1. What Is REM Sleep Behavior Disorder?Every night, you go through four to five sleep cycles. Each cycle, lasting about 90 to 110 minutes, has four stages. That fourth stage is REM sleep.
But someone with REM sleep behavior disorder will act out their dreams. For poorly understood reasons, the dream content is usually violent—patients report being chased or defending themselves, and as they sleep, they shout, moan, scream, kick, punch, and thrash about.
REM sleep behavior disorder can occur at any age, but symptoms usually start in people in their 40s and 50s. For those younger than 40, antidepressants are the most common cause of REM sleep behavior disorder; in these younger patients, the disorder affects both sexes about equally, but past age 50, it’s more common in males.
2. What Causes REM Sleep Behavior Disorder?The disease mechanism is not well understood. In some cases of RBD, a clear cause cannot be identified. In other cases, the disorder may be caused by something specific, such as obstructive sleep apnea, narcolepsy, psychiatric disorders, use of antidepressants, autoimmune disorders, and brain lesions, which are areas of damaged brain tissue.
3. What Are the Links Between the Sleep Disorder and Dementia?RBD may be the first symptom of Parkinson’s disease or dementia with Lewy bodies. It is observed in 25 to 58 percent of patients diagnosed with Parkinson’s, 70 to 80 percent of patients with Lewy body dementia, and 90 to 100 percent of those with multiple system atrophy.
Some factors that independently increased the risk of developing a neurodegenerative disorder were irregular motor symptoms, abnormal dopamine levels, loss of sense of smell, cognitive impairment, abnormal color vision, erectile dysfunction, constipation, and older age.
4. Does an Early Diagnosis Help?For most neurodegenerative disorders, there is a phase that may last for decades in which brain changes are taking place, but the patient either remains asymptomatic or develops symptoms without the full expression of the disease. RBD, in that scenario, is an early sign of those disorders. Therefore, this provides an opportunity to study how the disease progresses in the brain and to develop therapies that could either slow this process or prevent it from happening.
Currently, there are no approved therapies to prevent the onset of these neurodegenerative diseases in those with RBD. There are, however, medications such as melatonin and clonazepam that may improve the symptoms. We also recommend measures to avoid injury, such as removing breakable objects from the room, protecting windows, and padding floors.