REM Sleep Disorder

What is RBD?

REM sleep behavior disorder, or RBD, is a type of sleep disorder known as parasomnia.  In these conditions, unusual or dangerous events occur that disrupt sleep. In RBD, these events take place during the REM phase of sleep, which is the deep dream state of sleep. For most people, REM sleep involves a temporary paralysis of the body’s muscles. But for people with RBD, that temporary paralysis never takes place, causing them to act out their vivid REM dreams physically—including punching, kicking, shouting, and grabbing—that interrupts their sleep. RBD occurs most often in middle-age to elderly people, affecting men more than women.


Symptoms of RBD may be gradual or sudden. Episodes may occur from time to time, or several times in one night. Symptoms usually worsen over time.

A person with RBD may show the following symptoms:

  • Movement during sleep, including kicking, punching, arm flailing or jumping from bed
  • Talking, laughing, crying, cursing, or emotional outbursts during sleep
  • The ability to recall a dream if awakened during an episode


A series of tests are used to diagnose REM sleep disorder, including a sleep study. It will almost always show a lack of paralysis during REM sleep. Below are the tests used to make the diagnosis.

Neurologic exam

Your doctor will use this test to look for underlying neurologic causes of RBD. Symptoms of this condition include slowness in movement, hand tremors, and muscle stiffness.


This test is the actual sleep study, and it’s the most important for diagnosing RBD. You’ll sleep at the sleep center while your brain, heart, muscle movement, eye movement, and respiratory movement are all monitored.

Imaging studies

A CT scan and MRI of the brain may be recommended if something abnormal is discovered during the neurologic exam.


During REM sleep, there are nerve pathways in the brain that prevent muscles from moving. When these pathways no longer work, the muscles aren’t temporarily paralyzed during sleep and you act out your dreams, causing REM sleep disorder to occur.

Risk Factors

  • Being a male over 50 years of age
  • Having Parkinson’s disease, stroke, or dementia with Lewy bodies
  • Having narcolepsy
  • Taking certain medication, especially newer antidepressants
  • Withdrawal from drugs or alcohol


REM sleep behavior disorder treatment may include both medications and lifestyle changes.


  • Melatonin
    Melatonin is a dietary supplement available over the counter. Your doctor may prescribe you use it as it can be as effective as prescription medications with few side effects.
  • Prescription Medications


For safety’s sake, persons may consider:

  • Using a mattress on the floor
  • Placing cushions around the bed, placing the bed against a wall, or installing bed rails
  • If you have RBD and get out of bed at night, sleeping on the ground floor
  • Keeping the area around the bed clear of other furniture or sharp objects
  • Moving the bed away from windows
  • Bed partners should sleeping in separate rooms until RBD symptoms are under control

Learn More About REM Sleep Disorder from Baptist Health

REM sleep disorder can be conquered. Start by scheduling an appointment with a Baptist Health primary care or sleep specialist today. 

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