REM Sleep Behavior Disorder

Rapid Eye Movement Sleep Behavior Disorder (RBD) is a sleeping disorder in which people physically act out their dreams by using their arms and legs. These dreams are normally distasteful and violent and may occur frequently. It also involves screaming, shouting, sleep talking and hitting. People normally ignore these symptoms and usually notice it once the patient gets out of bed and hurt themselves or anyone else in the surroundings. It also involves REM (Rapid Eye Movement) while sleeping. On an average, REM sleep occurs for 20 – 25% of the sleep time where vivid dreaming occurs.

As medical science investigates, researchers say that the brain’s electrical activity during an REM sleep is pretty similar to that during walking. In addition to this, the brain also initiates muscle paralysis during this activity. There is a neurological barrier between three states of sleep which are wakefulness, rapid eye movement and non-rapid eye movement. When we sleep our brain goes through a transition between these three states. RBD occurs when this neurological barrier does not function properly. What causes this barrier to malfunction is still a question that bothers sleep researchers and scientists.

RBD patients lack muscle paralysis which enables them to act out their dreams and start limb movement and talking. Such behaviors can be dangerous to their sleeping partners and even to themselves.

Causes of REM

As per medical researches, in normal circumstance, when we fall asleep our brain ceases muscle movement through nerve pathways. However, during RBD these nerves do not work efficiently and in some cases, they completely stop working. This enables a person to move their limbs and carry out physical activities. There are three major categories of causes of RBD:

  1. Physiological Causes

This involves dysfunction of the central nervous system and abnormal cortical activities.

  1. Idiopathic Causes

This is related to genetic and gene patterns that run in the family of a patient. It involves drastic increase in the percentage of slow wave sleep.

  1. Symptomatic Causes

It is deeply correlated to neurodegenerative diseases such as Parkinson’s, multiple sclerosis and many others.

Symptoms of REM

REM sleep intervals occur at a frequency of 1.5 to 2 hours in every sleep. The behavior of dreamers helps characterizing the sleep disorder. Researchers have concluded different analogies and observed various symptoms for RBD. In some cases, these symptoms occur once a week or even a month which makes it much difficult to diagnose. These symptoms include:

  • Rapid muscle movement such as kicking, punching, running and jumping etc. A person may carry out these activities in response to a violent dream where they are being chased or beaten.
  • Ability to recall the dream if their sleep is disturbed in the middle of the dream.
  • Response to an emotional dream through crying, screaming or even abusive gestures.
  • REM episodes normally occur in the later half of the sleep i.e. more towards morning hours.

Treatment for REM

People suffering from RBD can be treated in several ways depending upon the nature of their disorder. There are different medications and physical measures which can remedy the disorder the high efficiency. Some of these treatments are as follows:

Physical Measure

  • Padding the sleeping area with foam or thick cloth can reduce chances of injuries to patients.
  • Moving away unnecessary furniture and obstacles from the dreamer.
  • Barrier placing on sleeper’s sides.


Some of the medications for REM include

  • Clonazepam can help reduce the symptoms by 95%. Patients do not develop immunity from the medicine for years so it can be used for longer instances.
  • Melatonin reduces the symptoms effectively, but it has a tendency to causes grouchiness upon waking up.

Even though, REM is considered as a dangerous sleeping disorder but it can be cured through proper treatment.