REM Behavior Disorder
REM behavior disorder
REM Behavior Disorder (RBD) is a sleep disorder that causes a person to physically or verbally act out their dreams during REM sleep.
Instead of the body remaining still as it normally does during this stage of sleep, a person may talk, yell, punch, kick, sit up, or even jump out of bed.
A person experiencing REM behavior disorder may not realize these behaviors are happening. A bed partner is often the first to notice unusual movements or sounds during the night.
While occasional movement or talking during sleep can be normal, frequent or forceful movements may be a sign that something more is going on.
Common Symptoms of REM Behavior Disorder
Acting Out Dreams
Moving or behaving in ways that appear connected to vivid dreams.
Talking or Yelling
Speaking, shouting, or making other sounds while asleep.
Punching or Kicking
Forceful movements of the arms or legs during sleep.
Sitting Up or Jumping Out of Bed
Suddenly sitting up, getting out of bed, or falling from the bed.
Vivid Dreams
Remembering intense, vivid, or frightening dreams after waking.
Sleep-Related Injuries
Accidentally injuring yourself or a bed partner during an episode.
What Causes REM Behavior Disorder?
The exact cause of REM behavior disorder is not always known. In some cases, it may occur without an identifiable cause. RBD can also be associated with certain medications or neurological conditions.
REM behavior disorder has been associated with conditions such as Parkinson's disease and other disorders affecting the nervous system. However, having REM behavior disorder does not necessarily mean that someone will develop one of these conditions.
Because nighttime movements can have several possible causes, an evaluation can help determine what may be happening during sleep.
Is rem behavior disorder dangerous?
REM behavior disorder can create a risk of injury because a person may physically act out what is happening in their dreams. A person may accidentally:
- Fall out of bed
- Hit or kick a bed partner
- Run or jump from the bed
- Hit nearby furniture or objects
- Cause bruises or other injuries
If you or your bed partner are experiencing frequent or forceful movements during sleep, making the sleeping environment safer can help reduce the risk of injury while you seek an evaluation.
Diagnosis
How Is REM Behavior Disorder Diagnosed?
If REM behavior disorder is suspected, a healthcare provider may ask about your symptoms, sleep patterns, medications, and medical history. Information from a bed partner can also be helpful, especially if you do not remember what happens during sleep.
An overnight sleep study, also called a polysomnogram, may be recommended to help determine what is happening during sleep. During a sleep study, different aspects of sleep and body activity can be monitored, including brain activity, eye movements, muscle activity, breathing, heart rate, and body movements.
A sleep study can also help distinguish REM behavior disorder from other conditions that may cause unusual movements or vocalizations during sleep.
REM Behavior Disorder vs. Other Sleep Disorders
Acting out dreams does not always mean someone has REM behavior disorder. Other sleep conditions can cause nighttime movements, talking, or unusual behaviors. These may include:
Sleepwalking
Obstructive sleep apnea
Night terrors
Periodic limb movements
Sleep-related seizures
Medication-related sleep behaviors
Because these conditions can look similar, an evaluation can help identify the possible cause of unusual nighttime behaviors.
How Is REM Behavior Disorder Treated?
Treatment for REM behavior disorder depends on the individual's symptoms, health history, and possible underlying causes.
A healthcare provider may recommend making changes to the sleep environment to reduce the risk of injury, reviewing medications that could be contributing to symptoms, or evaluating for other health conditions.
In some cases, medication may be prescribed to help reduce nighttime behaviors. Your healthcare provider can determine which approach is appropriate based on your individual situation.
COMMON QUESTIONS ABOUT REM BEHAVIOR DISORDER
What is REM behavior disorder?
REM behavior disorder is a sleep disorder in which a person physically or verbally acts out dreams during REM sleep. Symptoms can include talking, yelling, punching, kicking, or other movements.
Is it normal to move during REM sleep?
The body normally experiences temporary muscle relaxation during REM sleep, which helps prevent people from physically acting out their dreams. Occasional movements or sounds during sleep can happen for many reasons, but repeated or forceful dream-enacting behaviors may warrant an evaluation.
Who is at risk for REM behavior disorder?
REM behavior disorder is more commonly diagnosed in older adults and is more frequently seen in men. It can also be associated with certain neurological conditions and medications.
Can REM behavior disorder cause injuries?
Yes. Acting out dreams can lead to falls, bruises, or injuries to the person experiencing RBD or their bed partner.
How is REM behavior disorder diagnosed?
A healthcare provider may review symptoms, medications, medical history, and observations from a bed partner. An overnight sleep study may also be recommended to monitor brain activity, muscle activity, eye movements, breathing, and other aspects of sleep.
Can REM behavior disorder be treated?
REM behavior disorder can be managed with approaches based on the individual's symptoms and health history. Treatment may include improving sleep safety, reviewing medications, addressing underlying conditions, or using medication when appropriate.
Other Sleep Disorders
Sleep Apnea
& Snoring
Insomnia
Narcolepsy
Restless Leg
Syndrome
Shift Work
Disorder
Shift work disorder occurs when your work schedule conflicts with your body's natural sleep-wake cycle, causing excessive sleepiness and difficulty sleeping at the right times.
Concerned About Unusual Sleep Behaviors?
If you or your bed partner notice frequent talking, yelling, kicking, punching, or other unusual behaviors during sleep, talk with your healthcare provider. These symptoms can have several possible causes, and an evaluation can help determine what may be happening.
A sleep study may be recommended to better understand your sleep and help distinguish REM behavior disorder from other sleep conditions.