Thursday, October 22, 2015

REM sleep behavior disorder: Symptoms, risk factors, and treatment

The rapid eye movement (REM) sleep phase occurs approximately 90 minutes after a person goes to sleep.  During REM sleep, the brain is very active, often resulting in vivid dreams. REM sleep is marked by rapid eye movements, irregular breathing, and temporary paralysis.  The temporary paralysis in REM sleep prevents the sleeper from acting out dreams.


Symptoms

A person with REM sleep behavior disorder (RBD) experiences loss of paralysis, which results in him or her acting out dreams.  While people without RBD rarely make any movements during REM sleep, people with the disorder perform actions they made in their dreams, such as:

• Jumping out of bed

• Kicking

• Punching

• Talking or yelling


Unlike sleepwalking, people with RBD do not have their eyes open, walk, or leave their rooms. 


Image sourceplus.google.com

When they have awakened, people with RBD remember details of the dream they were having.  However, they might not be aware that they were acting it out. 


Risk factors

Risk factors for RBD include being male, being older than 50 years of age, and having a neurodegenerative disorder. 

Recent research published in the journal Neurology also suggests that environmental factors, such as smoking, a recent head injury, pesticide exposure, are possible risk factors for RBD.

Treatment and management

Management and treatment of RBD involve injury prevention and medication. 


The patient's sleeping area must be made into a safe environment, and sharp objects and weapons must be removed.  If the patient has a bed partner and tends to become violent during sleep, his or her partner might need to sleep in another room.  Other precautions include padding the bedroom floor and reinforcing windows.

Clonazepam, a drug used to treat seizures and panic disorders, has proven to be very effective in treating RBD in 90 percent of patients.  Clonazepam needs to be taken by RBD patients indefinitely, as stopping can lead to recurrence of RBD.  It controls the symptoms but does not cure RBD.

Other drugs used to treat RBD include tricyclic antidepressants and melatonin. 

Patients who have RBD with no discernible cause can rely on management and medication to treat their symptoms for the long-term.  People who suspect that they might have RBD should consult a physician for a diagnosis and to determine whether an underlying neurological condition causes it. 

Dr. Lisa Marie Cannon is a physician who specializes in treating sleep disorders.  For related articles and news, subscribe to this blog.

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