Ask the Doctor: Sleep Paralysis Treatments; Dental Fillings & AD; Panic Attack Symptoms

Is there any type of sleep paralysis treatment that helps people who experience these events, and if so, what does it consist of?

Sleep paralysis (SP) is a condition in which individuals awaken in the midst of vivid dreams that occur during the rapid eye movement (REM) stage of sleep and find themselves physically immobilized and unable to breathe normally. The frightening experience usually occurs when falling asleep or waking up, and ends after a minute or two. It is not dangerous, but it may sometimes involve hallucinations and can be very disturbing. If you experience these events regularly, feel anxious about going to sleep, or find that you are very sleepy during the daytime, consider seeing a health care provider for assessment. SP treatment varies from patient to patient, depending on factors such as the frequency of the SP events, your sleep patterns, and your medical and psychological history. Treatment usually involves adjusting your sleep routine to ensure proper sleep hygiene (such as making sure your sleep environment is cool, dark, and comfortable; keeping a regular sleep/wake schedule; and avoiding big meals, caffeine, exercise, alcohol, stimulating activities, or “screen time” on computers, smart phones, etc. close to bedtime). Learning to use meditation to promote relaxation, especially during SP attacks, can also be effective. In some cases an antidepressant such as clomipramine may be prescribed for its ability to alter REM sleep.

Q: I have a number of silver dental fillings. I recently heard that this type of filling increases the risk of Alzheimer’s. Is this true?

A: Scientific research suggests that you need not be concerned about your dental fillings. It is true that silver-colored fillings are made from a combination of metals that include mercury, a heavy metal that has been found to be toxic to the brain and other organs in certain forms. However, numerous respected studies have concluded that mercury used in dental fillings—which are composed of 35 percent silver, 15 percent tin and 50 percent mercury—are not a major risk factor for Alzheimer’s disease. This has convinced many experts and public agencies, including the U.S. Food and Drug Administration, that the durable and inexpensive amalgam is safe for dental use.

Q: What are the symptoms of a panic attack? Are they dangerous?

A: A panic attack may occur without any warning and usually passes within a few minutes. Fear seems extreme, and involves at least four of the following symptoms:

  • A feeling of imminent catastrophe or doom, or a need to escape; fear of “going crazy” or dying; feelings of unreality or being detached from oneself
  • Pounding heart or chest pain
  • Trembling, sweating and shaking
  • Difficulty breathing or shortness of breath
  • Flushing, chills, or hot flashes
  • Numbness or tingling sensations
  • Dizziness or lightheadedness; nausea

Panic attacks involve a triggering of the fight-or-flight response that helps people react quickly to danger, although individuals who experience panic attacks are not necessarily in any danger. Experts do not know what causes panic attacks. Stressful life events or heredity may play a role in certain cases (people with close relatives who have suffered an attack have four times the risk). Other theories involve an imbalance of chemicals in the brain, greater sensitivity in brain circuits that process feelings of fear, or an over-reaction to changes in carbon dioxide levels. Professional assessment should be considered for frequent attacks.

When an attack occurs, try to reassure yourself that that you are not dying or losing your mind, and that you will feel better in a few moments. Take slow breaths, and progressively tighten and relax muscles from your toes to your shoulders and arms to release tension.

—Editor-in-Chief Maurizio Fava, MD

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