What a Comedy About Sleepwalking Can Teach Us

Convinced that a guided missile was headed his way, and that its coordinates were set specifically on him, Mike Birbiglia jumped, screaming, through the second-story window of his hotel room in Walla Walla, Wash. The window was closed. It was 3 a.m. And Birbiglia, a 20-something comedian on his first cross-country tour, was sleepwalking. Later, an ER doc would stitch up Birbiglia's legs and explain that the glass had missed the comedian's femoral artery by a hair. It was pure luck that he hadn't bled to death.

Perhaps even more astounding, when he crashed through the window, Birbiglia was still asleep. That made it easy for him to bounce up and run across the hotel grounds, away from the fictional missile, without feeling a thing. It was not his first sleepwalking episode. In the five preceding years, he had thrown a chest of drawers across his living room to block an attack from Brad Pitt, destroyed his TiVo digital recorder in the course of a dream where he thought he was in an Olympic dust-busting competition and assumed karate poses at the edge of his bed to ward off a flying jackal. But not until his window-dive in Walla Walla did Birbiglia see a sleep specialist, who diagnosed him with REM Behavior Disorder (RMBD).

What is RMBD? Normally, as the brain enters REM sleep, or dream sleep, the body's muscles become paralyzed, except for the diaphragm, which is essential to breathing. That prevents us from acting on our thoughts, essentially protecting us from our own minds while we dream. But in people with RMBD, the muscles never enter dream paralysis and the body remains fully capable of action—an easy recipe for injury or death, given that sleeping people usually feel no pain.

"It's terrifying if you think about it," says Birbiglia, who, to prevent further catastrophe now zips himself up in a sleeping bag and mittens every night. "Your body decides to basically ignore your conscious brain. Your brain is like, 'We're going to shut down for a while,' and your body is like, 'We're going skiing!'"

They may be terrifying, but these nighttime antics also make for great stories. So it's no surprise that the comedian decided to spin his experiences into "Sleepwalk With Me," a hilarious 80-minute off-Broadway monologue that weaves his sleepwalking yarns into more profound narratives about his fears of intimacy and adulthood. The show opened in November to rave reviews, and it has just been extended through the end of March. Among Birbiglia's biggest fans: a handful of sleep researchers who have praised him for drawing attention to a condition they say is more common, and potentially more dangerous, than most people care to acknowledge.

"Mike is really de-stigmatizing this disorder," says Mark Mahowald, the University of Minnesota neurologist who first identified RMBD in the mid-80s. "He's drawing attention to something that too many people would rather ignore."

An estimated 5 percent of the adult population suffers from RMBD, but experts suspect the condition is vastly under-diagnosed, and a growing collection of anecdotal cases suggests they may be right. One English hotel chain reported roughly 400 cases of sleepwalking last year alone. Dozens of Birbiglia's fans have logged their own sleepwalking stories on his Web site [www.birbigstube.com]. But telling an audience of strangers is not the same as telling a doctor. "It's one of those things that people normally don't want to bring to medical attention," says Mahowald. "One, they don't want to be told they're crazy, and two, the actual behaviors are often very embarrassing."

In the past, sleepwalking was not just embarrassing, but was also thought to be a sign of serious mental illnesses like schizophrenia or bipolar disorder. And while most sleep experts now agree that's not the case, the misconception has persisted among medical professionals as a whole. A new scapegoat for sleepwalking behaviors has also emerged in recent years: sleep medications. "We know that drugs like Ambien can induce some of these incidents," says Mahowald. "But that doesn't mean all sleepwalking stems from the medications. We've been documenting this stuff for a long time now—it happens without the drugs, and it doesn't mean you're crazy."

So what does it mean? Is RMBD a purely physiological problem, or does it have psychological roots? The answer is unclear, but experts say that anxiety and stress may play a role in those who are predisposed to the disorder.

Birbiglia believes his own harrowing but hysterical sleepwalking incidents were the result of pressures and realities he had refused to confront in his waking life, boiling over in his dreams. "The show is really about the length to which we will go to avoid dealing with sh*t," he says. But one way or another, our flying jackals always find us.