Q: My husband always talks in his sleep. Later he does not remember what he has said. He says things he does not usually say when he is awake. Why does this happen?
A: Talking in one’s sleep, sleep walking and any intricate behaviour which the person does not remember on waking up, comes under the umbrella of somnambulism. These are common occurrences in human beings. It usually occurs during young age and a person often grows out of it.
On the basis of electroencephalographic (EEG) studies, sleep is found to be of two states. One is the REM sleep or rapid eye movement sleep, also called dream sleep, D-state sleep or paradoxic sleep. The other state is NREM (Non-REM) sleep, also called S-sleep.
On the basis of EEG studies, the NREM stage sleep is further divided into four stages recognizable by different EEG patterns. It has been established that a person dreams mostly in the REM sleep and slightly in the NREM sleep during the night. A person alternates between REM sleep and NREM sleep during the night. As a person grows older the amount of sleep and the sleep patterns change.
Sleep is affected by a number of different factors. Among them is daytime napping which will ultimately lead to less sleep during the night. Somnambulism occurs during the early part of the night, during the stage of sleep called stage 3 and 4. It may also occur in REM sleep during the later part of sleep. This is sometimes associated with epilepsy. A person should develop a regular routine of sleeping. Avoid tobacco and most of the food should be consumed during the daytime. A person with somnambulence should be left alone as long as he is not harming himself or others.
Dr Ayub Wasim
ZMU
Q: My father is about 65 years old. He is generally in good health and very active. He doesn’t have high blood pressure or diabetes, but he has been having prostate and hernia problem for more than a year now. He is reluctant to have a prostrate surgery done because many of his friends who have had it say that the problem remains and one can even end up with a urine bag for life if things go wrong.
Can you please tell me the possible treatments for prostate and about the chances of success in case of surgery?
A:Your father needs evaluation with a detailed history including a symptom severity score, physical examination and further work up to see how much alteration in the voiding function is being caused by the enlargement of the prostate gland. An ultrasound scan of the bladder will check if the bladder is emptying properly and a uroflowmetery will show the degree of obstruction. The renal function and the presence of urinary infection also needs to be checked.
Once these are available, a reasonable plan can be made about treating him with medication or surgery. If surgery is indicated then, both hernia and prostate operations can be performed at the same sitting. With proper case selection, the chances of significant long term complications of the operation are quite low.
Dr S. Raziuddin Biyabani
AKUH
Q: For some time my 88-year-old grandfather has complained that he can’t stand the taste of anything sweet anymore. He used to enjoy sweet food. Now he complains of a bitter taste in his mouth more or less all the time. He has also lost a lot of weight. Have you any ideas?
A: The taste receptors are all over the oral cavity but mostly concentrated on visible surface of tongue. The senses from these receptor are relayed to brain by different nerves. The change or loss of taste could be due to multiple causes. In old age there may decrease in taste sensation. Patients who are on multiple medicines or have had radiation treatment for head and neck cancer also have problems of taste.
Similarly, neural or brain diseases also effect the taste sense. But in your grandfather’s case there is a history of weight loss, which is a serious complain and should not be ignored. The best advice would be that patient should be examined by ENT surgeon and also by neurophysician.
Dr Mubasher Ikram
AKUH
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