REM Sleep Behavior Disorder: Acting Out Your Dreams

All sleep disorders are inconvenient and often debilitating because we need sleep to function properly. REM Sleep Behavior Disorder, however, is one of the most difficult sleep disorders to live with. About 25% of your total sleep is composed of REM sleep, which is usually the time when you dream and when your brain is most active. REM stands for "rapid-eye movement" because the eyes are often active during REM and most people experience vivid dreams during this stage of sleep.

One of the most telling signs of REM sleep is a muscle paralysis that comes over the body, which is nonexistent in patients with REM Sleep Behavior Disorder. This disorder causes the patient to "act out" their dreams during REM sleep, which can often result in harm to the patient or to others sleeping in the same bed. The brain is still as active as ever and the dreams are just as vivid, but the patient acts as though he or she is actually "in" the dream, and the muscles in the body respond to fear, anger, apprehension and anxiety as though the patient were actually experiencing the dream in reality.

Who is Subject to REM Sleep Behavior Disorder?

The most common patients to suffer from REM Sleep Behavior Disorder are middle-aged men, though it can also appear in women and in the elderly. A few cases have been reported of children and teenagers who have the disorder, but this is uncommon; usually, REM Sleep Behavior Disorder is developed later in life.

What Causes REM Sleep Behavior Disorder?

The exact cause of this disorder is unknown, but approximately half of the patients who report experiencing it are suffering from alcohol or drug withdrawal. This can occur when going off of prescribed medications or recreational drugs and when a patient stops a prolonged abuse of alcohol. The tendency of certain people to develop REM Sleep Behavior Disorder is thought to be at least somewhat genetic, though the precise reasons for proclivity have not been determined.

What Are the Symptoms of REM Sleep Behavior Disorder?

The symptoms can vary, but usually include violent movement during sleep. Patients may yell, punch, kick, bite, flail, jump out of bed, grab objects and attempt to leave the room. The severity of REM Sleep Behavior Disorder varies among patients, but many people suffer or inflict injuries during REM sleep. The greatest danger is presented to anyone sleeping in the same bed as someone with the disorder because they are often the target of violence.

What Can You Do About REM Sleep Behavior Disorder?

If you or someone you sleep with has REM Sleep Behavior Disorder, the following tips can help prevent injury or damage:

1. Remove objects from the room which may pose a danger to the person with REM Sleep Behavior Disorder. This could include anything that can be picked up and thrown or swung as well as any sharp objects. Hair brushes, lamps, nail files, television remotes, hair dryers and other objects could potentially be dangerous in a bedroom.

2. Keep the sides of the bed clear. Since people with REM Sleep Behavior Disorder often get out of bed in their sleep, remove anything on the sides of the bed over which that person could trip or fall.

3. Sleep on the floor. It can also help to sleep on the mattress on the floor rather than on a bed frame so that if the patient falls out of bed, he or she won't be injured. If this isn't possible, place couch cushions or large body pillows along the sides of the bed.

4. Sleep downstairs. If the patient has a habit of leaving the bed during an episode, sleep on the ground floor so that stairs aren't an issue. A person experiencing REM Sleep Behavior Disorder doesn't have any respect for objects that might pose a danger, so eliminate the possibility of a tumble down the stairs.

If you sleep in the same bed with someone who has developed REM Sleep Behavior Disorder, it would be a good idea to sleep in another bed until the symptoms have subsided. In extreme cases, the patient will need a bed with padded rails to keep him or her from causing too much damage.