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REM Sleep Behavior Disorder

Description

A person with REM sleep behavior disorder is a person who, basically, acts out his or her dreams. Normally, during REM sleep the brain is highly active but, so the body can get adequate rest, the skeletal muscles are in a state of paralysis. Usually reported after causing self-injury or injury to a bed partner, this person’s body does not have the muscle atonia a normal person has during the REM stage of sleep, causing them to unknowingly kick, punch, and move during sleep. These episodes generally happen ninety minutes after the onset of sleep, ranging from once a week to three of four times per night.
Most cases of RBD begin in older adulthood, although it is possible for a person of any age to have it. Occasionally, it is so severe that the person wakes him or herself up, and if this happens frequently, he or she might have excessive daytime sleepiness. This condition has been associated with several degenerative neurological conditions, alcohol withdrawal, and the use of a few types of medication.

Diagnosis

The main characteristic of RBD is dream-enacting behaviors during the REM cycle including kicking, punching, or jumping. Occasionally the person with the condition wakes themselves up and is able to vividly recall the dream that they were enacting.

Treatment

Because this condition can be dangerous to the person with the condition as well as others in the same bed, there are several precautions that one can take to reduce the risk of injury: removing potentially dangerous objects form the room, sleeping on the ground floor, placing padding around the bed or the mattress on the floor, and having bed partners sleep in another room until the episodes subside. There do exist medications that are highly effective in relieving nearly all of patients RBD symptoms.

Source: Adapted from International Classification of Sleep Disorders Diagnostic & Coding Manual, American Academy of Sleep Medicine.