ArcaMax

DEAR DR. ROACH: My question to you is about an affliction I have struggled with since childhood. Apparently, it is called sleep paralysis. As explained to me in an old newspaper article, it is when your brain is awake, but your body is still sleeping. This leads me to have minor to moderate panic attacks!

It has lessened as I've aged, and I've learned to live with it. But I discovered by trial and error that it is somewhat avoided with slight head elevation and by strictly sleeping on my sides. I would appreciate any advice from you on keeping this affliction to a minimum. -- M.J.M.

ANSWER: When we are in dream sleep (also called REM sleep), the body's muscles are essentially turned "off" by the brain. If you are dreaming you are running, you don't want to actually be running in your bed! This system normally works very well, but it can fail in two different ways:

The first is called REM sleep behavior disorder (RBD), and it's when people do move or talk while dreaming. (Sleepwalking is different since it happens in non-REM sleep.) People with RBD can hurt themselves or their sleep partners, and people with RBD are at risk for developing a serious neurodegenerative disease (such as Parkinson's disease or dementia with Lewy bodies) within 10-15 years of the diagnosis. People with RBD should see a neurologist.

Sleep paralysis is when the inability to move your muscles happens outside of REM sleep, usually just before or after entering dream sleep. Many people may note that if they are suddenly woken out of a dream, they are unable to move for a few seconds. This is common, especially when stressed or sleep-deprived, and it can sometimes be associated with hallucinations. However, people who have very frequent episodes should be considered for narcolepsy, as sleep paralysis is much more common in people with narcolepsy.

I don't have any more advice for you other than good sleep hygiene, keeping the same bedtime each night, avoiding screen time before bed, and avoiding excess alcohol or caffeine. Sleep paralysis usually doesn't need any special treatment.

DEAR DR. ROACH: With the recent uptick in measles cases, I have been hearing many reports on the need for people to update or repeat their measles vaccinations, depending on age, health, and which vaccine they got in the past. What I have not heard is what those of us need to do if we actually got measles before there was a vaccine.

I was born in 1954 and contracted measles sometime before 1960. I am fine and get all my recommended vaccinations for everything as needed, but I hear nothing about this one. -- B.G.

ANSWER: People born before 1957 are assumed to have gotten measles, and the immunity from a natural case among survivors is very high. So, no additional doses are needed in people born before 1957, even if they don't recall getting the disease.

Adults living in an area of an outbreak should either have documentation of two doses of the vaccine or laboratory evidence of immunity. Without either of these, two doses of the MMR vaccine are recommended.

Those born between 1963-1967 might have had the killed vaccine, so people who were in the outbreak or who might've been exposed (including health care workers) should get two doses of the MMR vaccine. People with severe immunodeficiency or those who take care of people with immunodeficiencies should speak with their doctor about getting the vaccine or getting blood tests done to prove immunity.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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