Rapid eye movement sleep behavior disorder

MEDICAL EDITOR

Prab R. Tumpati, MD — Editor-in-Chief, WikiMD Medical Encyclopedia
Internal medicine • Obesity medicine • Sleep medicine
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Rapid eye movement sleep behavior disorder
File:Sleep-Related-Declarative-Memory-Consolidation-and-Verbal-Replay-during-Sleep-Talking-in-Patients-pone.0083352.s004.ogv
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Vivid dreams, acting out dreams, sleep talking, sleep walking
Complications	Injury to self or bed partner
Onset	Typically after age 50
Duration	Chronic
Types	Idiopathic, secondary to other conditions
Causes	Neurodegenerative disorders, medication
Risks	Parkinson's disease, Lewy body dementia
Diagnosis	Polysomnography, clinical evaluation
Differential diagnosis	Night terror, sleepwalking, nocturnal seizures
Prevention	N/A
Treatment	Clonazepam, melatonin
Medication	N/A
Prognosis	Variable, often associated with neurodegenerative disease
Frequency	Rare, more common in older adults
Deaths	N/A

Sleep Stage REM

Rapid eye movement sleep behavior disorder (RBD) is a type of parasomnia characterized by the loss of normal muscle atonia (relaxation) during REM sleep, leading to physically acting out dreams. People with RBD may exhibit violent or aggressive behaviors, often causing injury to themselves or their bed partners.

Symptoms

• Symptoms of RBD include:
• Kicking, punching, or flailing during sleep
• Shouting or talking loudly
• Falling out of bed or jumping around
• Experiencing vivid, action-packed dreams

Causes

• RBD can be caused by various factors, including:
• Neurodegenerative disorders, such as Parkinson's disease or multiple system atrophy
• Brainstem lesions or damage
• Withdrawal from certain medications, such as benzodiazepines
• Use of certain antidepressants

Treatment

• Treatment options for RBD include:
• Medications, such as clonazepam or melatonin
• Safety measures, such as padding the bed or removing dangerous objects from the bedroom
• Treating underlying medical conditions, if applicable

Summary

Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of RBD is loss of muscle atonia (i.e., the loss of paralysis) during otherwise intact REM sleep (during which paralysis is not only normal but necessary). The loss of motor inhibition leads to sleep behaviors ranging from simple limb twitches to more complex integrated movements that can be violent or result in injury to either the individual or their bedmates. RBD is a very strong predictor of progression to a synucleinopathy (usually Parkinson's disease or dementia with Lewy bodies). Melatonin is useful in the treatment of RBD.

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