REM Sleep Behavior Disorder

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Normal sleep has2 distinct states: non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. NREM sleep is divided into4 stages. During REM sleep,rapid eye movements occur,breathing becomes irregular, blood pressure rises, and there is loss of muscle tone (paralysis).However, the brain is highly active, and the electrical activity recorded in the brain by EEG during REM sleep is similar to that recorded during wakefulness.REM sleep is usually associated with dreaming.REM sleep accounts for 20-25% of the sleep period.

In a person with REM sleep behavior disorder (RBD), the paralysis that normally occurs during REM sleep is incomplete or absent, allowing the person to "act out" his or her dreams. RBD is characterized by the acting out ofdreams that are vivid, intense,and violent. Dream-enacting behaviors include talking, yelling, punching, kicking, sitting, jumping from bed, arm flailing, and grabbing. An acute form may occur during withdrawal from alcohol or sedative-hypnotic drugs.

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