REM Sleep Behavior Disorder – Symptoms and Causes
Overview
REM sleep behavior disorder causes people to physically act out their dreams during rapid eye movement (REM) sleep. This condition involves sudden movements and vocal sounds while dreaming.
Normally, the body remains still during REM sleep, which makes up about 20% of total sleep time. REM sleep primarily occurs in the second half of the night.
The disorder typically develops gradually and may worsen over time. People experiencing this condition often have vivid, unpleasant dreams that they physically express through movements that can sometimes be violent or aggressive.
REM sleep behavior disorder frequently appears alongside other neurological conditions, including:
- Lewy body dementia
- Parkinson’s disease
- Multiple system atrophy
This connection with other neurological disorders makes it an important condition for healthcare providers to identify and monitor. The abnormal muscle activity during what should be a period of physical paralysis distinguishes this disorder from normal sleep patterns.
Signs and Symptoms
People with REM sleep behavior disorder physically act out their dreams instead of being temporarily paralyzed during REM sleep.
This condition can begin gradually or suddenly. Episodes might happen rarely or multiple times each night, and often get worse over time.
Common symptoms include:
- Physical movements like kicking, punching, waving arms, or jumping out of bed when dreaming about action or violence
- Making sounds such as talking, laughing, yelling, emotional outbursts, or swearing
- Being able to remember the dream if woken during an episode
When Medical Help Is Needed
If you notice any of these symptoms or have other sleep problems, it’s important to speak with your healthcare provider. Early diagnosis can help manage the condition and prevent potential injuries during episodes.
Causes
During REM sleep, the brain typically activates pathways that keep muscles still. This natural paralysis stops people from acting out their dreams.
In REM sleep behavior disorder, these control pathways fail to work properly. When these brain circuits malfunction, people may physically move while dreaming.
These movements can range from small twitches to complex actions that mirror dream content. The disorder disrupts the normal sleep cycle’s protection mechanisms.
Risk Factors
Several factors might increase your chance of developing REM sleep behavior disorder:
Age and Gender:
- Men over 50 face higher risk
- Women under 50 are increasingly being diagnosed
- Young people and children can develop it, usually with other conditions
Health Conditions:
- Neurodegenerative disorders (Parkinson’s disease, multiple system atrophy)
- Stroke
- Dementia with lewy bodies
- Narcolepsy
Medications and Substances:
- Newer antidepressants
- Drug or alcohol use or withdrawal
Environmental Factors:
Research suggests these may play a role:
- Pesticide exposure through work
- Farming
- Smoking
- Previous head injury
Complications
REM sleep behavior disorder can lead to several issues. People may worry about disturbing their sleeping partners with their nighttime movements and sounds.
Some individuals might avoid sleeping around others due to embarrassment about their condition. This can lead to feelings of isolation.
The most serious concern is the risk of physical harm. People with this disorder may accidentally hurt themselves or their bed partner during episodes when they act out dreams.
