Hektoen International

A Journal of Medical Humanities

Somnambulance and other surprises

Brent Russell
Marietta, Georgia, United States


Palpation for tusks

In one of the odder experiences of my life, I woke up in the middle of the night to find my wife prodding my face with her fingers. “What are you doing?” I asked. “I’m trying to see whether you have tusks,” she replied. Apparently, she already had seen that I had tusks – she was palpating simply to verify her observations.

My wife (here referred to as “S”) claims, “I’m an artist. I have a creative mind.” My face, I am told, changes size, shape, and color many times during the night. My identity has changed as well, as I have frequently been replaced by other people, aliens, and animals. Sometimes nocturnal creatures have tried to attack us in bed and S has warded them off with various hand motions, such as forming as cross with two index fingers, or with incantations and verbal warnings. Sometimes she pokes me to see whether I am solid. I am usually not aware of any of this.

Before we were married, we spent a night in her mother’s home, sleeping in twin beds on opposite sides of the room. I awoke to hear S attempting to make her medium-high pitched voice sound booming and authoritative: “Get down there!” she shouted, repeatedly jabbing her finger toward the floor. This was my first experience with her nighttime dream states. I hesitated, grasped what was happening, and then responded with equal authority, “No! You get down there!” There was a long pause, then a meek little voice squeaked, “Brent?” “Yes?” “Oh! None of my apparitions ever talked back to me before.”

I have got better at handling these episodes. One night, while lying half awake, I felt the bed move. I sat up to see my S leaning on one elbow, looking down at the floor. “Whatever you see, it isn’t really there,” I said. She replied, “I thought I saw my slippers crawling toward me.” “That can’t be,” I said. “I gave them explicit instructions not to do that.”

Most of these incidents have come during times of stress. Of course, other people admit to experiencing active, unsettling dreams when dealing with unresolved conflicts. My wife’s dreams are just a little more active than some. Shortly after our daughter was born, we were both sleep-deprived by being repeatedly awakened at odd hours, like many new parents. I was grouchy; but S saw things in the dark. Once, our antique dresser advanced toward her in the middle of the night, its ornate, carved wooden drawer pulls having turned into giant lips that opened and closed in a puckering action, wanting to breastfeed. A switch to baby formula came within a few days.

We are not young people. When I first looked into this topic in the 1980s, there was no Internet access. I had Dorland’s Illustrated Medical Dictionary and The Merck Manual of Diagnosis and Therapy.1,2 According to my old copy of Dorland’s, somnambulism, somnambulance, and somnambulation not only refer to sleepwalking but also to “a hypnotic state in which the subject has the full possession of his senses but no subsequent recollection.”1 The old Merck manual expanded sleepwalking to include “performing other complex behavior during sleep,”2 which gets a little closer to what I have observed. Both books claimed there is no accompanying dream and the participant usually does not remember the episode; but S usually does remember both a dream and her physical actions, especially if reminded the next morning.

Articles discussing disorders related to sleep and insomnia have become common in recent years, and access to information is much easier. There are more peer-reviewed publications than I can possibly digest but a quick look at several rules out most serious concerns. While her hallucinations could be blamed on insomnia,3 S does not have schizophrenia,4 nor paranoia 5 (nothing severe, anyway), and the incidents are not related to consumption of large quantities of alcohol6 (for her, a “large quantity” would be a second drink). It was more common when she was younger, so we cannot blame it on menopause or the modern ubiquitousness of electronic screens. We do not think it is caffeine-related, but could maybe blame it on the reading of complex novels – a possibility I did not see in my not-very-exhaustive search of the relevant peer-reviewed literature.

It could be worse. We heard of a case of a young man who often woke up in the morning on the floor of his bedroom with his pillow in shreds and his sheets pulled out of the bed and strewn around the room. Video recordings of him sleeping in a lab showed him moving around the room on all fours, then rolling on his back, roaring like a tiger, biting his pillow and shaking it in his teeth, and biting his sheets and pulling them from the bed. I am told this was published in an old journal called Dissociative Disorders, but in a couple hours of searching I could not find the case nor any trace of the journal.

S has never exhibited any tendencies quite so aggressive, though I have been jabbed and flailed at a couple of times. I mostly feel safe in our bedroom. But I am told that at times a man can be seen crouching in the corner of our bedroom. He appears and disappears, and sometimes glows, and he may or may not have my face. If these apparitions become more menacing, I am not sure what to do. My old Merck manual recommended diazepam and selective serotonin reuptake inhibitors. Recent publications suggest treating for insomnia is the way to go.3,4 I am thinking more along the lines of old-fashioned lion tamer equipment, such as a bullwhip and a chair. If I should never need the whip, at least the crouching man would have a place to sit.



  1. Berkow R (ed.) The Merck Manual of Diagnosis and Therapy, 14th Rahway, NJ: Merck and Co. 1982.
  2. Dorland’s Illustrated Medical Dictionary, 26th Philadelphia: W.B. Saunders Company. 1980.
  3. Sheaves B, Bebbington PE, Goodwin GM, Harrison PJ, Espie CA, Foster RG, Freeman D. Insomnia and hallucinations in the general population: Findings from the 2000 and 2007 British Psychiatric Morbidity Surveys. Psychiatry Res. 2016;241:141-146.
  4. Reeve S, Sheaves B, Freeman D. The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review. Clin Psych Rev. 2015;42:96-115.
  5. Freeman D, Pugh K, Vorontsova N, Southgate L. Insomnia and paranoia. Schizophr Res. 2009;108:280-284.
  6. Pressman MR, Mahowald MW, Schenck CH, Bornemann MC. Alcohol-induced sleepwalking or confusional arousal as a defense to criminal behavior: a review of scientific evidence, methods and forensic considerations. J Sleep Res. 2007;16:198-212.



BRENT DA SILVA RUSSELL holds a Masters in Exercise Science with a concentration in biomechanics from Georgia State University and a Doctor of Chiropractic degree from Life University. He is a researcher on projects that explore the motion and forces of physical activities such as walking or performance of spinal manipulation. He and his wife have been married for thirty-seven years.


Winter 2018  |  Sections  |  Neurology

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.