REM Behavior Disorder

REM behavior disorder (RBD) occurs during a stage of sleep known as Rapid Eye Movement (REM) sleep.

The characteristic behaviors of this sleep disorder can sometimes be cruel and may cause damage, if left untreated.

During the dreaming state, people are normally paralyzed during their dreams and cannot act out their behaviors. But people who suffer from REM behavior disorder (RBD) act out their dreams.

They physically move limbs or even get up and engage in activities associated with waking. Some talk, yell, scream, beat, punch, or fly out of bed while sleeping. RBD is generally noticed when it causes danger to the sleeping person, their bed partner.

Causes Of REM Behavior Disorder

Sleep involves transitions between three different states: wakefulness, rapid eye movement (REM) sleep, which is related with dreaming, and non rapid eye movement (N-REM) sleep.

There are a variety of characteristics that describe each state, but to understand REM Behavior Disorder it is important to know that it occurs during REM sleep. During this state, the electrical activity of the brain, as recorded by an electroencephalogram, looks alike to the electrical activity that occurs during waking.

Although neurons in the brain during REM sleep are functioning much as they do during waking, REM sleep is also characterized by temporary muscle paralysis.

REM Behavior Disorder Symptoms

Persons who experience REM behavior disorder may call out or talk out loud and shout during sleep. Other symptoms may include:

• Sleepiness during the daytime,
• Awakening with injury such as cuts, bleeding, bumps or bruises and/or
• Vivid dreams,
• Acting out vicious behaviors, such as hitting or thrashing about in or out of the bed.

REM Behavior Disorder Diagnosis

Because a number of parasomnias may be confused with RBD, it is necessary to conduct official sleep studies performed at sleep centers that are experienced in evaluating parasomnias in order to establish a diagnosis.

A sleep study will monitor a patient’s sleep, particularly REM sleep and will help in making an correct diagnosis. Video monitoring and/or a full montage EEG may be performed along with the sleep study to differentiate the unusual behaviors during sleep.

REM Behavior Disorder Treatment

Once the diagnosis has been made, the sleep center physician will guide the patient regarding a treatment plan. Many times medication can help suppress REM sleep and the behaviors related with this diagnosis.

Clonazepam, a benzodiazapine eliminates the disorder about 90% of the time. However, make the bedroom safe, eliminating all sharp and breakable objects.