CNN
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Donald Dorff could be heard cheering from the crowd as he caught the quarterback’s ball out of the air and sprinted toward the goal line.
“There was a 280-pound tackle waiting for me, so I decided to lend my shoulder,” the 67-year-old said. National Geographic Magazine 1987.
“The next thing I knew, I was on my bedroom floor,” Dolph said. “I’d crashed into my dresser, dropped everything, broken the mirror, made a huge mess. It was 1:30 in the morning.”
How did a retired food manufacturer’s dream from Golden Valley, Minnesota, turn into something that would get him featured in a nationally known magazine?
Five years ago, Dolph became the first patient to be diagnosed with a rare condition called rapid eye movement sleep behavior disorder (RBD).
Furthermore, Dolph’s case led researchers to the following discovery. The earliest signs of two devastating diseases: Parkinson’s disease and a unique form of dementia called Lewy body dementia.
Symptoms include screaming, kicking and punching.
RBD was discovered in 1982, when Dolph, after years of suffering from “intense, dynamic nightmares,” became a patient of Dr. Carlos Schenk, a psychiatrist and sleep specialist who was then at the Minnesota Regional Sleep Disorders Center in Minneapolis.
“During REM, or rapid eye movement, sleep, your brain basically paralyzes your body so you can’t act out your dreams,” Schenck, now a professor and senior psychiatrist at the University of Minnesota Hennepin County Medical Center, recently told CNN.
“But Dolph exhibited some very strange behavior, like getting up and hurting himself while dreaming, which left us scratching our heads,” he says. “We then put him in a sleep lab, and lo and behold, all of his physical behavior occurred during REM sleep. This had never been reported before.”
Schenck said more patients with this unusual disorder are being identified, many of whom exhibit a series of disturbing and violent symptoms.
“They’ll kick in bed, they’ll hit their bed partner, they’ll start yelling and screaming – ‘Get out of here!’ and then the wife has to scream really loud to stop the attack,” he said.
“Jerking limbs, twitching, throwing arms out, punching, kicking, getting up, standing up, jumping out of bed, running — these behaviors are very typical of RBD,” he added.
Schenk said his wife described the 70-year-old man as having a good-natured nature during the day, but that night he would punch and kick her five times and at one point try to choke her while dreaming about fighting an attacking bear.
Another patient, also 70 years old, dreamed that he was hunting a deer and trying to break its neck, when in reality it was his wife’s neck, and he woke up to discover this (she had stopped sleeping in the same bed).
By 1986, Schenck and his team The first paper was published A newly discovered sleep disorder.
But as Schenck followed his patients over the years, he discovered something even more disturbing: Their behavior could be a canary in the mine for later neurodegeneration.
“Loss of REM sleep paralysis, the basis of RBD, is the earliest and strongest predictor of a later diagnosis of Parkinson’s disease or dementia with Lewy bodies,” Schenk said.
Lewy body dementia includes two different types of dementia: Parkinson’s disease dementia and Lewy body dementiaBoth affect cognition.
However, Parkinson’s is a slowly progressing disease that impairs muscle control, balance and movement. About four out of five people with Parkinson’s eventually develop dementia. According to Johns Hopkins Medicine.
In both Parkinson’s and the two dementias, cells in and around the stem-like trunk at the base of the brain begin to die. In addition to breathing, swallowing, heart rate, and eye and face movements, the brain stem also controls sleep and wake cycles.
Early brain stem damage caused by Parkinson’s interferes with the body’s natural ability to tighten muscles during dreaming, causing people to jump up, scream, thrash or otherwise act out their dreams.
Hallucinations, which are common in Parkinson’s disease, may also occur. According to a case study. A 67-year-old man was awake in the middle of the night when he saw a faceless, hooded or cloaked figure or animal. When he turned on the light or got up to investigate, the vision disappeared.
Schenk said this nighttime behavior can often be controlled with drugs such as clonazepam or large doses of melatonin, which stop seizures and relax tense muscles.
“Either one or the other, or a combination of both, is 80 to 90 percent effective, and there are plenty of alternative treatments available,” Schenk said. First to publish a connection In February 1996, the link between RBD and Parkinson’s disease was revealed.
“The mechanisms of RBD are well understood and we have treatments,” he said. “The next step is to slow or stop the progression to Parkinson’s disease or Lewy body dementia.”
Initially, researchers thought that RBD only affected men, but then realized that women were affected as well.
“Women have this problem as well, but their symptoms are much milder and they don’t injure themselves as much, so many of them don’t come to the doctor for help,” Schenk says, “but they lose the muscle paralysis that occurs during REM sleep, and they’re at higher risk of developing Parkinson’s disease later in life, just like men.”
Schenk said clinical trials are underway at nine medical centers across the United States. North American Predrill Synucleinopathy ConsortiumThe research hopes to identify potential treatments for REM sleep behavior disorder and slow the progression to Parkinson’s disease and dementia.
As a child, Donald Dorff shared a room with three siblings and never showed any signs of a sleep disorder, but on his wedding night, he frightened his bride by yelling, groaning, grinding his teeth and making small movements, according to Schenck’s case study.
But about 41 years later, he started having vivid, violent dreams and acted on them: In one dream, he was riding his motorcycle when another biker tried to run over him.
“I decided to kick his bike, and then my wife woke me up and said, ‘What the hell are you doing?’ because I was kicking her so hard,” Dolph told Schenk during treatment.
In another dream, Dolph was attacked by a man with a rifle and was about to shoot back when he suddenly woke up: “I was kneeling beside my bed with my arms outstretched as if I had a rifle raised and was preparing to shoot.”
One night, Mr. Dolf jumped into a bedside drawer and hurt himself, Mr. Schenk said, after which Mr. Dolf found Mr. Schenk’s clinic and went there for treatment.
Some people with RBD develop full-blown Parkinson’s disease quite quickly, but Dolf was not one of them. Dolf died of prostate cancer, but he was able to control his violent nighttime behavior until the day he died, as long as he continued taking medication, according to Schenk.
Dolph’s case helped doctors discover an early clue to two serious diseases, allowing for earlier diagnosis and treatment.
“If you’ve never sleepwalked or talked in your sleep before and then suddenly, after turning 50, you start sleepwalking or talking in your sleep and it becomes louder and more frequent, it’s time to see your doctor,” Schenk says.
“Doctors should consider a neurological evaluation as this may be the first sign of a neurodegenerative disease.”
