Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Sleepwalking is a disorder characterized by walking or other activities while
seemingly still asleep.
What are the causes, incidence, and risk factors of sleepwalking?
Sleepwalking has been described in medical literature dating before
Hippocrates (460 BC-370 BC). In Shakespeare's tragic play, Macbeth, Lady
Macbeth's famous sleepwalking scene ("out, damned spot") is ascribed to her
guilt and resulting insanity as a consequence of her involvement in the murder
of her father-in-law.
Sleepwalking is characterized by a complex behavior (walking) occurring while
asleep. Occasionally nonsensical talking may occur. The person's eyes are
commonly open, but have a characteristic glassy "look right through you"
character. This activity most commonly occurs during middle childhood and young
adolescence. Approximately 15% of children between 4-12 years of age will
experience sleepwalking. Generally sleepwalking behaviors wane by late
adolescence. However, approximately 10% of all sleepwalkers begin their behavior
as teens. It appears that persons with certain inherited genes have an increased
tendency toward developing sleepwalking behaviors.
There are five stages of sleep. Stages 1, 2, 3 and 4 are characterized as
non-rapid eye movement (NREM) sleep. REM (rapid eye movement) sleep is the sleep
cycle associated with dreaming as well as surges of important hormones essential
for proper growth and metabolism. Each sleep cycle (stages 1,2,3,4 and REM) last
about 90-100 minutes and repeats throughout the night. The average person
experiences four to five complete sleep cycles per night. Sleepwalking characteristically
occurs during the first or second sleep cycles, during stages 3 and 4. Due the
short time frame involved, sleepwalking tends not to occur during naps. Upon
waking the sleepwalker has no memory of his or her behaviors.
The sleepwalking activity may include simply sitting up and appearing awake
while actually asleep, getting up and walking around, or complex activities such
as moving furniture, going to the bathroom, dressing and undressing, and similar
activities. Some people even drive a car while actually asleep. The episode can
be very brief (a few seconds or minutes) or can last for 30 minutes or longer.
One common misconception is that a person sleepwalking should not be awakened. It is
not dangerous to awaken a sleepwalker, although it is common for the person to
be confused or disoriented for a short time on awakening. Another misconception
is that a person cannot be injured when sleepwalking; however, injuries caused
by such events as tripping and loss of balance are common for sleepwalkers.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Dissociative identity disorder (formerly known as multiple personality disorder or split personality disorder) is a mental illness in which a person has at least two distinct personalities. Symptoms and signs include lapses in memory, feeling unreal, blackouts in time, hearing voices in their head that are not their own, not recognizing themselves in the mirror, and finding items in one's possession but not recalling how they were acquired. Treatment usually involves psychotherapy, medications, and sometimes hypnosis.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions, environmental changes and stressful events. Treatments may include non-drug treatments, over-the-counter medicines, and/or prescription medications.
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Nightmares are dreams that cause high anxiety or terror. Nightmares may be a part of posttraumatic stress disorder (PTSD), and they usually occur during rapid eye movement (REM) sleep. There are several different treatment options for nightmares, including cognitive-behavioral therapy and medications.
Bedwetting, or nocturnal enuresis, is the accidental passage of urine while asleep. There are two types of bedwetting: primary and secondary. Primary enuresis is bedwetting since infancy, and secondary enuresis is bedwetting after being consistently dry for at least six months.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
When sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called "problem sleepiness." A person can have problem sleepiness without realizing it. Symptoms of problem sleepiness include: consistently don't get enough sleep, or poor quality sleep, fall asleep while driving, struggle to stay awake when inactive (like watching TV or reading), have difficulty paying attention or concentrating at work, school, or home, have poor performance problems at work or school, have difficulty remembering things, have slowed responses, have difficulty controlling your emotions, and/or if you have to take naps on most days.
Sleep needs in children and teenagers depends on the age of the child. Sleep disorders in children such as sleep apnea, parasomnias, confusional arousals, night terrors, nightmares, narcolepsy, and sleepwalking can effect a child's or teen's sleep. Healthy sleep habits and good sleep hygiene can help your infant, toddler, preschooler, tween, or teenager get a good night's sleep.
GERD is a condition in which the acidified liquid
content of the stomach up into the esophagus.
The causes of GERD include an abnormal lower
esophageal sphincter, hiatal hernia, abnormal esophageal contractions, and
slow emptying of the stomach.
GERD may damage the lining of the esophagus, thereby
causing inflammation (esophagitis), although usually it does not.
The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea.
Complications of GERD include ulcers and strictures of
the esophagus, Barrett's esophagus,
cough and asthma, throat and laryngeal
inflammation, inflammation and infection of the lungs, and collection of fluid
in the sinuses and middle ear.
Barrett's esophagus is a pre-cancerous condition that
requires periodic endoscopic surveillance for the development of cancer.
Sleep RSS
Healthy Living Tips
This site complies with the