What is it?

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.

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Signs & 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

Diagnosis

To diagnose REM sleep behavior disorder, your doctor reviews your medical history and your symptoms. Your evaluation may include:
* Physical and neurological exam
* Talking with your sleeping partner
* Nocturnal sleep study (polysomnogram)- Doctors may recommend an overnight study in a sleep lab. During this test, sensors monitor your heart, lung and brain activity, breathing patterns, arm and leg movements, vocalizations, and blood oxygen levels while you sleep. Typically, you'll be videotaped to document your behavior during REM sleep cycles.

Treatment

Treatment for REM sleep behavior disorder may include physical safeguards and medications.
Physical safeguards- Your doctor may recommend that you make changes in your sleep environment to make it safer for you and your bed partner, including:
* Padding the floor near the bed
* Removing dangerous objects from the bedroom, such as sharp items and weapons
* Placing barriers on the side of the bed
* Moving furniture and clutter away from the bed
* Protecting bedroom windows
* Possibly sleeping in a separate bed or room from your bed partner until symptoms are controlled

Medications- Examples of treatment options for REM sleep behavior disorder include:
* Melatonin
* Clonazepam (Klonopin)

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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