REM sleep behavior disorder

Medically reviewed by Valerie Cacho, MD, board-certified sleep medicine physician

 

In short: During REM sleep, when most vivid dreaming happens, the body normally switches off the large muscles so we stay still. In REM sleep behavior disorder (RBD), that switch doesn't fully work, so people physically act out their dreams. It is very treatable, and an evaluation also matters for long-term health.

 

Common signs

• Talking, shouting, laughing or swearing during sleep

• Kicking, punching, flailing or jumping out of bed, often during action-filled or frightening dreams

• Remembering the dream clearly if woken during an episode

• Injuries to yourself or a bed partner

 

Who gets it

RBD is most often diagnosed in men over 50, though women and younger adults are diagnosed too. It can be triggered by certain medications, especially some antidepressants, and by alcohol or drug withdrawal, and it is more common in people with narcolepsy. In some people, RBD appears years before neurological conditions such as Parkinson's disease or Lewy body dementia, which is why ongoing follow-up with a specialist is important.

 

How we diagnose and treat it

Confirming RBD requires an in-lab overnight sleep study with video, which shows muscle activity during REM sleep and rules out look-alikes such as sleep apnea or sleepwalking. We arrange this through an accredited partner sleep lab.

 

Treatment starts with safety: padding sharp corners, moving objects away from the bed and, if needed, sleeping apart from a partner for a while. We review medications that could be contributing, and medicines such as melatonin can reduce episodes.

 

Acting out your dreams?

Book an appointment in person in Fullerton, Los Alamitos or Ewa Beach, or by telehealth anywhere in California and Hawaii. Call (657) 553-3799 in California or (808) 500-7077 in Hawaii.

 

Source: Mayo Clinic, "REM sleep behavior disorder." This page is for education only and is not a substitute for a medical evaluation.