REM Behavior Disorder

REM Behavior Disorder (RBD) is a condition, which causes individuals to act out dramatic and/or violent dreams during the rapid eye movement (REM) phase of sleep. Accompanying these actions may be grunting or shouting. REM Behavior Disorder usually affects men 60 years of age or older but can be seen in people of every age and women as well.

REM Behavior Disorder is an uncommon sleep disorder and there is no known cause. It is known to occur during the REM phase of sleep. REM is when there are brain wave patterns that resemble wakefulness and has been discovered using polysomnography and other sleep tests.

Most dreaming occurs during the REM phase of sleep. The brain is very active during REM sleep however the body in a normal sleeper will be very still. The disorder has been linked to other neurological disorders such as Parkinson disease, multi-system atrophy, dementia, or Shy-Drager syndrome. REM Behavior Disorder often shows up a few years before the other neurological disorders are present.

The main symptom of RBD is the individual acting out their dreams. This sometimes includes violent behavior and causes self-injury or injury to others. These behaviors may include punching, hitting, shouting, kicking, and leaping or jumping from the bed while the person is still asleep.

If the person is awakened or wakes by themselves during these episodes, they will most likely be able to vividly recall the episode. Medical help should be sought if unusual behavior s such as kicking and shouting occur during sleep.

Due to the risk of self-injury of injury to others, a safe sleeping environment is important for people with REM Behavior Disorder. Potentially dangerous objects should be removed from the bedroom and the floor should be cleared of furniture and objects that could hurt the person if they fall or jump from the bed.

Ideally, the mattress should be placed on the floor or a cushion should surround the bed and a bed that has padded bedrails could be an option. The person with the disorder should sleep on the ground floor, especially if they are known to leave the bed during episodes and bed partners should sleep in a separate bed until the symptoms subside.

A medication called Clonazepam, or Klonopin, is effective in treating REM Behavior Disorder. This drug has been known to relieve symptoms in 90-percent of patients with little evidence of tolerance or abuse being reported.

The treatment usually begins working within the first week, often with the first night of the medication being taken. After several years of being on the medication, leg twitches and sleep talking may emerge. The medication should be continued indefinitely as nightmares have been known to reoccur in individuals that have stopped taking the medication.

Other medications have also been used to treat RBD. These have included medications such as tricyclic antidepressants. However, these medications have also been known to promote the occurrence of REM Behavior Disorder as well. Careful neurological follow-up is needed as REM Behavior Disorder can indicate the onset of other more serious neurological problems.