child but in the past few years they are coming at a rate of about one a month.  Is this real sleep paralysis or something else? And could it be dangerous?

Thank you very much for considering my questions.

- Lynette

[Leah on Sleep Paralysis]

The only thing I keep asking of my doctors is for them to please stop calling
it "Sleep Paralysis".  Because the more I (or they) keep perpetuating that label,
the next doctor will also assume it's a 'sleep disorder'.  Come to find out it's not
really.

I finally (since my last post) found the paper I got off the internet on the subject
of the Period Paralysis.  I found it under:

    "Thyrotoxic Periodic Paralysis"
The specific URL I found the info under was:

http://www.healthanswers.com/centers/body/overview.asp?id=urinary+system&filename=000319.htm

Actually, I think the search words I used were under "Hypokalemic paralysis"

It is defined as ...A disorder characterized by intermittent episodes of muscle weakness that occurs in people with thyrotoxicosis, a disorder associated with high levels of thyroid hormones.
Causes, incidence, and risk factors:
Hypokalemic periodic paralysis (familial eriodic paralysis) is an inherited condition, and in most cases, it is directly inherited. In other cases, the disorder appears sporadically in a family group. It can occur in people with THYROTOXICOSIS (high thyroid hormone levels) especially when the condition has persisted for several months/years.  About 10% of people with HYPERTHYROIDISM will exhibit thyrotoxic periodic paralysis.  The disorder is most common in men, particularly Latin American and Asian men.
     The disorder involves attacks of muscle weakness OR paralysis alternating with periods of normal muscle function.  Attacks usually begin after syyptoms of hyperthyroidism have developed.  The frequency of attacks varies from daily to yearly,.  Episodes of muscle weakness may last for a few hours or may persis for seceral days.
       During an attack, there is a low level of potassium in the bloodstream (serum). Serum potassium leels are normal between attaks.  There is no decrease in total body potassium, however.  Potasssium flows from the bloodstream into muscle cells.  Insulin leels may affect the disorder in some people because insulin increases the flow of potassium into cells.
     Weakness most commonly affects the muscles of the arms and legs. It may occasionally affect the muscles of the eyes or the muscles involved in breathing and swallowing (which can be fatal).  Heart
arrhythmias may occur during attaks because of the drop in potassium levels.  Although muscle strength is initially normal between atacks, repeated attacks may eventually cause progressive and persistent muscle weakness.
Signs and Tests:
The health care provider may suggest genetic counseling. Treatment of the underlying thyroid disorder prevents attacks of weakness.
    The health care provider may suspect thyrotoxic periodic paralysis based on a family history of the disorder, the episodic nature of symptoms, low potassium levels during attacks, obnormal throid hormone levels, and elimination of other disorders associated with low potassium as the cause of symptoms.
   Between attacks, examinamtion is normal, or thre may be signs of hyperthyroidism, such as a palpably enlarged thyroid.  During an attack, reflexes may be decreased or absent. Weakness is constant rather than spastic (spasmodic) and is greater in proximal muscle groups (near the body, such as the shoudlers or hips) than in distal groups ( away from the body such as the arms or legs) The health care provider may attemtpt to trigger an attck by administereing insulin and glucose (which reduces potassium levels) or
thyroid hormone.  

For the rest of it go to the address above.  I just paraphrased what the paper said, so I don't think I
violated any copyright laws, I did not write exactly.  It also goes on to say some things that further
interested me about chronic attacks eventually resulting in progressive muscle weakness, which is present even between attacks.  Now THAT made me take extra notice, since I have been diagnosed
with Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) which is much MORE than just being
'tired', believe me.  It's not being fatigued, it's being totally disabled by devastating weakness; where
it takes 6-8 hours just to crawl to the shower, get out, dry off, and crawl back in bed.
   It went on to explain the breathing and heart arrhythmias dangers involved.  It explains that its difficult to diagnose because lab reports often show 'within normal limits' (thyroid test for T3 and T4).  But I
don't know what other test BESIDES the usual T3 and T4 for thyroid one would get.

   Perhaps the doc on this site can advise another more in-depth test for thyroid problems.  I have had
tons of never-ending thyroid problems all my life.  Now this thryoid 'cancer' which is 'not really
cancer'.  Geeez.  Actually, they are going to cut open my throat and take out my thryoid because they
"can't say its NOT cancer".  What my surgeon does not realize is that I've had thyroid problems ALL
my life since a baby, thats 53 years now.  But doctors still believe those measly, crummy T3 and T4
tests.  Why?  WHen so many of us have stuff wrong with our Thryoids which are NOT reflected on
that rinky-dink test?

    I am still NOT going to have a thyroidectomy until I make an appointment with either an
endocrinologist (adrenals, thyroid, pitutary- all interrelate)....to see what s/he says.  I hope s/he
can give me a more in-depth thyroid test.  I deserve it after 54 years of all the Periodic Sleep Paralysis,
and the last 10 years of profound weakness which has left me with no social life.

   If nothing else, I would assume I ned to see a specialist about what causes Potassium imbalances,
OTHER than thyroid malfunction.  On the web page they said that a diet low in carbohydrates and low in salt may be recommended; but that treatment of the underlying thyroid disorder usually stops attacks.  But I don't think any "underlying thyroid disorder' can be treated properly unless it is FIRST DIAGNOSED
properly.   So far, I've had 54 years of saying, yeah there is something wrong with you thryoid, but
we don't know...and by the way your thyroid test is normal; but, also, by the way, we want you to have
surgery to have it remove".  
Huh?
   I am NOT comfortable with that -- so I  am not going to stop asking questions!  Thanks for reading
such a long post!    Leah Neal/ ***@****

[Maya]

I am a 20 year old female and have been experiecning sleep paralysis since I was 15. I realized this when I described what I thought was a reccuring nightmare to a friend when she told me that it sounded very much like this condition and that I should do some research. I did some research and  needless to say, what I thought was a recurring nightmare is most definitely sleep paralysis. What I found even more unsettling was the connection that Leah Neil mentioned between thyroid problems and this disorder- I have had an enlarged thyroid since I was a child but doctors said that it posed no health risks.

Although it is reassuring that there is a name for this condition I would very much appreciate any light that could be shed on the subject. I'm sure that all sufferers of sleep paralysis understand what a terrifying experience this is.

Thank you.


Maya

[Leah Neal]

I just HAD to respond to Lynette, whose husband experiences some sort of sleep paralysis.

I don't blame the CCF Neuro MD for recommending that her husband be tested for sleep disorders.
And I sure it won't hurt.  Since 1962, I have been to countless neurologists and been tested in
countless sleep labs, through the years.  - for the same experience Lynettes husband has.

But I have experienced the exact same episodes since I was a child. They were [and still are] very,
very scary.   Mine happen in that peroid of 'just drifting off' when ones brain waves go from Beta
to Alpha.   I also have the same episodes as her husband, IE during the night.

I am paralyzed all over, cannot speak, cannot gesture, and so far I've never, ever been able to make
a sound so that anyone will ever hear me.

I just looked on the computer couple of weeks ago.  Since I was just diagnosed with a thryoid tumor,
solid 'cold' tumor and just had a biopsy, I am preparing to have a thyroid-ectomy next week. In
the course of surfing the net and reading about thryoid stuff in general, my  jaw dropped open
when I saw a paper entitled "Sleep Periodic Paralysis".  It is a condition just like Lynettes husband
and mine.  It has been primarily reported by Asian men.  [Go figure]

I am a Caucasian female, aged 54. The only other paper on the topic was a Black man in his late '40's
brought into an Emergency Room in Florida in 1997.

Come to find out, the cause is a sudden drop in blood Potassium.  To further complicate things, the
patients who have these, will always show normal potassium levels in our blood all during the day.
The research does not say what can be done about it.  It implies that it is NOT a sleep problem, but
more of a Blood Gas problem, and/or inability to regulate ones blood pressure and other blood
distribution while in a supine position (lying down).

Us patients who get it have potassium levels which are fine all day long.  Then right after we fall asleep,
lying down, BAM....potassium level drops to an alarming degree.  The articles did not give the cause, nor
a preventative.   But it is MORE related to thyroid and endocrine malfunction than it is to sleep disorders.
Or at least the article kept talking about the thyroid and never once said anything about sleep lab tests as necessary.

For myself I would assume [probably incorrectly] that more potassium would be the answer, especially
before bedtime -- but not only is that dangerous for me to assume that, it might be fatal. I know there is
a very delicate balance between the electrolytes, and potassium/magnesium balance which is crucial
to keep ones heart beating.  I don't want to mess around with that.  But I don't trust doctors anymore than
I trust myself -- after all, I've been describing this for the last 54 years, and not one of hundreds of
physicians has ever had a clue.  They either shrugged their shoulders or sent me to a neurologist to
be treated for atypical, unknown 'seizures' - or sent me to a sleep lab.   In other words, I HAD TO DO THE
RESEARCH and look it uup myself.  I will never give any physician credit for my finding out what the
sleep paralysis was caused by.  In all fairness, since I am a clinician, I know it's impossible for any
clinician to sit and do hours of research for every client/patient.  That would take lifetimes.

But, each time I take a potassium supplement [they are often found in diuretics, anyway] I have
found that the Potassium makes my "mind race" and causes me to have insomnia.  I hope this all makes
sense.  But instead of going back to a sleep clinic [where they said I have severe sleep apnea] I'm NOT
going to stop there.  I will go to an endocrinologist, or someone who knows about blood gas,etc. At least
i know it's thyroid/potassium related and can start from that point.

I am scheduled for surgery for cancer on my thyroid next week.  One of the other research articles
warns physicians to be SURE and check all patients blood Potassium level just 5 minutes before surgery;
while patient on the gurney in supine position. That research artlcle was fairly new, just published in
the last year.  I shudder to think of patients like me or Lynettes husband who perhaps have had other health problems or surgery which 'didn't go right' but nobody  knew what happened.  I am going to FORCE my surgeon to read the research  article -- or I'd rather not have the surgery.  When I had a C-section in 1967 for birth of second son, I woke up during surgery, was not fully anesthesized, but could not speak.

It maysound like a  tiny detail to others,  but for me [especially preparing for surgery] this is life or death detail. My surgeon AND my anesthesiologist  will ALL be expected by me to know about, BEFORE I consent to surgery. Thank you for reading such a long post. But its worth it.  Leah Neal, ***@****

[Leah Neal]

About Lynette's husband and 'sleep paralysis'.

I just submitted a post about the info I found about my sleep paralysis, which is actually caused
by a drop in potassium level [which is fine all day, but not after lying down at night].

I also mentioned that I found it while researching "Thyroid" since I've been diagnosed with
thyroid cancer.  I am posting again, in hopes that Lynette and/or her husband will read this.

I also surfed on over to a web site at :   http://www.downwinders.com

It's about the effects of radiation on the thyroids of baby-boomer aged kids back in the
1950'.s  Lynette husband and I are about the same age.  Come to find out, many of us are
having thryoid problems [Tipper Gore just had a thryoid biopsy, her's was benign]. But
still, there is proof that there are is a vast, inordinate amount of people who were kids
under the age of ten years, between 1950 and 1956.  A person did not have to live anywhere
near Nevada to be exposed to any of the radiation.  As a matter of fact, the winds carried more
stuff to New Jersery.  Now there are more people on the East Coast with thryoid problems
in the early or mid'50's - than persons who lived several miles from the nuclear testing site
itself in Nevada.  It depended on which way the wind was blowing and which day/year the nuke
test was conducted.

Since I read about Potassium and related thryoid cancers/whether benign or not, I couldn't help
but mention it.  I'd hate for people who are paralyzed in their sleep to be told like me, it's
just 'sleep apnea', etc.  That's great to know...but there is more to the Paralysis.  Please read
up on Thyroid, potassium, etc.  - and look up the sites on radiation, then correlate all the info
with Lynettes husband's age.  Lynette if you are reading this, please think about your husband
getting MORE than just a little T3/T4 thyroid test done.  [Mine was a normal thryoid function
test, but I have thryoid cancer].  Please consider getting an Sonogram of his neck, of his thryoid.
Don't stop with just a thryoid function test.

Good luck.  I hope you come back to this site soon.  I wish you and your husband well. Let me know
how it all comes out, okay?  Kindest regards, Leah |  ***@****

[CCF Neuro[P] MD, RPS]

thanks for the comments.

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Lynette:

Sorry to hear about your husband.  What you describe might be sleep paralysis.  I would recommend that he see a sleep expert.  There are sleep disorders that may accompany sleep paralysis.  This would be especially true if he has daytime sleepiness or trouble sleeping at night.

Sincerely,

CCF Neuro MD