Rapid Eye Movement Behavior Disorder: Information, Symptoms and Causes

Rapid Eye Movement Behavior Disorder (RBD): Information, Symptoms and Causes

Rapid Eye Movement Behavior Disorder (RBD) is a parasomnia sleep disorder characterized by the acting out of violent or dramatic dreams while in REM sleep.

RBD involves a dissociation between the various stages of sleep.

The average age of the onset of RBD is estimated to be around 60 years of age.

Symptoms

The major, and arguably only, abnormal feature or symptom of Rapid Eye Movement Behavior Disorder (RBD) is the loss of muscle atonia, that is the loss of muscle paralysis, during otherwise normal sessions of REM sleep. REM sleep is the stage of sleep during which the most vivid dreaming occurs, and the loss of muscle paralysis by RBD sufferers can lead to a wide range of behavioral releases during sleep. This extends from simple limb twitches to more complex integrated movements where RBD sufferers appear to be unconsciously acting out their dreams.

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The resulting behaviors and movements are often violent in nature and commonly result in injury to either the patient or their bed partner. Such injuries range from bruises and cuts to fractures, subdural haematoma, and other serious injuries.

In contrast, all other aspects of an RBD sufferer's sleep appear normal.

Causes

Approximately 60% of Rapid Eye Movement Behavior Disorder (RBD) cases are idiopathic (that is, they have no known cause).

However, the following are suspected or known causes for RBD:

Sex: RBD is far more common in males. Most studies report that only around a 10% of sufferers are female.

Please Note: This imbalance may be due to a referral bias, as violent activity carried out by men is more likely to result in harm and injury and is far more likely to be reported than injury caused to male bed partners by women. Or the imbalance may reflect a true difference in the prevalence of RBD as a result of genetic or androgenic factors.

Linked or Related Medical Conditions: It is now known that RBD appears in association with a variety of different injuries or medical conditions, such as:

Narcolepsy: this link is hardly surprising, as both RBD and Narcolepsy involve dissociation of sleep states probably arising from a disruption to the sleep control mechanisms.
Brain Injuries: RBD has also been reported following cerebrovascular accidents and neurinoma, indicating that damage to the brainstem area may precipitate RBD.
Drug or Alcohol Withdrawal: RBD may be acute and have a sudden onset if it is triggered by or associated with a drug treatment or withdrawal or with alcohol withdrawal.
Neurodegenerative Diseases: This includes RBD that is found in association with conditions such as Parkinson's disease and dementia with Lewy bodies, where it is often seen to precede the onset of neurodegenerative disease.

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