REM sleep behavior disorder

Symptoms vary from one person to another and it may occur once every month or several times during one night. In this condition, the normal temporary paralysis in muscles doesn’t occur, which results in symptoms such as :

Movements such as Kicking, punching, jumping from bed, and flailings as if the patient is protecting himself
Vocalizations such as Speaking, shouting, laughing, and swearing
Viewing the dreams as nightmares and dreaming of people chasing him or his relatives or friends and he’s trying to defend them
Being able to recall the dream if he was awakened during the episode
Visit a General Practice doctor who may refer you to a Neurologist to be diagnosed and treated properly, If you or one of your family have any of these symptoms

Normally certain brain chemicals lead to temporary paralysis during sleeping and dreaming. This condition is caused due to imbalance in these brain chemicals which disrupts the normal process, which makes the patient act out his dream.

Risk factors associated with this disease development may include :

Age (>50 years)
Being a man
Having a sleep disorder called “Narcolepsy”
Certain medications (ex: antidepressants)

Diagnosis depends on the symptoms in addition to other diagnostic tests such as :

Physical and neurological examination : To exclude any other condition causing these symptoms.
Polysomnography : A type of sleep study in which several parameters such as brain waves, heart rate, and oxygen levels are monitored during sleep to help in diagnosis.
Diagnostic criteria : Certain conditions should be fulfilled to confirm the diagnosis and they include :
The presence of repeated episodes of abnormal movements or vocalizations.
These abnormal behaviors are documented by a sleep study and occur during REM sleep or can be inferred from clinical history to occur during REM sleep.
The sleep study shows that the patient experiences REM sleep without muscle paralysis.
The disturbance is not better explained by other sleep disorders, mental disorders, or medication use.

Creating a secure sleeping environment for patients and their bed partners is the main objective of treatment. This can be accomplished by non-pharmacologic and pharmacologic methods.

Lifestyle modifications :

Moving sharp and rigid objects away from the bed
Placing pillows or other soft items between the patient and structures (such as the headboard or nightstand)
Placing a mattress on the floor adjacent to the bed and/or using padded bedside rails
Stopping the use of medications that exacerbate this condition such as antidepressants
Sleeping in bed alone
Avoid using alcohol
Medications :

Some medications are useful in treating this condition such as Melatonin and Clonazepam.