Rem Sleep Behavior Disorder

Rapid eye movement (REM) sleep behavior disorder is a sleep disorder in which you physically act out vivid that is often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements.

This is also known as dream-enacting behavior. We spent about 20 percent of our sleep in REM, when this is the time that we are dreaming. This is sudden and you may have a few episodes a night and this can get worse with time. Lewy body dementia and Parkinson’s disease may be related to this condition.

Possible signs and symptoms of REM sleep behavior disorder include:

• Movement such as punching or kicking because of the violent dream that you are having like being chased or someone is attacking you,
• Noises such as talking,
• Shouting or laughing,
• You remember the dream if you woke up after an episode.

REM Sleep Behavior Disorder is caused when the nerve pathways that prevent muscles from moving are not working while you are sleeping. I results to temporary paralysis of your body and you may act out your dreams while you are sleeping.

Consult your doctor and he may refer you to a sleep specialist to receive a diagnosis of REM sleep behavior disorder. Bring a family member or a close friend to accompany you.

Make a list of all the supplements and medications that you are taking and all of the symptoms that you are experiencing. Tell your doctor if you had major stresses or recent changes in your life.

Some of the questions that you can ask your doctor include:

• What is causing my symptoms?
• What are the other possible causes?
• What tests do I need?
• Is this temporary or long term?
• What are the treatments available?
• Should I see a specialist?

Your doctor will also ask you questions such as:

• When did you begin experiencing your symptoms?
• Have you ever experienced sleep walking?
• Are you having motor symptoms?
• Are you having any problems in your memory?
• Have you had sleep problems in the past?
• Does anyone in your family have this?
• What medications are you taking?

Your doctor may recommend tests such as:

• Physical and neurological exam – this is done to evaluate your REM sleep behavior and to rule out other sleep disorders
• Nocturnal sleep study or polysomnogram – this will be an overnight sleep study in a sleep laboratory, the sensor monitors your brain activity, lungs and heart, arms and legs movements, breathing problems

There is a diagnostic criterion for REM sleep behavior disorder that is in the International Classification of Sleep Disorders – Third Edition (ICSD-3). It includes:

• You recall dreams associated with these movements or sounds,
• A sleep study shows you have increased muscle activity during REM sleep,
• You have repeated times of arousal during sleep where you talk,
• Make noises or perform complex motor behaviors, such as punching, kicking or running movements that often parallel the content of your dreams.

Your sleep disturbance is not caused by another sleep disturbance, a mental disorder, medication or substance abuse.If you awaken during the episode, you are alert and not confused or disoriented.

Medications and physical safeguards might be the treatments for REM sleep behavior disorder.

For medications:

• Melatonin – a dietary supplement to reduce the symptoms but side effect is grogginess in the morning,
• Clonazepam or Klonopin – to reduce the symptoms but side effects are worsening of sleep apnea and daytime sleepiness.

For physical safeguards:

• Changes in your sleep environment such as removing dangerous objects such as sharp items,
• Protecting windows,
• Padding the floor,
• Placing barriers on the sides of the bed, avoid furniture near the bed.

To best prevent REM sleep behavior disorder episodes, visit a sleep specialist to develop a treatment plan.

Some of the safety measures to prevent injuries from that you can do are:

• Make sure that the windows and doors are secured,
• It is preferable to have a ground floor bed most especially for people who leaves the bed during an episode,
• Sleep in a big bed so your sleeping partner will not be injured,
• Put pads on the bed rails and nearby furniture,
• Clear the floor of any sharp objects.

There are no homeopathic or alternative remedies for REM sleep behavior disorder.

Lifestyle modifications are necessary in order to cope with REM sleep behavior disorder.

You should make some changes in your bedroom such as:

• Clear the floor of furniture or objects to prevent injury,
• Keep away any sharp objects from the bedroom,
• Surround the bed with cushions as a precaution from falling,
• Your bed rails should be padded,
• Try sleeping on the floor if you have severe REM.

There are several risks and complications associated with REM sleep behavior disorder.

The risk factors are:

• Mostly men are diagnosed with this condition over 50 years old but nowadays many women are also diagnosed with this and under the age of 50,
• You have a chronic sleep disorder because there are narcolepsy at night,
• If you have a neurodegenerative disorder like Parkinson’s disease or dementia with Lewy bodies, sometimes this can be the first indication of a neurodegenerative disease,
• Taking antidepressants or use of alcohol and drugs,
• Personal risk factors such as previous head injury,
• Environmental risk factors such as smoking.

Complications are:

• Distress to people living in your home,
• injury to yourself or your sleeping partner.