The Insomnia Blog by Sleep Doctor Michael Breus, Ph.D.

The Dangers of Sleeping Naked

I was amused this week when I read in the Guardian about Travelodge’s current crisis with sleepwalkers in the buff. The hotel chain now keeps towels on hand at the front desk to help these lost souls cover up when they wake up and find themselves out in public with, well, everything out in public.

Towels? I think they should use robes. If, God forbid, I were to wake up in the lobby of a hotel with strangers checking me out, I think I'd rather don a robe and dash as politely as possible back to my room than wrap a flimsy hotel towel around my waist and make a run for it (we know how insubstantial some of those hotel towels can be). According to Travelodge, the incidence of naked sleepwalking, which occurs almost exclusively among its male guests, has increased sevenfold in the past year. Now the staff is learning how to deal with this unsettling trend. I love how they call it a “phenomena.”

Sleepwalking is not very common in the general population (estimates vary between 1 and 15 percent). It’s more common in children than in adults, and Travelodge may be seeing more men than women in this behavior simply because it has more male than female guests. Because sleepwalking typically occurs if a person is sleep deprived, I’d venture to guess that many of these men are in work-related stays at the hotel and could use more sleep. Sleepwalking originates during deep sleep and the person usually remains in that state throughout the episode. Sometimes it’s hard to awaken a sleepwalker, and the person may or may not recall getting out of bed…but no doubt he may think twice about forgoing the pajamas the next time.

Which brings to me this question: What’s with all these men sleeping bare naked? I was curious enough to find out if there were any statistics about people who sleep in their birthday suit. I came across ABC News' poll called “American Sex Survey,” which was done three years ago (this kind of data tends to be evergreen). Guess what: men are twice as likely as women to sleep in the nude (31 percent of men, 14 percent of women). Who knew?

But I wonder if those figures change when it comes to traveling. I don’t know about you, but even if you’re not a sleepwalker, being in a place other than the comforts of my own bed has its own hazards. Perhaps with the allure of carry-on luggage only these days, the pajamas get left behind.

Ask the Sleep Doctor: Sleep-Scratching

This week's Ask the Sleep Doctor question is a challenging one:

Q:

I have this problem where every once in a while, meaning maybe once or twice a month, I will scratch my face while I am sleeping.  I do not have long nails, but it does leave significant scratch marks below my eyes.  What could be causing this?  I read something about nocturnal seizures, but I am a pretty healthy person. 

A:

I am not sure what may be going on with you. I would likely see a sleep specialist in person, but here are some questions I would be prepared to answer when you get there:

1. Are you dreaming about something that makes you scratch yourself?
2. Are you sleep deprived on the days when this occurs?
3. Do you snore or suffer from other possible symptoms of sleep apnea?
4. Do you have a history of sleepwalking or sleep talking?
5. Have you been tested for allergies?

Ask the Sleep Doctor: To Wake or Not to Wake? (A Sleepwalker)

I recently read a great quick question and answer section on the Scientific American website (April: this shows you how far behind I am with my reading!) about sleepwalking.

As I have been asked this question before, I thought it may be worthwhile to address it:

“Should you wake a sleepwalker?”

...and the usual follow-up,

"If you wake a sleepwalker can they die?"

First of all, the answer is a resounding YES, you should wake a sleep walker... and a resounding NO, they will not die.

Sleep Aids and Severe Side Effects

There was an interesting article about Lunesta up the other day on The Examining Room of Doctor Charles.

Says drcharles:

I received a letter today from Sepracor, the manufacturers of Lunesta, a popular sleep aid indicated for the treatment of insomnia. Many doctors are hesitant to prescribe sleep aids, partly because of their often habit-forming nature and potential side effects. Sepracor's letter discussed labeling changes approved by the FDA. The new labeling will include warnings about severe allergic reactions that may occur during sleep, and sleep-driving or other complex behaviors (e.g. preparing and eating food, making phone calls, or having sex) with associated amnesia for the event.

From an FDA press release a few weeks old:

Although all sedative-hypnotic products have these risks, there may be differences among products in how often they occur. For this reason, FDA has recommended that the drug manufacturers conduct clinical studies to investigate the frequency with which sleep-driving and other complex behaviors occur in association with individual drug products.

The medications that are the focus of the revised labeling include the following 13 products:

    Ambien/Ambien CR (Sanofi Aventis)
    Butisol Sodium (Medpointe Pharm HLC)
    Carbrital (Parke-Davis)
    Dalmane (Valeant Pharm)
    Doral (Questcor Pharms)
    Halcion (Pharmacia & Upjohn)
    Lunesta (Sepracor)
    Placidyl (Abbott)
    Prosom (Abbott)
    Restoril (Tyco Healthcare)
    Rozerem (Takeda)
    Seconal (Lilly)
    Sonata (King Pharmaceuticals)

Dr. Charles is right to point out that severe reactions to these medications are rare; but even so, it does make you take pause and wonder if non-pharmacologic alternatives are the better way to go, whenever possible.

If you're interested in learning more on this subject, you can listen to the Health Hacks podcast interview I recently recorded. I do talk in that podcast about cases I've seen.

Jennifer Aniston's Sleepwalking Again

We have heard it before, and now we are hearing about it again -- "Friends" star Jennifer Aniston is out on the prowl -- in her sleep. 

Aniston is a sleepwalker.  Back in 2006 she reportedly made it out of the house she shared with Brad Pitt.

She is quoted as saying:

"I sleepwalk. I set off our alarm once. I was outside. The alarm scared the s*** out of me and I woke up, and I was out by the pool equipment in the back. I don't know what I was doing. I heard this yelling because he's terrified, he hears the alarm and I'm not there!"

Aniston's recent ventures into the world of somnambulism are thought to be brought on by stress from her break-up with actor and all around Swinger Vince Vaughn.

In truth, stress can bring about sleepwalking. It is not uncommon to have patients explain to me that they were sleepwalkers as children, and then, during times of sleep deprivation and stress, it comes back.

The treatment?  Get more sleep and it should subside. If this is not the case and you sleepwalk all the time, then there are a few things to do:

1. Safety first:  make sure there are gates on the stairs.
2. Put a door alarm on the bedroom door.
3. Move furniture with sharp corners, and key lock the door and hide the key.
4. Consider seeing a sleep specialist and ask about the medication Klonipin.