REM Sleep Behavior Disorder

Symptoms

REM sleep behavior disorder (RBD) is much more common in men than in women and usually begins in middle age or later, though it can occur earlier.

RBD is characterized by physically acting out dreams. The dreams are sometimes pleasant, but are more commonly nightmarish or violent and involve being chased or attacked. The dreamer's attempts at self-defense may result in screaming, yelling, hitting, grabbing, punching, kicking, jumping out of bed, or other actions.

Episodes of RBD usually do NOT include walking, eating, drinking, sexual activity or going to the bathroom.

If awakened from a dream, the dreamer can usually recall the dream's content, which matches the acted out behavior. (Unless awoken, however, dreamers typically are unware of having had the episode.)

REM sleep occurs every 1and 1/2 to 2 hours each night, so the earliest an episode usually takes place is 90 minutes into sleep.

The frequency of episodes varies. Most people with RBD have episodes about once a week, while others may have several episodes per night, several nights a week.

Episodes tend to become more aggressive over time and can result in the dreamer or a bed partner being seriously injured.

People with RBD are no more violent in waking life than other people. RBD is not a psychiatric disorder.

Other sleep disorders that often coexist with RBD include:

• Obstructive sleep apnea (OSA)
  
• Periodic leg movement disorder (PLMD)
  
• Narcolepsy