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REM Sleep Behavior Disorder

© November 2008 Anthony Lawrence

I came across this in a Discover Magazine article and had a flash of recognition: I have this disorder.

REM sleep is the period when you are dreaming. You are supposed to be paralyzed (atonia) at this time so that you don't act out (parasomnia). Sleep walking is an example of parasomnia, but REM Sleep Behavior Disorder (RBD) is characterized by more aggressive behaviour: kicking, punching.. people get hurt, either the person with the disorder or sometimes other people.

I've had this as long as I can remember. With me, the dreams almost always are that someone has broken into the house. I attack them, screaming loudly. When I say "attack", I mean exactly that: I've leaped out of bed, run across the house and done a flying tackle of an imagined intruder. I got rug burns out of that incident.

While in my teens I caught the thief (or murderer or whatever he was supposed to be) and tried to wrestle him to the ground. He was amazingly strong and I wasn't able to get him down.. I yelled for help ("I've got him! I've got him!"). When my sister came running, she found me holding my own wrist and flailing about wildly. My arm hurt for a week after that one.

Last year I broke a big toe. In that case, I caught the s.o.b. and was kicking him viciously..

Fortunately I have never hurt anyone other than myself. This has been a "normal" part of my life, so I never thought of it as a disease, but apparently it is: WebMD has a whole page on it.. Apparently it's most common in men over 60 and "may occur in association with various degenerative neurological conditions such as Parkinson disease". Oh, great..

It's a bit strange to think of this as a disease. I've experienced these things for so long it really does seem normal. Statistics for the number of people who have this problem are low, but they are probably also very inaccurate: like me, many people with RBD may never have thought it was anything for which they should seek medical help.

I'm most likely to have these incidents when I'm overtired or stressed. From what I've read, treatment with drugs such as Clonazepam can prevent this, but I don't like the idea of taking things with possible side effects that are much worse than a broken toe or some rug burns. On the other hand, my poor wife has to live with this too. Her sleep gets disturbed and of course she's worried that she might become the object of my aggression. I don't think that's likely, but I understand her fear so I have to do something.

In scouting about, I've read that melatonin might help this also. That has far fewer side effects, especially if I only take it when I think one of these episodes is likely. I'll try that first.

If I weren't a stubborn old coot, I might go see my doctor about this. Well, if the melatonin doesn't work, I will, but it's hard to imagine that this is anything degenerative after having had it for so long. I don't want to waste a lot of money and time on tests for things that I'm extremely unlikely to have.

So there we are. I thought it was just nightmares, but gosh no, it's a "disorder". I'll try melatonin and hope that it helps.

Sweet dreams.

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-> REM Sleep Behavior Disorder


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Tue Nov 11 17:16:46 2008: 4771   BigDumbDinosaur

When I say "attack", I mean exactly that: I've leaped out of bed, run across the house and done a flying tackle of an imagined intruder. I got rug burns out of that incident.

I couldn't help but laugh at the thought of you careening around the house, tilting at virtual windmills in your sleep-deprived mind. Lord only knows what your wife's reaction must have been the first time you went on one of your somnolent escapades! <Grin>

Seriously, thought, sleep disorders are nothing to laugh about and, as most anyone knows these days, have been linked to various health problems that can result in shorter longevity (is that an oxymoron?) or even death. I've long had a sleep disorder in which I seldom reach the REM stage of sleep and thus wake up fatigued and fuzzy-headed (my wife thinks the latter condition is congenital, BTW). Eventually, fatigue forces a proper night's sleep on me and I'm temporarily back in the groove -- only to be doomed to endlessly repeat the process.

Another sleep issue is apnea, which a lot of older people tend to suffer. I used to deal with apnea and finally went for help with it -- the problem is diagnosed with a test called a polysomnogram. Although I still seem to lack adequate REM sleep, when I do get it I don't seem to have an issue with apnea anymore.

Tony's mentioning of his sleep maladies highlights something very important that seems to get overlooked in the hustle and bustle of day-to-day life. Sleep serves a very important function beyond merely allowing the body to rest and rebuild. There is some sort of physical and psychological need buried deep within the brain for sleep, dreaming (especially about attractive members of the opposite sex) and all that entails, a need that is not fully understood by medical science at this time. What is known, however, is that you cannot make up for lost sleep, no matter how hard you may try. The time to get a good night's sleep is now, not later. If you have sleep problems, don't hesitate to discuss it with your family physician. He or she may not be able to directly help you, but can refer you to someone who can.

Wed Nov 19 17:33:56 2008: 4786   anonymous

Similarly, I've discovered this disorder this week and have had it as long as I can remember. Instead of intruders, I leap out of bed convinced that a huge lorry has driven at high speed into the house. I'm all ready to make a rope out of sheets and abseil from the window.
I have violent dream fights with a sister and I have bitten the top of my partner's head as a result. I frequently get into life or death situations where I need to punch my way out or fall down a hole (and out of the bed).
I also wake during pleasant dreams feeling groggy and exhausted. Your post was indeed funny but I realise the serious aspects. You are not alone.

Wed Nov 19 23:37:09 2008: 4787   BigDumbDinosaur

I leap out of bed convinced that a huge lorry has driven at high speed into the house.

Good thing you don't live adjacent to railroad tracks! <Grin>

Wed Nov 19 23:51:02 2008: 4788   TonyLawrence

The melatonin *may* be helping.. not sure yet. Tonight might be a good trst case. Very stressful day, cell phone running out of juice when it resurrected old messages. As I was trying to skim them quickly (because of the weak battery) I thought servers I had fixed had crashed again, that some customers had gone bonkers (asking same question again).. all while walking quickly to try to catch a train.. we'll see..

Fri Nov 28 04:12:31 2008: 4826   anonymous

My husband has RBD - happily for me, not to the same extent you describe. He kicks, but no biting or running around the house :)

Are either of you left-handed? My husband is, and I was thinking that RBD possibly had something to do with the somewhat non-standard brain wiring lefties often have.

I've also seen the dire predicitions of dementia and Parkinson's, but I think they're talking about late-onset RBD, not folks who've been exercising in their sleep all their lives...

Fri Nov 28 11:38:20 2008: 4827   TonyLawrence

I'm not left handed, though one of my sisters is and I am noticeably more ambidextrous than most people.

I'm still not sure about the melatonin. I haven't been "up and at 'em" since I started taking this, but I have come close.. we'll see.

Fri Nov 28 19:26:55 2008: 4828   BigDumbDinosaur

I am more or less ambidextrous. I started out as a lefty but thanks to Roman Catholic ignorance, ended up somewhere left of center (physically, not politically).

Thu Apr 9 16:35:36 2009: 6086   rpda

My Dad was diagnosed with a severe case of RBD about 9 years ago. After years of medications at increasingly higher doses (the body builds a tolerance over time), he is now being treated with a small dose of Klonopin and a high dose of melatonin with incredibly successful results. He has annual neurological check-ups and so far so good! My best wishes to all who have to deal with this condition and my thanks for speaking out about it.

Thu Apr 9 16:42:27 2009: 6087   TonyLawrence

I think the melatonin is reducing this for me, but it hasn't eliminated it. I haven't actually gotten out of bed since I started taking it, but I have sat up and screamed loudly a number of times.

My poor wife has trouble sleeping anyway because of her joint pain; she gets somebody that screams as a bonus..

Fri Apr 10 13:28:35 2009: 6094   BigDumbDInosaur

My poor wife has trouble sleeping anyway because of her joint pain; she gets somebody that screams as a bonus.

You're lucky she doesn't kick you out of the bedroom. <Grin>

Fri Apr 10 13:33:56 2009: 6095   TonyLawrence

Luckily for me the bed in the other bedroom is covered with stacks of her papers.. no place to throw me to..

Sun Apr 12 16:03:45 2009: 6137   BigDumbDinosaur

What makes you think she won't clean off the other bed for you? <Grin>

Sun Apr 12 16:13:55 2009: 6138   TonyLawrence

Ooops - we cleaned it off yesterday :-)

But that's cuz we're having company today..

Mon Apr 13 14:28:33 2009: 6155   BigDumbDInosaur

BTW, what do you think of my "improved" avatar? <Grin>

Mon Apr 13 14:35:03 2009: 6157   TonyLawrence

Great :-)

What does the text say? Too small for my eyes..

Tue Apr 14 14:05:43 2009: 6171   BigDumbDinosaur

It says, "Rawr! I will eat you!"

No, I didn't draw or caption that picture. It came from a site with dino pics.

Tue Apr 28 21:02:20 2009: 6274   TonyLawrence

At the suggestion of a neighbor, I tried a sleep mask.

It seems to be working. I'd hate to think what might happen if it doesn't: jumping up while asleep is bad enough, doing it blind could really get scary..

Sat May 23 20:10:28 2009: 6395   anonymous

My husband used to have extremely violent dreams (due to his horrific childhood) and would punch me-breaking my nose and poking me in the eye as hard as humanly possible. I would wake up with blood gushing form my nose and in pure agony as he tried to poke my eye out. Of course- he said he knew nothing of this and would get mad a t me when I would wake him up screaming in pain. I had to move out of the bedroom..as he would not- even though he was the one assaulting me...and we haven't slept in the same bed since- I've had to work seperate shifts and lock his door so he wouldn't come after me at night. This almost ruined out marriage and now I have glaucoma because of it.

This is a horrible thing to have to deal with and it usually stems from a violent childhood.

Now I have to suffer for the rest of my life because of it.

Sat May 23 21:35:50 2009: 6396   TonyLawrence

Well, I didn't have a violent childhood..

The sleep mask I've been wearing has cut this down dramatically. I haven't been out of bed yet, just some minor moaning and thrashing.. it definitely helps!

Thu Jan 28 07:20:32 2010: 7964   anonymous


Seek a sleep specialist! There are a lot of other treatment options such as CPAP or BIPAP... check it out and learn more about them. I work in a pediatric sleep lab and even kiddos have these problems. Good luck!

Thu Feb 25 20:09:52 2010: 8143   TonyLawrence


The sleep mask helps, but last night i had two bad ones while wearing the mask, so it isn't a complete solution.

Thu Feb 25 22:27:06 2010: 8144   BigDumbDinosaur


The sleep mask helps, but last night i had two bad ones while wearing the mask, so it isn't a complete solution.

Maybe your subconscious thinks that when you are wearing the mask you are the Lone Ranger and need to fend off an unknown assailant. <Grin>

Seriously, you should probably consult with a sleep specialist. This isn't going to improve with age, y'know.

Sat Jun 5 09:58:25 2010: 8660   LizaS


My husband also suffers from this violent sleeping disorder! He has kicked me, punched me, fallen out of bed and this has happened for years now. It's almost 6 am and I am on the computer because he hit me in the chest hard and woke me up. I never know when these "attacks" will happen. We sleep together in the same bed, but if I forget to put a large pillow between us at night, I can become his victim. He had a very troubled childhood and often he is fending off attackers in his dreams. I am going to strongly suggest he go to a local sleep disorder clinic as I am tired of being the "battered" person and losing my sleep as well! Thanks for letting me post this.
By the way, how are your sleep patterns now? It's June 5, 2010

Sat Jun 5 11:07:32 2010: 8661   TonyLawrence


That's hard. I have never hurt anyone but myself, which is fortunate. If I ever hurt my wife, I'd be crazed over it.

I sure didn't have a difficult childhood - quite the opposite. It's something in my brain wiring that must do this.

Try the mask. It may not help, but it reduced mine.

Sat Jun 5 14:23:01 2010: 8663   BigDumbDinosaur


My husband also suffers from this violent sleeping disorder! He has kicked me, punched me, fallen out of bed and this has happened for years now.

You need to make him see a sleep specialist ASAP. I can't imagine why you have tolerated this all these years.

Not too long after I met my wife I discovered she was a roller and kicker, and I could almost bank on at least one good kick per night. Being a light sleeper, that just wasn't going to work for me. So I sleep in the guest bedroom. She can roam all over the bed as much as she wants and I can make it through the night without getting belted or shoved out of the bed.

My mantra when it comes to this sort of stuff is "Never confuse sex with sleep." We sleep together for sex but not for rest.

Fri Jun 25 11:47:39 2010: 8745   anonymous


My husband has this and has had it for as long as we have been together 31 years. I recently was diagnosed with fybromyalgia/chronic fatigue syndrome. i don't know if you are familiar with this but it involves chronic pain and fatigue and there is a major issue with sleep. What came first the chicken or the egg kinda thing. Did it come from poor quality sleep or you hurt and cant sleep. Anyway someone moving around in bed most nights does not do a body good.

Fri Jun 25 12:03:54 2010: 8746   TonyLawrence


Yes, we have friends with fibromyalgia. That can be a terrible disease.

Fri Jun 25 13:44:21 2010: 8747   BigDumbDinosaur


The doctor who is treating me for ITP refers to fibromyalgia as a "fake disease" and is of the opinion that what is being called fibromyalgia is an amalgam of several unrelated issues, including clinical depression. As he is a professor of medicine at a well-known mid-western university and as there is no scientific consensus as to what fibromyalgia might be or that it even exists, I'm inclined to agree with him. Also, the fact that complaints of fibromyalgia are almost overwhelmingly on the female side creates a certain kind of suspicion as to what is really going on. More likely, what is being called fibromyalgia is a physical response to anxiety, stress and/or depression,

Sun Jul 25 22:24:17 2010: 8857   anonymous


I have had a similar dream twice over the last few weeks. In my dream I am defending myself against an attacker by kick boxing him, on both occasions I have fallen out of bed.

Thu Dec 9 16:33:42 2010: 9154   anonymous


i would like to ask some one how does having rbd affect your daily life ....what do you do that makes having the disorder dangerous

Thu Dec 9 16:37:56 2010: 9156   TonyLawrence


Obviously you can hurt yourself as I have done many times and people have hurt their bedmates - fortunately I have never done that!

Sat Mar 2 01:45:15 2013: 11920   Anonymous


There is a lot on the internet about this now as of 2013 and only hypotheses on it's cause.and no cure. Clonazepam if prescribed treats as well as causes the problem. Avoiding stress and getting to bed at a reasonable hour helps.Those who have had sleep disorders such as sleep walking all their lives are experiencing that within another sleep stage and don't have RBD. The prognosis is not good for RBD sufferers but a small percentage escape and have it for years without it developing further complications. How are you three years later? I have had it for about five years now but have no other signs of disease. I want to get off clonazepam but I understand melatonin as my neurologist says doesn't work - perhaps in combination with clonazepam as the earlier post suggests may avoid increases in clonazepam if clonazepam begins to lose its effectiveness and you don't want to increase the dose. Stem cell research is a hope for the future but unfortunately there is so little the medical field knows about this condition. Helpless all round.

Sat Mar 2 01:57:18 2013: 11921   TonyLawrence


Yes, stress and being over tired are definite triggers. I've also cut back on coffee to one cup a day and that may be helping.

I am taking no medications but really try to avoid getting worn out. That seems to be the best way for me to avoid incidents.

Sun Mar 3 18:31:35 2013: 11924   BigDumbDinosaur


Something that I have gotten into doing in the last year or so is "deteching" my mind before going to bed. I spend the final hour of each evening doing something that doesn't involve the use of electronics. No TV watching, no computer activity, no fiddling with the phone, etc. Usually I read a few pages of whatever book I happen to be reading at the time. Right now I'm working on Killing Kennedy and am about three-quarters through it (note aside, Killing Kennedy is very interesting and has a lot of good historical detail). I usually finish eight to ten pages before retiring. I'm finding that the "deteching" routine makes it easier to fall asleep.

Like Tony, I have a sleep disorder, although one that is considerably different. Some intermittent research appears to draw out a pattern. People who spend a lot of time working on complicated technology (e.g., computers) tend to have more frequent sleep-related problems than those who don't. I've also noted that doctors themselves tend toward sleeping problems. Apparently, the high level of cerebral activity required to be a good doctor (or computer jock) makes it harder for mental activity to slow to a crawl so one can fall asleep. I have no idea what, if anything, can be done about it, as I'm not about to quit working with computer technology, and I sure hope the hematologist who is treating me for my bleeding disorder doesn't decide to quit the medical profession and go to work for the post office.


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