What is REM Sleep Behavior Disorder?
Exploring an unusual sleep disorder associated with Parkinson's disease and Alzheimer's disease.
When Patients Act Out Their Dreams
A certain sleep disorder can endanger sleepers and their partners. Here's how to stay safe.
During the deepest phase of sleep, called rapid eye movement, or REM, most people have a lot of brain activity but experience a type of paralysis that keeps them from moving around while they dream.
For people with REM sleep behavior disorder, however, that paralysis doesn't work, and they may physically act out their dreams, kicking, flailing their arms, screaming, or even getting out of bed and walking around.
Both Parkinson's disease and Lewy body dementia are associated with REM sleep behavior disorder, says Jennifer Molano, MD, FAAN, of the University of Cincinnati. In fact, about half of those with Parkinson's disease may have the disorder, according to a 2013 study in the Journal of Clinical Sleep Medicine. "It not only may disturb sleep, but can injure the person and their bed partner or caregiver," says Dr. Molano.
Consider these strategies for dealing with the disorder:
- Enroll in a sleep study to confirm the diagnosis. Since obstructive sleep apnea can cause someone to act out his or her dreams, a sleep study is usually needed to make the definitive diagnosis of REM sleep behavior disorder.
- Review the medication list. Medications such as antidepressants can be associated with REM sleep behavior disorder and may need to be reduced.
- Discuss medication. Melatonin or clonazepam can help those with REM sleep behavior disorder, Dr. Molano says. Clonazepam may increase the risk of falls and can make nighttime breathing even worse for people with obstructive sleep apnea, says Dr. Westwood, so be sure to discuss risks and benefits and possible interactions with other medications with your doctor. In some cases, taking an extra dose of anti-Parkinson's medication before bed can alleviate the symptoms.
- Protect against injury. Consider adding extra padding on the headboard or put the mattress on the floor so the person doesn't fall out of bed, says Dr. Molano. "And keep anything dangerous, such as knives, weapons, or sharp objects, out of the room."