ROUND 1: SLEEP FIGHTING? AKA REM SLEEP BEHAVIOR DISORDER
by Amie Peterson, MD
REM Sleep behavior disorder, also known as RBD, is a sleep disorder commonly seen in persons with Parkinson's disease. REM stands for rapid eye movements and is the stage of sleep during which dreaming occurs. Generally the body is intentionally paralyzed during sleep with only the eyes being able to move hence the name rapid eye movements of sleep. In persons with RBD the body is not effectively paralyzed during sleep, and they are able to act our dreams. This often involves hitting, kicking, punching, leaping out of bed, and running. It can result in significant injury to the person with RBD, as well as his or her bed-partner.
RBD often presents many years prior to Parkinson's disease or other related disorders, such as multiple system atrophy or Lewy body dementia. It is estimated that up to 1 in 3 people with Parkinson's may have RBD. Men more often have RBD as compared to women. Thankfully there are very effective treatments.
If you have these symptoms it is important to tell your doctor. A low dose clonazepam, a prescription medication called benzodiazepine, tends to be extremely effective. Your doctor may also want to have you undergo an over-night sleep study. This can be helpful for a number of reasons. Sometimes treating sleep apnea if present can help with RBD symptoms. Also, clonazepam can reduce respiratory drive so it is best to treat any sleep apnea symptoms prior to starting this medication.
Frenette, E. REM Sleep Behavior Disorder. Med Clin N Am 2010; 94: 593-614.