Reminiscence of your Dreams: REM Sleep Behavior Disorder
"It was the most bizarre dream I've ever had!"
Many of us have a lot to laugh at the bizarre situations we face while drifting through REM (rapid-eye movement) sleep.
Marri Horvat MD, MS is a sleep specialist and neurologist who discusses RBD, its effects on your sleep, and the treatment options.
What's Rem sleep behavior disorder?
REM is a normal time when our bodies become paralyzed. This exception being our eye muscles, and diaphragm which allow us to breathe.
RBD means that you are no longer restricted by a switch within your brainstem, or your brain, and your muscles can perform the actions in your dream," Dr. Horvat explains.
These symptoms can manifest in violent, outlandish behavior. These signs can be:
- Punishment, including kicking, punching and grabbing.
- Jumping from bed.
- Follic language.
Dr. Horvat states that "you can injure yourself diving out from bed into a chest or drawers, running against a wall or hitting windows." Inadvertently striking a partner in bed can lead to injury. Ironically, this is while you are trying to keep them safe from their nightmare.
RBD is a relatively rare condition. RBD is a rare condition that affects less than 1 percent of adult patients. This condition is more common among men, and those who were born males (DMAB), over 50. But RBD can develop earlier in life - even in children.
Dr. Horvat states that RBD can be seen in young patients with antidepressant drugs or as a result of narcolepsy.
What Rem Sleep Disorders Can Do to Your Quality of Sleep
Dr. Horvat states that each stage of sleep is cycled through between 90 and 120 minutes. Your REM sleep lengthens with each cycle.
RBD is most common in the second half of the evening, but sleepwalking or night terrors are more likely to happen during the first third.
Your safety is crucial if your partner has REM sleep disorder.
Dr. Horvat states that the best thing you can do is to modify your bedroom environment . You must make your bedroom safe.
There are many options to consider:
- Place your mattress on the ground so that you are less likely to slip.
- Move furniture from the bed to ensure you don't get hit by anything when you dive or run.
- Take out any weapons or knives that could be dangerous.
- You can cushion the corners of your bedroom furniture.
Elle adds that "we also encourage your partner to sleep in another bedroom or bed until your REM-related disorder is under control."
Others Factors It is common for RBD and parasomnias to be accompanied by:
- Sleep-related eating disorder.
- Confusional arousals.
- Night terrors
This happens to both men and women DMAB, as well as people who were born females. They are often affected at younger ages.
Night terrors or sleepwalking may seem like RBD but are actually disorders of arousal. Although your eyes may be open but you aren't able to recall, they're aware of what's around you.
Dr. Horvat says that this is why sleepwalkers can navigate their way through their bedrooms, out of the house and even drive cars. "REM Sleep disorder causes you to lose awareness of your surroundings and it is impossible for you to get too far from your bed.
RBD can be mimicked by seizures, sleep apnea and sleep terrors.
RBD has been linked to multiple neurodegenerative conditions, including Parkinson's disease and Lewy body dementia.
Studies indicate that people with RBD have a greater than 80% likelihood of developing one of these neurodegenerative diseases within 10 to 12 years of developing RBD.
Scientists are hard at work to create early diagnostic tests for the brain and drug treatments that may protect it.
Dr. Horvat says that "if we can find a drug which is neuroprotective, then we might be able stop, arrest or even reverse further degeneration."
What is Rbd?
RBD can be diagnosed with a combination of clinical history and sleep studies.
"A prior study geared to diagnose sleep-disordered breathing like obstructive sleep apnea can miss the diagnosis; you need one specifically for RBD," according to Dr. Horvat.
Sleep studies allow experts to observe whether your muscles are paralyzed during REM sleep. They are looking for an increase in muscle tone during REM sleep.
RBD symptoms can be managed with medication, but they cannot be cured.
"Medications may reduce the frequency of these events, quieten disruptive screaming, and enable partners to share a bed in safety, which is wonderful," Dr. Horvat says.
Melatonin is the most safest and easy to take. For effective treatment, however, you may need to take high doses of melatonin. Clonazepam (a benzodiazepine) is the other medicine that's commonly used. This medication can be used for anxiety and seizures.
Dr. Horvat states that while Clonazepam may be effective for controlling certain symptoms, many patients cannot tolerate the side effects. They include:
Cognitive issues, which can worsen memory problems.
You may experience sleepiness in the morning, and difficulty getting up at the morning.
The risk of falling increases when there is unsteadiness.
The drug can worsen sleep apnea because it relaxes your throat muscles. According to Dr. Horvat other drugs can cause RBD or even unmask it.
Some antidepressants, such as venlafaxine(r), can cause symptoms like hyperactivity and tremors. If you have these symptoms, your doctor will likely recommend that bupropion (Wellbutrin®) be switched to an alternative.
Dr. Horvat says that many people don't share their dreams with their doctors.
She emphasizes that even though you may feel embarrassed by your situation, you should talk to your physician about it. We can discuss ways that you and your partner are safe, and we will be sharing the bed.