REM Sleep Behavior Disorders

Posted by Darian Dozier on Dec 15, 2021 8:00:00 AM

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REM sleep behavior disorders are a series of activities that one does in their sleep at a time when they would normally be temporarily paralyzed. One of the sleep stages that we enter every night is called REM, or rapid eye movement. It is the stage in which dreaming occurs. During this time, we are normally very still, with only our eyes moving about. However, during REM sleep behavior disorders, we may be acting out our dreams. Continue reading to find out more about this disorder. 

The onset of REM sleep behavior disorders is slow and can progress overtime. It may also be associated with other neurological disorders including Lewy body dementia, Parkinson's disease or multiple system atrophy. 


REM sleep behavior disorders is the movement of the extremities, like arms and legs, during REM sleep. Essentially, you are physically acting out your dreams, and this can take the form of kicking, punching, flailing from the bed, noises, or being able to recall the dream if you awaken during an episode. 

It's important if you are experiencing any of these symptoms, that you talk to your doctor right away because this is abnormal. 


Normally, there are nerve pathways in the brain that prevent muscles from moving and are active during normal REM or dreaming sleep. This leads to temporary paralysis in order to protect yourself from the movement that could happen during your dreams. 

There are some risk factors associated with the development of this disorder including being a male over 50, having a certain type of neurodegenerative disorder, narcolepsy, and certain medications.

Parkinson's disease and multiple system atrophy are a couple of the disorders that can increase the risk for developing a REM sleep behavior disorder. Also medications like antidepressants or withdrawal of drugs and alcohol can increase the risk.   


REM sleep behavior disorder may include distress to a sleeping partner, or others in the hope, social isolation from fear that others will learn about your disorder, or injury to yourself or partner. 


Diagnosis requires a review of the medical history, as well as symptoms. This evaluation could include a physical and neuro exam, talking with your sleeping partner, or a polysomnogram (nocturnal sleep study). 

In order to be diagnosed, you have to meet the following criteria: 

  • Repeated times of arousal during sleep where you talk, make noises, perform complex motor behaviors related to the content of your dreams
  • Recall dreams associated with movements or sounds 
  • Polysomnogram that shows increased muscle activity during REM sleep 
  • Disturbance isn't caused by another sleep disturbance, mental health disorder, or medication/substance abuse. 

It's also important to be aware that REM sleep behavior disorders can be indicative of a serious neurological disorder, so it cannot go untreated. 


Treatment includes physical safeguards and medication. This may include changes to the sleeping environment that make it safer like padding on the floor, barriers around the bed, and protecting the windows. Medications may include sleep aids like melatonin or a benzodiazepine like clonazepam. 

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Topics: Sleep Disorders

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