REM Sleep Disorders

When the majority of people enter into REM sleep they begin to dream, and during this time the body becomes paralyzed (sleep paralysis typically happens during this time when your brain becomes alert, but your body doesn’t). People with REM Behavior Disorder (RBD) aren’t always paralyzed during the REM portion of sleep and are able to act out dreams and/or nightmares, often causing harm to themselves and others.

The first time RBD was diagnosed was in 1985 by Dr. Mark Mahowald and Dr. Carlos Schenck at the University of Minnesota. They also found that more than 90% of RBD patients are male and the disorder doesn’t strike until after the age of 50, although kids have been diagnosed as early as the age of 9. They also go on to say that most RBD patients are calm, easy-going, and good-natured when awake, here are a few case histories documented by Drs. Mahowald and Schenck.

A 77-year old minister had been behaving violently in his sleep for 20 years, sometimes even injuring his wife.
A 60-year old surgeon would jump out of bed during nightmares of being attacked by “criminals, terrorists and monsters.”
A 62-year old industrial plant manager who was a war veteran dreamt of being attacked by enemy soldiers and fights back in his sleep, sometimes injuring himself.
A 57-year old retired school principal was inadvertently punching and kicking his wife for two years during vivid nightmares of protecting himself and family from aggressive people and snakes.

RBD can easily be confused with a number of parasomnias, this is why patients should be observed over night in a sleep center. A single night of monitoring almost always reveals a lack of muscle paralysis during REM sleep that leads to a diagnoses of RBD. After a diagnosis has been confirmed a treatment can begin, most commonly Clonazepam is prescribed, a benzodiazepine that can reduce or eliminate the disorder about 90% of the time.

Drs. Mahowald and Schenck made a startling discovery while conducting research on RBD; they found that 38% of 29 otherwise healthy patients with RBD went on to develop a parkinsonian disorder. “We don’t know why RBD and PD are linked,” says Dr. Mahowald, “but there is an obvious relationship, as about 40% of individuals who present with RBD without any signs or symptoms of PD will eventually go on to develop PD.” Other research has also shown a connection between RBD and neurodegenerative diseases related to Parkinson’s.

If you have any concerns about RBD you should consult with your doctor or find a sleep specialist in your area.

2. Maas, Dr. James B., Megan L. Wherry, David J Axelrod, Barbara R. Hogan, and Jennifer A. Blumin. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York : Villard, 1998.

The Sleep Foundation—REM Behavior Disorder and Sleep
Web. 01 Jan. 2014. <http://www.sleepfoundation.org/article/sleep-related-problems/rem-behavior-disorder-and-sleep>.