Ideomotion and sleep

[mortene]

Have this been discussed in an earlier thread? If so, could someone point me in the right direction?

Thanks

[Barrett Dorko]

Morten,

Perhaps it's been mentioned. I have the sense that nighttime dreams are the way that the unconscious expresses itself while we sleep.

In my essays (on my web site), Dreamcatcher and Beautiful Dreamer come to mind.

Anyway, we're dreaming most of the day. According to many.

[Curious One]

Have this been discussed in an earlier thread? If so, could someone point me in the right direction?

I did try to do a search for you here with the keywords "ideomotion and sleep". I've linked to it, in case you want to come back from time to time and check through it to see if anything leads to a new or better search.




On a quick look of the first few posts, did notice this comment that may be helpful:

I now think in terms of relaxation, hypnogogic and sleep states.

Touch is used to cue relaxation in areas that fail to let go.

Ideomotion and breathing patterns are less inhibited as relaxation deepens.

It is possible that Brain Maps reconfigure in response to verbal and tactile suggestion in a patient who is in a relaxed state.

Anxiety is an additional problem for those in the earlier stages of Alzheimers and other dementias, as it is for many with sub optimal freedom of movement and perceived pain.


From my point of view, effective interaction gets easier as outdated hypotheses become less intrusive.

[Jo Bowyer]

I do work with sleeping patients.

There are issues of consent here and it would be advisable to consider whether you should have a chaperone.

[Jo Bowyer]

I saw a lady yesterday who has been recently diagnosed with Alzheimers. She took herself for testing and diagnosis because she recognised that she is becoming forgetful. She has been anxious for the 25+ years I have known her. I wasn't chaperoned on this occasion but her husband was in the waiting room and we could both hear him chatting to the receptionist, until she dozed off.

Due to the fact that these cases are now being picked up earlier, I am hoping that this will form an increasing percentage of my work. Someone I have seen for 5 years or so says that when he is away working or on holiday, he doesn't miss the treatment, but he really notices the difference after the first treatment following a break. Anxiety and agitation can feature in this disease and a 25 minute session of deep relaxation seems to put them in touch with an underlying calmness. Knowing that they have this and that it can be accessed empowers these patients.

None of my dementia patients, so far, have experience of meditation. They don't come from that type of background. It will be interesting to meet and work with patients who are meditators.

[mortene]

Thank you all!

I've been thinking about non-conscious movement and correction. Two nights ago I woke up in the midle of the night. My girlfriend was moving, particularly her right leg. I observed it for a while, found it quite fascinating. I know she had been working a lot that day, went for a run, and also told me her legs felt totally dead before going to sleep. So here's my question concerning ideomotion and sleep.

Do you think it's common to express ideomotion while asleep?
- If it is, shouldn't people who experience pain with a mechanical component wake up with a decreased perception of pain? And how come people wake up in pain because of sleeping in an awkward position if ideomotion occurs at night?
- If it's not, why do you think it's so?

Thanks again

[Barrett Dorko]

Morten,

It appears that you're equating unconscious expression with sleep. They aren't the same thing. Nighttime dreams, sure. I mentioned them earlier in this thread.

In addition, sleep might provide us with an opportunity to change in other ways, sympathetic increase for instance (I've read that it wakens us). That isn't going to produce pain relief in many. Context also changes when we sleep, and that's both variable and potentially huge.

As I've said many times, relaxation follows expression, personal expression, I suppose. Perhaps your girlfriend could use more of that. Who knows?

[mortene]

I see, I put it wrong when saying "if it is" and "if it's not", making it sound like I wanted an answer saying either yes or no.

I'm not equating sleep and unconscious expression, I'm wondering if it may coincide? If This kind of expression might take place while asleep? And then, if someone have some extra info to add, it's warmly welcomed.

[Jo Bowyer]

From my point of view, unplanned movement can be expressed during sleep along with movement related to dreams (ideomotoric). Patients with poorly managed pain will often interrupt or suppress movement and this may be accompanied by grimacing and or groaning.

As a young hospital based physiotherapist, I went through a particularly unlucky run of on calls where I had more than one chest patient on 2hrly treatment, which meant that it wasn't worth going to bed.

The orthopaedic ward where I worked during the day always had plenty of tea available and I could could take the opportunity to catch up with the housemen if they were around, or look at updates to the medical notes if they weren't. Morphine was given 4hrly by injection in those days and sometimes a night time dose would be missed if the patient appeared to be asleep. Those with fractured femurs were particularly susceptible and sometimes it was possible to get the patient to settle by making small adjustments to the bed frames without waking them fully.

Terminally ill patients will express dream/hallucinatory ideomotion as well as unplanned movement, this is less apparent during the agonal phase, which may or may not involve Cheyne Stokes breathing, or prolonged rasping breath in someone with a strong heart. Following the final breath, reduced movement continues with the winding down of the brain stem which can take minutes. I have followed this through to it's conclusion on one occasion with my own next of kin. Any movement following cessation of operation of the brain stem appears to be due to gravitational settling of the body and it's gases and fluids.

On the occasions I was bleeped for dying patients on my medical wards for agonal breathing that was apparently causing distress; provided that the patient was kept as comfortable as possible, my primary focus and that of nursing and medical staff was in supporting and reassuring the next of kin.

[Jo Bowyer]

Do you think it's common to express ideomotion while asleep?
- If it is, shouldn't people who experience pain with a mechanical component wake up with a decreased perception of pain? And how come people wake up in pain because of sleeping in an awkward position if ideomotion occurs at night?
- If it's not, why do you think it's so?

There is less movement during deeper sleep states which can be difficult to distinguish from stupor and light coma. Think of Saturday Night Palsy, which is caused by falling into a drink induced sleep with the arm draped over the side of an arm chair. Ideomotion/unplanned movement is, by itself insufficient to cause the patient to shift pressure off the nerve. Reflex shifting is also likely to be diminished.

[nykinvic]

Morten, I'm still coming to an understanding of ideomotion so please take my comments in that context.

I wonder how the cultural practice (in Canada anyway) of sleeping on 12 or more inches of dense foam changes the natural movement and position changes that occur when sleeping on a thin mat. By my understanding, as with 'ergonomic' chairs etc, our furniture use nurtures unnatural stillness to the detriment of oxygen delivery to the tissues. I encourage some clients who complain of morning stiffness to trial a thinner, firmer sleeping mat.

Christine

[nari]

I would agree with Christine about a firmer mattress, even a futon is worth trying, although they have gone out of fashion now.

I wonder about sleepwalking and the trigger/s that provoke its occurrence. Any ideas?

[mortene]

Morten, I'm still coming to an understanding of ideomotion so please take my comments in that context.

I wonder how the cultural practice (in Canada anyway) of sleeping on 12 or more inches of dense foam changes the natural movement and position changes that occur when sleeping on a thin mat. By my understanding, as with 'ergonomic' chairs etc, our furniture use nurtures unnatural stillness to the detriment of oxygen delivery to the tissues. I encourage some clients who complain of morning stiffness to trial a thinner, firmer sleeping mat.

Christine

Good thought! I think the culture acts in mysterious ways. It's all around us, and no one escapes, for better or worse.

It's a good thing to be aware of it's influence, I thank Barrett for that!

[mortene]

I would agree with Christine about a firmer mattress, even a futon is worth trying, although they have gone out of fashion now.

I wonder about sleepwalking and the trigger/s that provoke its occurrence. Any ideas?

Nari, that's an interesting question! I wonder, since it's possible to sleepwalk, why we don't shift position but instead, sometimes wake up in pain (like Jo's example of satuday night palsey, or a sore/stiff back or neck).

I have little knowledge about sleep, definetly something to delve deeper into.

There is less movement during deeper sleep states which can be difficult to distinguish from stupor and light coma. Think of Saturday Night Palsy, which is caused by falling into a drink induced sleep with the arm draped over the side of an arm chair. Ideomotion/unplanned movement is, by itself insufficient to cause the patient to shift pressure off the nerve. Reflex shifting is also likely to be diminished.

Jo, when you say less movement during deeper sleep, does that include ideomotion? If it is, what's the reason for that? And do you have an idea concerning my question above? Thanks for your thoughts and inputs!

[Jo Bowyer]

Jo, when you say less movement during deeper sleep, does that include ideomotion? If it is, what's the reason for that? And do you have an idea concerning my question above? Thanks for your thoughts and inputs!

Morten,

I have a problem with the use of the word ideomotion as a catch all description of unplanned movement.

Ideomotion can be seen as a "poker tell", during the telling of a deliberate lie, while framing the answer to a question, water divining, shadow fencing/boxing and when a skilled musician is on cruise control during a jam session. When other musicians join in, there is interaction some of which may be ideomotoric. If I have my hands on a patient the movement quickly becomes an interaction between the two of us, three, if there is a baby in the mix.

Ideomotion can be seen in a patient that you are talking to and in patients that catch sight of you when you walk onto a ward or into a waiting room.

Ideomotion is unlikely during deep sleep, but there is unplanned movement, even during deep sleep and coma which I first felt as a physio student, and learned to work with as an osteopath, as the so called "cranial rythmic impulse", a movement throughout the body similar to breathing, but slower and present throughout life until shortly after death.

The "cranial rythmic impulse" type movement was incredibly useful on medical wards when the lobar pneumonias were transitioning from grey hepatisation to resolution, I found that it was possible to interfere with it hands on by extending the apparent expansion phase. Nowadays, these patients are rarely treated in hospital and I see them at home and in the clinic when the fever has settled.

Very young infants express unplanned movement which is modulated by the primitive reflexes, a form of ideomotion begins to express at around three weeks when the baby starts to socialise.

I first saw the vermiform type of movement seen in some of Barrett's clips when I watched Stuart Korth the British paediatric osteopath treating babies. It runs its course and gradually settles. Imo this is possibly an involuntary hindbrain movement based seeking behaviour which may be ideomotoric.

It is often seen in the injured physiotherapists who attend toolbox courses because they are also hoping to find resolution of their own issues.



If this is the question you wish me to address

Two nights ago I woke up in the midle of the night. My girlfriend was moving, particularly her right leg. I observed it for a while, found it quite fascinating. I know she had been working a lot that day, went for a run, and also told me her legs felt totally dead before going to sleep.

It is possible that your girlfriend was in REM sleep at the time you observed her and may have been dreaming, although she might not have remembered the dream the following morning. Dreamers often produce ideomotoric movement, some will produce words and/or sentences, a few will participate in conversations.

I have known students who felt better the day after they had a dream about having treatment and an equal number who felt worse.

The above is written with the disclaimer that it is impossible to know whether what I think I feel is palpatory pareidolia.