REM sleep behavior disorder involves abnormal actions or behaviors during the sleep phase of rapid eye movement.
The condition is a type of sleep disorder called parasomnia. These are sleep disorders in which sleep is disturbed by strange or dangerous events.
Although it can occur at any age, men older than 50 usually have sleep deprivation disorder (RBD).
This article examines the nature of RBD, the symptoms of the condition, and how to diagnose and treat it, as well as its possible causes.
REM sleep is a phase of the sleep cycle that begins 90 minutes after falling asleep during a normal cycle.
Dreams happen in REM sleep.
During the REM sleep phase, the muscles in the body usually go into a state of temporary paralysis. In a person with RBD, this paralysis is incomplete or even completely absent, so the person “works” in their dreams, sometimes in dramatic or violent ways.
A temporary lack of muscle paralysis causes sleepers with RBD to become physically active, move their arms, leave the bed, and engage in other activities related to waking up.
In some cases, people with RBD may injure themselves or anyone else sharing the bed.
The risk of violent movement is higher if the person has an aggressive or frightening dream.
If the person wakes up, they may remember the dream but have no idea that they were involved in any movement.
An event can occur with each REM stage, doing around four each night. They can only occur once a week or even once a month in rarer cases.
The times tend to occur towards the morning hours when REM sleep is more frequent.
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A person with RBD may display the following behaviors while asleep:
- talking
- shouting
- screaming
- lashing out physically
- punching and bribing
- curse
- a clear ability to bring back dreams of waking up
- walk-sleep
Their partner or others who share the bed may worry about these awakening behaviors.
About 38 percent of people with RBD may develop other brain diseases such as Parkinson’s disease, Lewy body depression or multiple system atrophy. Sometimes RBD can occur 50 years before symptoms of other brain diseases occur.
People who experience it later may experience mental, emotional and brain problems, including:
- apath
- lower scores in attention
- mental issues
- problems with functional activity
- confused
The exact cause of RBD is unclear.
At times, RBD can be a side effect of certain medications and can occur when drugs are withdrawn. People with severe alcohol dependence may find a sudden cessation of RBD alcohol.
Studies suggest that antidepressant medications induce RBD in up to 6 percent of users.
There is evidence to link RBD to post-traumatic stress disorder (PTSD), and this sleep deprivation can occur in people who have recently experienced trauma.
For a proper diagnosis, a person with symptoms of RBD should be examined by doctors at a specialized sleep center with experience treating parasomnias.
The doctor may order a sleep test to test for RBD or other sleep disorders, such as sleep apnea. During a sleep check, the person stays in a special facility all night.
The medical team monitors sleep and breathing activity, brain activity, and muscle movement. A special facility will be able to recognize the absence of muscle paralysis during REM sleep.
The assessment also governs other possible causes or parasomnia.
Treatment for RBD is usually successful. The management of the condition often involves prescribed medication and by altering sleep habits.
Medication
Several treatments have been effective in cases of RBD depending on what symptoms are present.
Low doses of clonazepam, from the drug class benzodiazepine, can help in about 90 percent of people with RBD. These drugs stop muscle activity and relax the body during sleep.
If clonazepam is not effective, some antidepressants or melatonin may help reduce violent behaviors during sleep.
People with depression, leg disorders, and obstructive sleep apnea should exercise caution when using clonazepam. Always follow the instructions of a healthcare professional.
There are a number of steps to improve sleep habits in people with RBD, including the adoption of a sleep-deprivation cycle intended to prevent sleep deprivation and alcohol abuse.
The following strategies can help keep the person with the condition and their sleeping partner safe:
- Use a mattress on the floor, put cushions around the bed, or place the bed against a wall.
- Consider installing padded bed rails.
- If the person with RBD wakes up at night, they should sleep on the ground floor if possible.
- Keep furniture and sharp objects away from the bed.
- Remove potentially dangerous objects from the room.
- Move the bed far from the window.
- Bed rest partners should sleep in a separate room or bed until the symptoms of RBD are controlled.
The person with RBD should have regular follow-up checks for Parkinson’s disease.
Preview
The movements involved in RBD may become more violent over time. Treatment for this condition is important, as it can prevent injury overnight.
If a study does not clarify an underlying cause, medication can control symptoms, and there are usually no problems.
If an underlying neurological disease is causing symptoms, the prognosis will depend on the severity of the disease.
RBD is a condition where REM sleep does not completely stop muscle movement, and a person begins to “activate” the events of their dreams.
This often takes a violent turn and can include punching and shouting. The person with RBD can jump out of bed or walk around while asleep.
A particular sleeping center should be able to determine the condition. Treatment includes medications and lifestyle changes to reduce the risk of injury during bedtime.
The person with the condition may be frightened, but it is possible to treat the symptoms according to the nature of the underlying conditions.
Q:
Are the physical views involved in RBD always violent?
A:
No. The physical reactions involved in RBD can be irritating or even unpleasant. Doctors have reported laughing, laughing and singing at times of RBD.
Answers represent the views of our medical experts. All content is completely informative and should not be construed as medical advice.