Rude Awakenings

Carol Dresel has restless-legs syndrome. Coy Replogle flails around and whacks his wife. Local sleep researchers hope to put such nightmares to rest-- and find out what dreams are made of.

The dreams seemed harmless enough at first. Nightmares, shadow men, phantoms. But who doesn't have nightmares? Coy Replogle figured it was nothing to worry about.

But the dreams kept getting worse.

"I would be jogging," he says. "It was usually at night. Suddenly, these guys would come out of the bushes, jump in front of me, and act like they were going to grab me. Other times I would be in the grungiest alleys in town. I would have no idea what I was doing in such a place. And the men looked like they just came out of a coal mine, filthy and dark clothing. I don't think I could describe them so that anybody would be able to recognize them. Just dark, shady people." It got so the dream people were coming after him almost every night.

Diana Watters

And then, Replogle started fighting back.

"One time I was evidently very restless and my wife put a hand on my shoulder and I just went whump!--I punched her." Replogle's days were comparably quiet. He had no problems with his work at the factory where he managed an entire department.

But in the early hours of dawn, the couple's suburban bedroom became the staging ground for his brutal dreams: He would strike his wife, mistaking her for one of his demons. He would curse, and kick his bed. He would fall on the floor flailing. Once he fell face-first into the night stand, cutting himself badly.

"That's the way these dreams go," he says. "They're very pleasant and normal dreams, and then all of a sudden something triggers the disturbance. You know, someone would be in my face, something like that, and then I would just lash out to protect myself.

"It was always the strangest feeling," he adds, making a fist. "They're right there and ready to fight and I take a swing at them"--he shows his empty hand--"and it's like going through a ghost."

When Replogle finally checked into the Minnesota Regional Sleep Disorders Center, an internationally known clinic in the Hennepin County Medical Center in Minneapolis, the doctors told him his condition is not psychological, but physiological. He suffers, they explained, from a rare, mysterious--but treatable--malady called REM-Sleep Behavior Disorder (RBD), usually found in older men. Some misfire in Replogle's brain allows him to act out his dreams.

The doctors at the HCMC sleep lab knew his condition well; they were the first to identify the disease in a 1987 article in the Journal of the American Medical Association. In fact, RBD is just one of the bizarre, frightening, and sometimes dangerous syndromes that haunt the sleep center's patients. It's one of a group of peculiar sleep disorders called the parasomnias.

The parasomnias are so named to distinguish them from hypersomnia (too much sleep) and insomnia (not enough). They're sort of a catch basin for sleep problems no one understands: sleepwalking and nightmares are the most common. Other parasomnias are stranger and more destructive, like sleep terrors, restless-legs syndrome, and panic disorders.

And then there are the patients who suffer from parasomnias that don't yet have names. The boy who turns into a cat at night--prowling his room growling, biting the doorknobs and dragging his mattress around with his teeth--falls into this category. So does the woman who sits up in bed and rocks all night long, singing in her sleep.

Frequently, the center's sleep specialists know how to treat the symptoms. But often they're left guessing what causes them: They speculate that some chemical is out of balance, some tiny structure in the brain stem is frayed, some signal out of whack. Ultimately, they're convinced the answers will come from studying the brain.

That sounds like a simple idea. But it signals a fundamental change in the science of sleep and dreams. There are still those who believe that dreams reveal some secret desire, some repressed fear, that psychology rules consciousness. But the doctors at the sleep center consider sleep and dreams--and consciousness itself--to be physical properties of the brain. That's a radical idea, one that shakes the very foundation of who we think we are. For Coy Replogle and thousands more like him, this is no mere academic debate: It marks the difference between being "crazy" and being cured.

The Sleep Disorders Center takes up two floors of a wing in HCMC's Chicago Avenue building in Minneapolis. On the first floor are offices and meeting and examining rooms. On the second is the sleep lab, where every night, under the constant watch of technicians, up to six patients sleep.

Down the hall in the "living room," a television is up loud, lulling a patient toward sleep. In another room nearby, technician Dean Phillips is hooking up a patient with the help of a colleague. Steve (not his real name) is here tonight because he's worried about apnea. Patients with apnea actually stop breathing during their sleep. It's the most common problem people bring to the sleep lab, affecting as many adults as asthma and diabetes, and is easily treated with a pressurized sleep mask.

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