The REM Behavior Disorder (RBD) is a sleep disorder characterized by the disruption of REM sleep, resulting in the acting out of vivid, intense, and often violent dreams. Unlike normal REM sleep, which is normally associated with complete muscle atonia (paralysis), individuals with RBD have decreased muscle atonia, which allows them to physically manifest their dream activities.

Subtypes of REM Behavior Disorder:

  1. Idiopathic RBD: This subtype refers to RBD that occurs spontaneously with no identifiable cause or underlying neurological disorder.
  2. Secondary RBD: This subtype stems from an underlying neurological condition or associated factors such as medication or substance abuse.

Causes and Risk Factors:

  • Neurodegenerative diseases (e.g., Parkinson’s disease, multiple system atrophy)
  • Certain medications (e.g., antidepressants, antipsychotics)
  • Substance withdrawal (e.g., alcohol, sedatives)
  • Brainstem abnormalities


  • Vocalizations, such as shouting, moaning, or swearing
  • Kicking, punching, or other forms of physical movements during sleep
  • Presence of violent or aggressive dreams
  • Injury to the individual or their sleep partner due to dream enactment
  • Excessive sleepiness during the day


Diagnosing REM Behavior Disorder involves:

  1. Evaluating the individual’s medical history and conducting a physical examination.
  2. Performing a sleep study (polysomnography) to monitor brain activity, muscle movements, and other physiological signals during sleep.
  3. Ruling out other sleep disorders or medical conditions that may mimic RBD symptoms.


The treatment options for REM Behavior Disorder may include:

  • Clonazepam or other sedative-hypnotic medications to suppress muscle activity during sleep
  • Implementing safety measures in the sleep environment to prevent injury
  • Addressing any underlying neurological conditions, if present
  • Avoiding substances or medications that may aggravate RBD symptoms