Rapid eye movement (REM) sleep behavior disorder is a sleep disorder in which you physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep — sometimes called dream-enacting behavior.
You normally don't move during REM sleep, a normal stage of sleep that occurs many times during the night. About 20 percent of your sleep is spent in REM sleep, the usual time for dreaming, which occurs primarily during the second half of the night.
The onset of REM sleep behavior disorder is often gradual and it can get worse with time.
REM sleep behavior disorder may be associated with other neurological conditions, such as Lewy body dementia (also called dementia with Lewy bodies), Parkinson's disease or multiple system atrophy.
Symptoms
With REM sleep behavior disorder, instead of experiencing the normal temporary paralysis of your arms and legs (atonia) during REM sleep, you physically act out your dreams.
The onset can be gradual or sudden, and episodes may occur occasionally or several times a night. The disorder often worsens with time.
Symptoms of REM sleep behavior disorder may include:
Movement, such as kicking, punching, arm flailing or jumping from bed, in response to action-filled or violent dreams, such as being chased or defending yourself from an attack
Noises, such as talking, laughing, shouting, emotional outcries or even cursing
Being able to recall the dream if you awaken during the episode
Risk factors
Factors associated with the development of REM sleep behavior disorder include:
Being male and over 50 years old — however, more women are now being diagnosed with the disorder, especially under age 50, and young adults and children can develop the disorder, usually in association with narcolepsy, antidepressant use or brain tumors
Having a certain type of neurodegenerative disorder, such as Parkinson's disease, multiple system atrophy, stroke or dementia with Lewy bodies
Having narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness
Taking certain medications, especially newer antidepressants, or the use or withdrawal of drugs or alcohol
Recent evidence suggests that there may also be several specific environmental or personal risk factors for REM sleep behavior disorder, including occupational pesticide exposure, farming, smoking or a previous head injury.
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