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REM Sleep Behavior Disorder

Updated on June 6, 2021
Sam Shepards profile image

I'm Sam. I enjoy writing about sleep and mental health-related topics as well as ways to prevent stress and to relax.

REM Sleep Behavior Disorder, or RBD for short, is a parasomnia whose cause is still relatively unknown. The primary abnormality of RBD is the loss of sleep paralysis, a necessary constituent during the dreaming phase of sleep. This causes the individual to act out their dreams physically, often leading to turbulent behavior such as punching, kicking, walking, and speaking out loud. The estimated prevalence of this disorder is only .4 to .5 percent of the general public.

What is REM Sleep?

What is REM sleep and why do we need it so bad? Rapid Eye Movement sleep or REM sleep is characterized at the fifth of the five stages of sleep that most human beings go through each night. It is termed REM sleep due to the quick movements the eyes will make during this stage.

How does a sleep cycle work?

The period of non-REM sleep is comprised of stages one through four. Each stage can last up to fifteen minutes. A completed sleep cycle must progress through these initial stages before reaching the REM stage. As the stage of sleep cycle throughout the nighttime hours, they may repeat as many as five times. The length and intensity of the REM stage grows exponentially with each cycle. For example, the first cycle may result in a ten minute long REM stage, whereas it may last up to ninety minutes in the last cycle.

During this stage of sleep, it is found that the person’s breathing and heart rate are faster than normal. You may notice that the person’s legs, face, and fingers twitch as they experience this intense dreamlike state. Of course, as the name implies, you will also notice rapid movement of the eyes during this stage. The person may or may not remember their dreams upon waking.

What Affects REM Sleep?

REM sleep by age

The time a person spends in the REM sleep stage may be affected by age, with babies and children remaining at that stage for the longest period of time. The length will decrease as a person enters adolescence and will decrease even further in old age. It has been shown that people who are deprived of adequate REM sleep may have problems with their memory and have trouble learning new things.

On average 2 hours a night

People typically spend about two hours each night in this dreamlike state. It is not known why we dream, but our dreams may be linked to our subconscious desires. What we do know is that the mind processes the experiences of the previous waking period when dreaming.

REM sleep for mental and physical health

Making sure you get enough REM sleep is very important to your overall mental and physical health. It is considered the restorative part of the sleep cycle. If for some reason, your REM sleep cycle becomes disrupted for even one night, your body’s inner clock will be thrown off. Your sleep cycles will progress in the way they usually do and you will slip immediately into the REM stage due to the fact that you did not get the right amount of sleep the night before. It is possible that you will experience an extended period of REM sleep until your body catches up on this stage. A disruption to your sleep cycle can cause you to awake groggy and you may experience a lack of concentration.

REM sleep behavior disorder side-effects

For individuals stricken with RBD, the side effects can be devastating; the inability to sleep naturally beside a partner being one of the more prevalent difficulties. Due to the constant physical interruptions during the sleep schedule, it is almost impossible for an RBD sufferer’s partner to sleep appropriately without intervention.

Thankfully, there are medications that can assist with this issue that have as high as a 90% success rate. When the proper medication is found, the debilitating aspects of REM sleep behavior disorder can be controlled, in turn leading to a much more physically and psychologically healthy lifestyle.

REM sleep behavior disorder treatment options

The most popular treatment for REM sleep behavior disorder, clonazepam, is tremendously effective. It provides total control over the disorder in 79% of patients and moderate improvement in 11% more. Another great aspect of this medication is that it has a high tolerance and can actually work on the very first night. Side effects are not common but can include confusion and increased sleep apnea. Overall though, this is a powerful and useful medication that has changed a multitude lives.

For individuals desiring a more natural sleep aid, melatonin has been found to assist with REM sleep behavior disorder symptoms in a surprisingly high amount of patients. Just note that until you achieve the correct dosage, light side effects may occur. Yet, when the proper regimen amount is achieved, many RBD sufferers sleep just fine with melatonin alone; not requiring medical intervention at all.

A local sleep study in Portland, Oregon, as an example of melatonin efficacy, prescribed a varying array of drugs to a middle-aged REM sleep behaviour disorder patient. After failing with anti-depressants, and even clonazepam, the physician recommended a low dose of melatonin. The following is an excerpt from the patient’s results:

“After trying a multitude of medications to help my husband and me recover from RBD, our doctor decided to try a common hormone called melatonin. After four years of difficulty, my expectations couldn’t be lower. You can’t imagine my surprise; after all we went through, to see his RBD controlled by such a simple over the counter supplement. Ecstatic doesn’t even begin to convey it.” –Cindy Cooper

Such an outcome provides a promising method for those with REM sleep behavior disorder to finally discover a means of recovery. Given the power of melatonin in this situation, it can be recommended to first time suffers before needing to advance into more clinical trials and medications. Such an option can be a godsend to those looking for an inexpensive alternative to clinical behavior trials and expensive medication.

Concluding REM sleep behavior disorder

For those of you that suffer from RBD and are at a loss as to finding a proper REM sleep behavior disorder treatment, the options described above can provide you an indispensible means of recovery. Given the often unbearable effects of RBD, it’s a huge relief to know that there are opportunities available that can not only help control this disorder, but often stop it entirely.

How to improve REM sleep

Even when you don't suffer from REM sleep behavior disorder you can benefit from better REM sleep. It may be necessary for you to adjust your sleeping habits in order to achieve the sleep you need. In order to increase your rem sleep you can do the following:

  • Maintain a regular sleep schedule each night
  • Work at creating a relaxing bedtime routine (read a book, take a bath, etc.)
  • Keep your stress levels managed
  • Try to stay away from a big meal and rich foods at night
  • Avoid drinking alcohol before bed
  • Minimize the amount of caffeine you drink in the afternoon and evening

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2016 Sam Shepards


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