#Middlebury #Health
DEAR DR. ROACH: I am an extremely healthy 76-year-old woman. Almost every night, I am startled awake by visions of people standing over my bed. It’s usually once, but can happen up to three times in a night. It’s often after being asleep for an hour and a half.
They’re not dreams. Something wakes me up, and that is when I see a man or a couple or a child standing around my bed or attempting to jump onto the bed. Though it lasts only seconds, my heart hammers and I jump out of bed to chase “them” away, and even checking the door locks. Then I sort of come around and pretty much laugh at myself. As it’s quite frightening, I believe I shout out, and it takes me a bit to calm back down.
I take NO prescription drugs nor sleep-inducing medicine. Why am I experiencing this? What actually wakes me up to see these visions? Otherwise, I sleep very well. I would greatly appreciate your insight or any advice as to who I might talk with about it. – Anon.
ANSWER: I hesitate to tell you, but what I am concerned about most is a condition called dementia with Lewy bodies. This is not Alzheimer’s disease. In fact, the earliest symptoms are usually visual hallucinations. If you read this account (https://bit.ly/2Sk1Jzo), I think you may find some characteristics that sound familiar.
What makes me doubt this diagnosis is that you report no confusion or memory problems. Although some people may have the hallucinations well before any thinking problems come up, they are in a minority. Wobbliness may go along with Lewy body dementia. Parkinson’s disease may develop visual hallucinations, but that is usually late in the course of the disease.
This information can be shocking or depressing, but it is still important information for you to have. There is treatment for LBD. More importantly, there are medications that can make it MUCH worse.
I would recommend you visit a neurologist and specifically find someone with expertise in dementia, as that is who is unlikely to miss this diagnosis. Unfortunately, it is not always recognized early.
Here is some additional information to read about this condition: https://bit.ly/2BSdmYW.
DEAR DR. ROACH: I have been on hydrochlorothiazide for the past three weeks. Have you heard of vivid dreams associated with this medicine? I am having difficulty with it. – L.G.
ANSWER: Vivid dreams are not typically associated with hydrochlorothiazide. HCTZ does not cross the blood-brain barrier, so it wouldn’t be expected to have this effect. However, HCTZ often is given along with other medications that can have this effect, especially beta blockers, such as propranolol. If you are taking it as part of a combination drug, I would look at the other drug.
Some medications are particularly well known for causing vivid dreams, and it is wise to tell people that before prescribing them. The HIV drug efavirenz can cause such vivid, and sometimes unpleasant, dreams that some people can’t take it. Statins, steroids, antihistamines and SSRI anti-depression drugs all are known to cause dream problems in some people. When I was given the anti-malarial drug mefloquine, I had no idea that it was known to cause vivid dreams until I woke up the morning after taking it wondering what had happened.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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