Doctor's Notes on REM Sleep Behavior Disorder
During REM sleep, rapid eye movements occur, breathing becomes more irregular, blood pressure rises, and there is loss of muscle tone (relative paralysis), but the brain is highly active, and REM sleep is usually associated with dreaming. In REM sleep behavior disorder (RBD), the paralysis that normally occurs during REM sleep is incomplete or absent, and is characterized by a person acting out dreams that are vivid, intense, and sometimes violent.
The main symptom of REM sleep behavior disorder is dream-enacting behaviors that may be violent and cause injury to the person to the bed partner. Dream-enacting behaviors include talking, yelling, punching, kicking, sitting, jumping from bed, leaping, arm flailing, and grabbing. A common complaint includes a sleep-related injury. If a person wakes during the attack they can usually vividly recall the dream that corresponds to the physical activity.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.