A 47-year-old Ghanaian farmer takes a nap after lunch. He quickly falls asleep in his chair and dreams that he is cutting meat and sharing it with his family in a larger-than-life scene. A pleasant moment that will turn into a nightmare when you wake up! When his nap is over, he realizes that he is covered in blood and he feels intense pain in his crotch. He cut off his genitals while he was dreaming!
He yells to attract his neighbors as he tries to get up. He was taken to a hospital in Assim Akomfode, the central region of Ghana where he resides. Doctors treated him quickly with painkillers, but he needed reconstructive surgery for his mutilated genitals. By listening to the story of this extraordinary patient, the medical profession understood that this was a particularly violent case of parasomnia.
Parasomnia, a disorder that disturbs the nights
Parasomnia is a sleep disorder characterized by abnormal, sometimes violent, behaviors or automatic activities during sleep. In general, these disorders are classified into two categories: non-REM disorders which appear in the so-called “non-REM” phase of sleep (REM for quick eyes movementsmovements) and REM disorders that occur during paradoxical (or REM) sleep.
What are the phases of sleep?
Non-REM parasomnias are rather common, particularly in childhood; it is estimated that they affect between 1 to 4% of the adult population. They materialize in different ways: sleepwalking, eating disorders linked to sleep, terrors nocturnalnocturnal in children, or a confusional state (troubled attitude, disorientation, with few memories upon waking). REM parasomnias are rarer and can be associated with neurodegenerative diseases such as Parkinson’s or dementiadementia has Lewy bodyLewy body. The two characteristic manifestations of this disorder are sleep paralysis and abnormal behaviors that can be violent for others and the affected person. In general, parasomnias are favored or aggravated by the presence of comorbiditycomorbiditywith obstructive sleep apnea being the most important.
Rare extreme cases
The case of this Ghanaian appears to be a particularly violent non-REM parasomnia. Most patients do not have such impressive seizures. The medical literature also reports the case of a 55-year-old man who suffers from parasomnia andSleep ApneaSleep Apnea obstructive for many years and who had a seizure pushing him to bite his finger down to the tendon.
Parasomnias which have no impact on the health of the patient and those around them are not treated. On the other hand, when the parasomnic’s behaviors are dangerous, we can prescribe a mixture of benzodiazepine and melatoninmelatonin to soothe his nights.
