REM Sleep Behavior Disorder(Archived)

Rapid eye movement (REM) sleep behavior disorder (RBD) is a REM sleep parasomnia characterized by dream enactment during sleep. Patients often act out their dreams during the REM stage of sleep. Clinical features during sleep include abnormal vocalizations, abnormal motor behavior, and altered dream mentation. This enactment may be violent and can lead to injury to themselves or others without any conscious awareness. A patient can recall the contents of the dream upon awakening. Most patients with REM behavior disorder will eventually manifest neurodegenerative diseases like parkinsonism, dementia with Lewy bodies, or multisystem atrophy. There are also secondary causes of RBD associated with parkinsonism, narcolepsy, or the use of antidepressant medications. A patient may be warned about the future development of these neurological disorders. Treatment consists of preventive measures while sleeping to avoid injury to both the patient and their bed partner. In severe cases, the patient may be prescribed melatonin or clonazepam.