REM Sleep Behavior Disorder: Symptoms & Treatment

Instructor: Yolanda Williams

Yolanda has taught college Psychology and Ethics, and has a doctorate of philosophy in counselor education and supervision.

Did you know that you spend about 20 percent of your sleep in the REM stage? Learn more about REM sleep behavior disorder, its symptoms, and treatment. Then test your knowledge with a quiz.

What Is REM Sleep Behavior Disorder?

Dennis loves to watch and play sports, especially tennis. One night, Dennis dreams that he is playing tennis with his favorite tennis player. During one intense play, Dennis swings his tennis racket with all of his might to keep his favorite tennis player from scoring. Dennis's dream is interrupted by his wife's scream. She tells Dennis that he swung his right arm wildly during his sleep and hit her. Since this is not the first time Dennis has moved about in his sleep, he goes to see a specialist. Dennis is eventually diagnosed with REM sleep behavior disorder.

So what exactly is REM sleep behavior disorder? REM sleep behavior disorder, otherwise known as RBD, is a sleep condition in which the actions that you perform in your dreams are physically carried out by you in real life. In other words, you act out your dreams during sleep by moving your body or making sounds. REM sleep behavior usually develops without warning, and the episodes tend to become progressively more violent. If the bed is shared with another person, REM sleep behavior can interfere with their sleep and safety as well.

You spend close to 20 percent of your time sleeping in the REM stage, which is when dreaming usually occurs. It is normal to have several episodes of REM sleep that generally occur ever ninety minutes or so. Behaviors associated with REM sleep behavior disorder can occur during any one of those REM episodes. This means that a person who has RBD could potentially act out their dreams four times each night, depending on how long they sleep. Some others may experience episodes less often, e.g., once every two weeks.

Symptoms of REM Sleep Behavior Disorder

A major symptom of REM sleep behavior disorder is movement during sleep in response to what is happening in your dream. For example, if you are having a dream in which someone is trying to hurt you, you may find yourself punching and kicking in an attempt to defend yourself. Other movements commonly associated with this disorder include leaping out of your bed and moving your arms. Another symptom is making sounds, such as laughing, swearing, or shouting. If you have REM sleep behavior disorder, you should be able to remember what happened in your dream when you awake from your episode.

Many people mistake REM sleep behavior disorder for sleepwalking or night terrors. Unlike people who sleepwalk, it is unusual for people with REM sleep behavior disorder to walk, open their eyes during an episode, or exit the room where they sleep. The confusion that a person who sleepwalks or has night terrors experiences once they wake up is not present in RBD. It is much easier to wake a person out of an REM sleep behavior disorder episode than it is to wake a person who is sleepwalking. While people who sleepwalk or have night terrors usually have no memory of these events, a person who has RBD is able to clearly recall what happened in their dream.

A person with REM sleep behavior disorder does not eat, drink, use the bathroom, or engage in sexual activity during an episode. REM sleep behavior disorder does not make you a violent person while you are not sleeping and an episode usually does not occur when you are napping.

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