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Spotlight On: REM Behavior Disorder

Do you know the symptoms of RBD? photo credit: The Integer Club via photopin cc

Do you know the symptoms of REM Behavior Disorder? photo credit: The Integer Club via photopin cc

Most people know that there are several different stages of sleep.  Over the course of each night, we move in and out of the different stages in cycles.  Even though there are several stages of sleep, the sleep we get at each stage falls into only one of two categories, REM (Rapid Eye Movement) sleep and Non-REM sleep.  REM sleep is when we do most of our dreaming and EEG testing shows that our brains are as active during this time as they are when we are awake.  In fact, most experts agree that to brains there isn’t a big difference between being awake and being in REM sleep.  There is, however, one major difference in our bodies during REM sleep called muscle atonia.  This is a type of temporary paralysis that occurs when we sleep and it is the reason that we don’t walk, talk, fight, drive, or cook when we are asleep even though our brain thinks that is what we are doing.

People with REM Behavior Disorder (RBD) don’t experience the same muscle atonia as others which means that sometimes their bodies perform the actions occurring in their dreams even though they are asleep.  First discovered in 1986, RBD is a type of sleep disorder called a parasomnia which is a group of sleep disorders like sleepwalking, night terrors, and restless leg syndrome where abnormal behavior is exhibited during sleep.  According to the National Sleep Foundation, about 0.5% of the population has RBD and it is much more common in males than it is in females.  The disorder generally shows up around age 50 but can be diagnosed earlier.



The primary symptom of RBD is acting out your dreams.  Oftentimes, those with the condition will learn about their abnormal behavior because they are kicking or hitting their bed partner, screaming, jumping out of bed, or awaken to find that they have bruises and other injuries that were not there the night before.  People with this disorder may also respond to others as if they are awake and frequently experience RBD episodes more than once a night.



The majority of RBD cases are idiopathic, meaning that there is no direct cause.  RBD is also associated with several neurodegenerative disorders like Parkinson’s disease.   RBD can also be caused by an adverse drug reaction and may present during drug withdrawal.  The disorder may also present after an injury to the brain stem or a brain tumor.



RBD can be treated but effective treatment requires an accurate diagnosis.  Because RBD can easily be confused with other parasomnias, it is important to conduct in-depth sleep testing to confirm diagnosis.  Primary treatment options are medication and changes to the person’s sleep environment.  There are several different types of medication used to treat the disorder and the type usually depends on the person’s symptoms and co-existing conditions.  Changes to the sleep environment include moving the mattress to the floor, removing objects that could be a danger, and taking other measures to help preserve the safety of the person with RBD and their sleep partners.


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