Updated: July 20, 2021

REM Sleep Behavior Disorder (What it is and what it means for sleepers and their bed partners)

Written by Sumit Pandey

REM Sleep Behavior Disorder is a parasomnia, or a sleep disorder, that involves acting out of one's dreams during REM sleep. It is also known as "RBD." It is a disorder that is characterized by the loss of muscle paralysis during REM sleep and the subsequent acting out of dreams.

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 Although it has only recently been recognized as a legitimate disorder, it is associated with several other disorders including Parkinson's disease, Alzheimer's disease, narcolepsy, and depression. 

It has been seen in people up to the age of 90 and in both sexes equally. It is likely to occur only in one hemisphere of the brain at a time, and it affects only that one side of the body.

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The most effective treatments for RBD are clonazepam and sodium oxybate. Clonazepam has been used to treat RBD since the 1980s, but recently, sodium oxybate has been found to be even more effective. Clonazepam works by increasing GABA, an inhibitory neurotransmitter in the brain. 

Sodium oxybate, however, works by increasing GABA directly, while also increasing serotonin. Both of these drugs are effective, but it is unclear which is more effective. The drug is not offered to people with a history of substance abuse because it is an illegal substance in some places. 

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For people who do not respond to clonazepam or sodium oxybate, the next step is to treat depression.

What causes REM Sleep Behavior Disorder?

REM Sleep Behavior Disorder is typically caused by a degeneration of the brainstem. The brainstem is responsible for activating muscle paralysis during REM sleep. When this part of the brain degenerates, muscle paralysis does not occur while dreaming.

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There is some evidence that the amygdala is activated during REM sleep, which decreases the ability to control motor function during REM sleep.

What are the best-known treatments for REM Sleep Behavior Disorder?

The most effective treatments for RBD are clonazepam and sodium oxybate. Clonazepam has been used to treat RBD since the 1980s, but recently, sodium oxybate has been found to be even more effective. 

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Clonazepam works by increasing GABA, an inhibitory neurotransmitter in the brain. Sodium oxybate, however, works by increasing GABA directly, while also increasing serotonin. 

Both of these drugs are effective, but it is unclear which is more effective. The drug is not offered to people with a history of substance abuse because it is an illegal substance in some places. 

For people who do not respond to clonazepam or sodium oxybate, the next step is to treat depression.

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Conclusion

REM Sleep Behavior Disorder affects approximately one percent of the population. It tends to occur in older people and may be related to degeneration of the brainstem. 

It can affect anyone, but it is more common in males than females. The most commonly used treatments for RBD are clonazepam and sodium oxybate. 

Clonazepam helps prevent muscle paralysis during REM sleep and thus prevents acting out of dreams. Sodium oxybate has been found to be even more effective than clonazepam. 

The drug may be used to treat narcolepsy or sleep apnea as well as OSAHS or OSAS by itself or in combination with other methods. It can also be used as a treatment for depression in those without a history of substance abuse.

Frequently Asked Questions

  • Sleep disorders affect 20% of adults, and 50% of those over age 65. Sleep disorders can include: insomnia, obstructive sleep apnea (OSA), restless legs syndrome (RLS), PLMS, narcolepsy, and periodic limb movement.

  • A sleep study is a sleep test done in a sleep lab during the night. A sleep doctor is an expert in the diagnosis and treatment of sleep disorders.

  • PSG is the gold standard for diagnosing sleep disorders, and is also helpful in diagnosing breathing, heart and gastro issues that can cause sleep problems. It is usually done in a sleep lab. A polysomnogram is a test that records brain waves, eye movement, muscle tone, heart rate and breathing while you sleep. It helps diagnose and treat a variety of sleep disorders. The test is usually done overnight in a sleep center or hospital.

  • An overnight sleep study is an overnight stay in a sleep center or hospital where a polysomnogram (PSG) will be done. It is usually done in the evening (or afternoon following an afternoon nap). You will be monitored while you sleep, and have an opportunity to discuss any issues you have with the doctors and technicians. You may also have an opportunity to discuss and treat any breathing issues.

  • An APG is a daytime sleep test done in a sleep room at your doctor's office or sleep center. The room is equipped with a computer and all the necessary equipment to do a polysomnogram (PSG) during the day. The APG may be done instead of or in addition to a PSG at night. An APG may be requested if you have been experiencing sleep problems but cannot have a PSG for some reason.

  • A MSLT is a daytime test where you are given four or five opportunities to take a nap over the course of one to two hours. If you fall asleep within five minutes on three opportunities during the daytime MSLT, you are considered to have excessive daytime sleepiness.

Written by Sumit Pandey

My name is Sumit Kumar Pandey and I’m a content writer and blogger who specializes in writing about technology, web design, and online marketing. After working as a research scholar in the engineering field for many years, I’m now a full-time content writer, helping people get more exposure and generate more leads for their businesses.

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