REM sleep behavior disorder (RBD)
Find a doctorAre you or someone you know experiencing unusual behaviors while you sleep, such as talking, shouting or even physical movements? These could be signs of REM (rapid eye movement) sleep behavior disorder (RBD).
REM sleep behavior disorder disrupts the muscle paralysis that typically occurs during REM sleep, causing you to act out your dreams physically. This disorder is often associated with neurodegenerative diseases like Lewy body dementia and multiple system atrophy, particularly in older adults.
Aurora Sleep Medicine Centers can help you overcome REM sleep behavior disorder by identifying any underlying conditions or sleep disorders.
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What is REM sleep behavior disorder?
REM sleep behavior disorder is a sleep disorder where you physically act out vivid dreams during the REM stage of sleep.
Normally, your muscles are temporarily paralyzed during REM sleep, but with RBD, this paralysis is incomplete or absent, allowing you to move while dreaming. These movements can be quite dramatic and may include talking, yelling, punching, kicking or even jumping out of bed.
What is REM sleep?
REM sleep is a distinct phase of your sleep cycle characterized by rapid movement of the eyes, vivid dreams and increased brain activity. During REM sleep, your brain becomes highly active, like when you’re awake, while your body experiences temporary muscle paralysis.
The stages of sleep
Your sleep cycle consists of several stages, including non-REM (NREM) and REM sleep. The cycle repeats multiple times throughout the night. Here is an overview of the stages of sleep:
- NREM stage 1: This is the lightest stage of sleep, where you drift in and out of sleep. Your muscle activity slows, and your eyes move slowly.
- NREM stage 2: In this stage, your eye movements stop, and brain waves become slower. This stage makes up the largest portion of your sleep cycle.
- NREM stage 3: Also known as deep sleep or slow-wave sleep, this stage is crucial for physical recovery and growth. It’s difficult to wake up from this stage.
- REM sleep stage: Typically occurring 90 minutes after falling asleep, REM sleep is when most dreaming happens.
What are the causes of REM sleep behavior disorder?
The exact cause of REM sleep behavior disorder is not entirely understood. However, it is often linked to neurodegenerative diseases, such as multiple system atrophy or Alzheimer's disease. Additionally, withdrawal from certain medications and substances (especially alcohol or sedatives) can trigger RBD. Idiopathic RBD, where no underlying cause is identified, is also common.
What medications cause REM sleep behavior disorder?
Some medications are known to influence REM sleep and potentially cause RBD. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), and other psychiatric medications can increase the likelihood of developing RBD. Withdrawal from alcohol, sedatives or other drugs can also lead to REM rebound, which happens when you get more REM sleep than normal due to withdraw. It can develop into RBD.
What are signs of REM sleep behavior disorder?
Signs of REM sleep behavior disorder include physically acting out dreams, making sounds like talking or shouting, and moving limbs vigorously during sleep.
These actions can be violent and may pose a risk of injury to yourself or your bed partner. If you or someone you know exhibits these behaviors, it’s impotent to schedule an appointment with a sleep medicine specialist.
Sleep studies for REM sleep behavior disorder
Diagnosing RBD typically involves a sleep study, known as polysomnography. This study records brain waves, blood oxygen levels, heart rate, breathing, and eye and leg movements during sleep. In some cases, an at-home sleep test may be available to you.
A sleep study can help confirm the diagnosis of RBD and rule out other sleep disorders. It provides valuable information for tailoring a treatment plan specific to your needs.
How to stop REM sleep behavior disorder
Managing REM sleep behavior disorder often involves a combination of medication and lifestyle changes. Clonazepam, a medication commonly used to treat anxiety, is often prescribed for RBD.
Melatonin supplements may also be effective. Additionally, making your sleep environment safer by removing dangerous objects and padding the floor around your bed can prevent injuries. Stress management techniques and maintaining a consistent sleep schedule can also improve REM sleep and reduce RBD episodes.
How to improve REM sleep
Getting enough REM sleep is crucial for your mental and overall health. Here are some tips to help you enhance the quality and duration of your REM sleep:
- Maintain a consistent sleep schedule
- Avoid drastic changes to your sleep schedule, including on the weekends
- Create a sleep-friendly environment by keeping your bedroom cool, dark and quiet.
- Limit screen time before bed
- Manage stress
- Avoid caffeine and nicotine
- Limit alcohol consumption
- Address underlying sleep disorders
- Keep up with prescribed treatments for sleep disorders
If you continue to experience sleep difficulties, consider reaching out to a sleep medicine specialist for further evaluation and guidance.
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