REM Sleep Behavior Disorder
A Guide To REM Sleep Behavior Disorder
Most people have heard of REM sleep, but few have ever heard of REM Sleep Behavior Disorder, also known as REM Behavior Disorder or RBD. As we know, REM stands for rapid eye movement, which is 1 of the 2 normal sleep stages. During REM sleep, the eyes move rapidly, breathing increases, blood pressure rises and the body enters a state known as atonia, or sleep paralysis.
REM sleep usually occurs when a person is dreaming, and this is what makes REM Sleep Behavior Disorder alarming. A person with RBD has all of the typical symptoms of REM sleep except the atonia. This means that the person becomes active during their dreams, basically acting them out, instead of entering sleep paralysis.
Behavior exhibited by people with RBD can include talking, sitting up, getting out of bed, walking around, hitting, kicking, shouting, fighting – basically anything one might do if they were acting out a dream sequence. Even more alarming is that RBD seems to happen more during violent dreams, making the movements more dramatic and potentially dangerous to the sleeper and anyone nearby.
REM Sleep Behavior Disorder is usually seen in older people, mostly men, and it has no known cause. It is thought that RBD may be related to other neurological illnesses such as Parkinson’s disease, stroke, dementia, narcolepsy, multiple sclerosis and Guillaine-Barre syndrome. Studies have provided some evidence that RBD may actually be a precursor to Parkinson’s disease. One study showed that 38 percent of RBD patients developed Parkinson’s disease within 12 to 13 years. RBD has been reported in an estimated 70 percent of people who already have Parkinson’s disease.
RBD is also a known side effect to some antidepressant drugs. It can occur both while taking certain depression medicines and also during withdrawal from some of the drugs. These include tricyclic antidepressants as well as serotonin reuptake inhibitors like fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil). The symptoms of RBD usually disappear once the antidepressants are completely out of the system. The best way to avoid RBD when coming off of these kinds of medications is to eliminate the drug gradually.
Most of the time RBD sufferers have no memory of their actions during the night, but they can usually recall the dreams because they are extremely vivid and often violent. Because these dreams can involve chasing, running and jumping, there is significant chance of injury to the sleeper or anyone they share the bed with.
RBD patients are generally treated with Clonazepam, which is a benzodiazepine used to treat epilepsy and convulsions. The Clonazepam blocks neurotransmitters and allows people with RBD to achieve sleep paralysis during REM sleep, and it is usually very effective treating this disorder.