REM Sleep Behavior Disorder

People who suffer from REM sleep behavior disorder act out their dreams without knowing they are physically responding to dream sequences during sleep. REM stands for rapid eye movement, which occurs in the fifth of five sleep stages when dreaming takes place.

During REM sleep, the brain can be as active as it might be during waking hours. However, the body is frozen so that your muscles don’t move during dreams.

The muscle paralysis is temporary and occurs as a natural part of the sleeping process. Yet sometimes during REM sleep, the processes break down and the muscle paralysis does not work properly. This creates the parasomnia.

People with REM sleep disorder get out of bed and copy the movements and actions in their dreams. They have no idea they are moving around while dreaming. Usually a partner or someone in the home notices the problem. If dreams are violent, people can unintentionally hurt themselves or others.

Potential Causes 

REM sleep behavior disorder is more common in men than in women. The onset of the condition typically starts in middle age or later, though it can occur earlier. The symptoms can mimic other parasomnias, including sleep talking and sleep walking.

The cause of this parasomnia is not fully understood. Research has shown that acting out dreams may be linked to neurological conditions such as Parkinson disease, multisystem atrophy, or dementia.

It also may be associated with alcohol or drug withdrawal or the use antidepressants. Some studies indicate that lesions in the brain may be the cause of this problem. More studies are needed.


For an accurate diagnosis, a doctor will compile a complete medical history, perform a physical exam, and order neurologic testing.

In addition, an overnight sleep study at a qualified sleep diagnostics center is usually necessary to confirm a diagnosis and help identify the best course of treatment. Reports by a bed partner are also helpful in diagnosis.


Tranquilizers like Clonazepam are the treatment of choice for alleviating symptoms and have shown to be effective about 90 percent of the time.

Yet for individuals with sleep apnea or who experience site effects such as continued grogginess upon wakening, the diet supplement, melatonin, is often recommended as an alternative.

Individuals who suffer from REM sleep issues should avoid alcohol and certain medications - and follow a regular sleep schedule.

Additionally, creating a safe sleeping space is important. Removing sharp objects, blocking windows, and padding objects around the bed can help prevent potential injury until symptoms subside with treatment.

More on REM Sleep Behavior Disorder
Sleep Walking
Sleep Talking
Five Stages of Sleep

› REM Sleep Behavior Disorder

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