What Is Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD)?
REM sleep behavior disorder (RBD) is a condition that is characterized by an individual experiencing sudden body movements and vocalizations during vivid dreams in REM sleep. This condition is a form of parasomnia, which refers to abnormal behaviors during sleep. During regular REM sleep, the body undergoes temporary muscle paralysis, known as atonia, while the brain displays activity similar to wakefulness.
This paralysis allows people to dream safely, as it prevents us from acting out our dreams in person. However, for people with REM sleep behavior disorder, this paralysis does not occur which enables the individual to physically act out the events of their dreams. Usually, dreams associated with REM sleep behavior disorder are known to be intense and frightening, so when these dreams are acted out, it can be dangerous for the individual or their bed partner.
Risk Factors For REM Sleep Behavior Disorder
There are certain factors that may increase your risk of developing REM sleep behavior disorder, which include being male, being over 50 years old, having narcolepsy, or having another neurological condition, such as Parkinson’s disease, Lewy body dementia, or multiple system atrophy. Other factors may also increase your risk, such as using some medications or antidepressants, as well as use or withdrawal from drugs or alcohol.
Causes Of REM Sleep Behavior Disorder
The exact cause of REM sleep behavior disorder is unknown, though studies suggest it is related to neural pathways in the brain. Since REM sleep behavior disorder often precedes other neurological conditions, it is thought that RBD is a sign that the condition is a sign that others will develop. In fact, nearly 81 percent of men aged 50 or older with REM sleep behavior disorder ended up developing another neurological disorder such as Parkinson’s.
Symptoms Of REM Sleep Behavior Disorder
Since the temporary paralysis does not occur in individuals with RBD, symptoms will occur during sleep. Symptoms of RBD include minor movement of the limbs, noises such as talking, laughing, or shouting, and more intense body movements (usually in response to action-filled or violent dreams) such as punching, kicking, flailing, sitting up suddenly, or jumping out of bed.
People are unaware of this behavior during episodes, and many people only find out that they have this condition because they are told of their symptoms by a partner or roommate. When an individual is having an episode, they are typically relatively easy to wake up, and upon waking, they are usually alert, coherent, and can remember the events of the dream.
Complications Of REM Sleep Behavior Disorder
Since certain symptoms of REM sleep behavior disorder can be violent, there is a possibility of complications arising. Individuals can put themselves or anyone they share a bed with at risk of physical injury. This disorder can also cause distress to your sleeping partner or other people living in the home.
Testing For REM Sleep Behavior Disorder
According to the American Academy of Sleep Medicine’s International Classification of Sleep Disorders, a person must meet four criteria to receive a diagnosis of REM sleep behavior disorder. These include having repeated episodes of physically acting out your dreams, these episodes occur during REM sleep, these episodes include sleep without atonia, and the episodes are not due to another factor, such as other neurological conditions or as a side effect or medications or drug abuse.
In order to confirm this criteria, your doctor will conduct a sleep study known as polysomnography. Your doctor will also conduct a physical and neurological exam to rule out any other possible causes. If you sleep with a partner, your doctor may ask them questions about your episodes and symptoms. In addition to this, your doctor will ask you about your medical history.
By looking at the results of the sleep study as well as monitoring your symptoms, your doctor will be able to determine if you fit the criteria to be diagnosed with REM sleep behavior disorder.
Treatment For REM Sleep Behavior Disorder
Treatment for this disorder is catered to each individual and may involve a combination of lifestyle changes, medications, and injury prevention methods. Since alcohol and certain prescription drugs can contribute to this disorder, avoiding these can help reduce the amount of episodes you experience.
The preferred method of treatment for this disorder is the use of melatonin. Unlike other sleep medications, melatonin has relatively few side effects and provides the same level of efficacy. The dosage used for treating REM sleep behavior disorder differs from using the medicine to fall asleep regularly, so you should consult your sleep doctor for the correct dose.
Injury prevention methods include removing sharp objects from the bedroom, padding the floor around the bed, installing padded rails on the side of the bed, putting the mattress on the floor, and protecting bedroom windows. These techniques ensure that if you experience any symptoms, your sleep environment is safe and prevents any sleep-related injuries from occurring.
