REM Sleep Behavior Disorder – Symptoms and Treatment Explained


Sleep disorders are particularly challenging as they disrupt one of the processes that we need the most. This often results in serious issues which interfere with major parts of our overall lifestyle.

One of the rather unusual sleeping conditions is called REM sleep behavior disorder. It’s a rather rare one, and it is believed to appear in under than 1% of the population. Let’s find out more about it.

What is RBD?

This is a condition which gets you to act out your own dreams while you sleep. These dreams are often particularly vivid and could easily involve a myriad of different motions. It is quite different than sleepwalking and night terrors mainly because you can easily recall the thing you were dreaming of when you wake up.

This is a rare condition and it was believed that it affects mostly men. However, recent findings show that it takes place in women as well with a frequency which is quite similar. It could be treated with prescribed medication but it is known to occur with other sleep conditions which could easily require some additional treatment.

If you are diagnosed with it, you should definitely be monitored by a specialist. This is due to the fact that it could be symptomatic of a neurodegenerative disease or it could easily be caused by the intake of certain medications.


The condition usually manifests within a short episode which could include you talking, flailing, shouting, grabbing, kicking, jumping, punching and other motions of the kind. Once you wake up, you are most likely to remember certain details of your dream which would match your behavior. For instance, you might jump out of bed to run away if you dream that you’re being chased by someone.

In the majority of cases, the episodes take place within the first 90 minutes after you effectively fall asleep. Some people, however, could experience those later on throughout the night. You could easily have as much as four episodes in just one night or they could be much less frequent.

A man wakes up after a nightmare


Now, as you fall asleep, your body will go through stages of REM and non-REM sleep. The former is related to dreams and it is one of the most important components of the entire cycle. It would take place for about 90 minutes to as much as 2 hours every night.

Throughout the REM phase, your muscles are actually paralyzed temporarily as your brain is dreaming actively. In certain situations, the chemical which will cause your body to remain absolutely still while your brain continues to be active could fail. This is how RBD is developed or how narcolepsy or sleepwalking takes place.

If you suffer from RBD, your muscles wouldn’t be paralyzed as they should be. This will allow your body to react to whatever it is that your brain is projecting.

Associated Risks

Now, according to the NSF (National Sleep Foundation), men are actually in slightly bigger risk to develop this particular condition than women. It usually takes place after the individual turns 50. If you have a neurological disorder such as Parkinson’s, for instance, you are likely to be at larger risk. The same goes for multiple system atrophy which is similar to Parkinson’s in certain regards.

The risks associated with RBD, on the other hand, include the off-chance of developing:

  • Periodic limb movement disorder
  • Sleep apnea
  • Parkinson’s disease
  • Narcolepsy

Of course, there is no certainty that RBD will actually cause these and in the majority of cases it doesn’t, but it should be a signatory call that you visit your doctor and get yourself thoroughly checked out.

doctor check up

Diagnosis & Treatment

To get a proper diagnosis, visiting a specialist is absolutely imperative. Your doctor would have to perform a special neurological exam and he might even refer you to a neurologist if you need more extensive testing.

Additionally, the doctor could monitor your actual sleep patterns and you could be asked to keep a sleep diary. You might also have to fill out a special Epworth Sleepiness Scale which determines the way your sleeping patterns interfere with your regular life. You might also be asked to perform a study.

Regarding REM sleep disorder treatment, the majority of cases are taken care of using medication. The most frequently used drug out there is called Clonazepam. However, your doctor might also decide to prescribe melatonin in the form of a dietary supplement – this could help you get rid of the symptoms.

However, it’s important to make sure that you take a few precautions. You should treat any other associated disorder and avoid certain medications as well as alcohol. Additionally, it’s advisable to remove all objects away from your bed and maintain a proper bedtime.

Future Outlook

Now, it goes without saying that in the majority of cases, the condition is taken care of successfully with nothing but medication. If you take clonazepam, you might experience certain associated side effects. Memory issues, confusion, morning sleepiness or lack of balance are some of the most common ones. The medication could also worsen your case of sleep apnea.

On the other hand, you could start using melatonin which could relieve the symptoms and cause little to no side effects at all. This is also an important consideration. You should also get yourself checked out regularly for different neurological conditions such as Parkinson’s disease, for example.


While it may appear to be all fun and games, RBD is nothing to be taken lightly. If you notice that your partner acts out during his sleep, you ought to consider the off-chance of him or her having RBD. Going to the doctor is quite important. If you sleep alone, pay attention to your bedside objects – make sure that they are not moved throughout the night. And, in any case – move your bed away from the window.

The important thing to consider here is to act quickly as if you manage to interfere on time, and the consequences could be a lot less harmful altogether.

Sources and References:

  1. RBD: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions –
  2. “Handbook of Clinical Neurophysiology” –
  3. “Clinical Neurophysiology” –

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Author: Sleep Advisor



Sleep Advisor