Overview and Facts

Rem Sleep behavior disorder (RBD) is a parasomnia. A parasomnia involves undesired events that happen while sleeping.

RBD occurs when you act our vivid dreams as you sleep. These dreams are often filled with action. They may even be violent. Episodes tend to get worse over time. Early episodes may involve mild activity. RBD is often ignored for years. At some point it is likely to result in an injury. Either the person dreaming or the bed partner may be hurt. 

RBD can be confused with sleepwalking and sleep terrors. In these other disorders, the sleeper is usually confused upon waking up. He or she does not become rapidly alert. In contrast, it is normally easy to wake a person with RBD who is acting out a dream. Once awake, he or she is also able to recall clear details of the vivid dream. 

Signs and symptoms of REM Sleep Behavior Disorder include any of the following actions: 

  • Sleep talking
  • Shouting
  • Screaming
  • Grabbing
  • Hitting or Punching
  • Jumping
  • Leaping
  • Kicking

Sleep involves transitions between three different states: 

  • Wakefulness 
  • REM Sleep
  • Non-rapid eye movement sleep

REM Sleep behavior is associated with dreaming and occurs during REM Sleep. During this state, the electrical activity of the brain looks similar to the electrical activity that occurs during walking. 

Treatment for RBD

RBD tends to respond to treatment medications. Clonazepam is often used. However, treatment also requires the following: 

  • Bedroom safety precautions - move objects away from the patient's bedside including night stands, lamps or other objects that could cause injury.
  • Move the bed away from the window.
  • Place a large object such as a dresser in front of the window.
  • Maintain a normal total sleep time. Sleep deprivation can increase RBD. Monitor for any sleepiness.
  • Avoid certain medications and alcohol. They can cause or increase RBD.
  • Treat any and all other sleep disorder that will disrupt your sleep and increase RBD.
  • Undergo regular monitoring for any neurologic symptoms. This includes tremor or other Parkinson symptoms. 

© 2018 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns.