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Blog Feature

By: AAST Editor on April 18th, 2019

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RBD: The Kicking and Screaming Sleep Disorder

Sleep Disorders | strange sleep

Sleepwalking, yelling in your sleep, violently thrashing in bed and hurting those you love. No, it’s not a demonic possession; it is REM sleep behavior disorder, or RBD.

RBD is a sleep disorder that common presents itself in older men and causes people who suffer from it to physically act out their dreams. Its cause is unknown, but its effects can be terrifying.twittericon_2

Most of us experience dreams, but thanks to REM suppression of muscle activity, we don’t have persistent physical reactions to them. During REM, our brains are working hard — about the equivalent of what it would be doing if we were to take a walk. Most people enter a state of temporary muscle paralysis during this time, which allows our brain to work hard but our body to rest.

For those with RBD, REM does occur and causes them to dream. But the paralysis doesn’t. As a person with the disorder sleeps (and dreams), they have a physical response to what’s happening in their brain. This ranges from the mundane — benign sleepwalking or sleep talking — to the violent and aggressive.

In a 1985 paper that first identified the disorder, Mark Mahowald, MD, and Carlos Schneck, MD, described some of their patients punching and kicking their spouses in the midst of a bad dream.

This isn’t to say everyone who ever experiences this has RBD. Researchers believe the disorder is very rare, and affects less than 1% of the population. Children and adults experiencing other psychological disorders are prone to night terrors, which occur in the non-rapid eye movement (NREM) sleep cycle. Other non-paralysis sleep activity can be explained by a variety of things: medication, sleep deprivation, illness, etc. 

Researchers aren’t sure exactly what causes the disorder, but studies done in animals showed cats that had lesions on their brain stem exhibited symptoms similar to RBD. These lesions were on the part of the brain stem that affected locomotor activity. Other research shows a link between RBD and another mysterious illness. Mahowald and Schneck found of the 29 otherwise healthy patients they saw with RBD, 39% of them went on to develop Parkinson’s disease.

While not much is known about RBD, there are effective forms of treatment. Sleep studies can aid in diagnosing RBD, and prescription medicine has increased quality of life for a majority of those with the disorder.