Incubus Attacks!

[danielmd06]

Good evening.

I was providing a professional courtesy "consult" today for a middle aged woman who clearly described night terrors. No psychiatric issues, no overt concerns for sleep disordered breathing, and no stereotypy overtly suggestive of eplilepsy.

I was intrigued. It was the first instance where I have actually seen this in an adult. She plans on pursuing a polysomnogram to attempt an rule out major neurological or nocturnal respiratory problems.

I attempted to research medical therapy for this entity and came up bone dry. ICSD doesn't help with treatment. Nothing on Medlink, or a cursory internet search through the "normal" sites. Only the usual information on prazosin for nightmares...nothing specific for adult-onset night terrors.

I'm obviously going to comb through PubMed and do some more work myself...but I was very curious what you guys and gals may have used for this beyond prudent safety precautions. Are the adult-onset cases self-limited like the pediatric cases?

Any help would be appreciated.

Regards,

Dan

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[danielmd06]

Literature search revealed...nothing. There was an article in "Sleep Medicine" that covered violent sleep behaviors but I was not able to access a free copy.

So. Anyone out there have any suggestions? Klonopin maybe?

 

[michaelrack]

benzo or low-dose tricyclic (would try klonopin first). r/o osa + other disruptors of sws. avoid etoh, sleep depriv, and other increasers of sws.

 

[AlternateSome1]

Sounds like you should publish with your success/failure.

 

[Shikima]

Please do publish your case report. Anecdotal is better than nothing at times.

 

[BrainFart]

I just saw your old post. What exactly does your patient describe? Is there a component of sleep paralysis/hallucination? Isolated sleep paralysis is very common (20 - 40% of ppl experience at least once) and it is extremely frightful for most patients. It is the phenomenon which led to the "Incubus" tales. There is a lot of literature out there about it.

Kareem Nahra

 

[danielmd06]

I just saw your old post. What exactly does your patient describe? Is there a component of sleep paralysis/hallucination? Isolated sleep paralysis is very common (20 - 40% of ppl experience at least once) and it is extremely frightful for most patients. It is the phenomenon which led to the "Incubus" tales. There is a lot of literature out there about it.

Kareem Nahra

Yup. I'm aware of the etymology of the word "nightmare," the old myths of the succubus, incubus, "old hag," isolated recurrent sleep paralysis, and so forth.

This case is not that.

She had two occurrences of sleep termination paralysis in college that were completely unrelated to this issue. She had the chest pressure and the "I sense an evil presence in the room" factor with the ISP, too.