Could REM Sleep Behavior Disorder Kill You in Your Sleep?

Written by Adam Rothman with contributions by Kevin Morton, Winter 2010

REM sleep behavior disorder (or RBD) is truly one of the most intriguing, and indeed troublesome, sleep disorders known to man.

In essence, it causes the afflicted individual to act out their dreams to some extent. Can you imagine that?! Thinking about some of the dreams I've had, I know I could seriously harm myself or others if I ever unknowingly acted them out, even if in my room.

And indeed, REM behavior disorder has led to some gut-wrenchingly tragic tales. Extreme cases where RBD afflicted individual have unwittingly murdered truly loved spouses lying next to them in bed have caused some of the most intense grief. With the help of sleep experts, the court cases that follow these events have become incredibly intricate and complex, and in some cases the defendants have been acquitted. (Learn about some of these cases, and other incidences of violence during sleep.)

To understand how REM sleep behavior disorder works, you have to understand one characteristic mechanism of REM sleep. To do this, we'll start with a short hypothetical story.

But first, have you or anyone you know ever been affected by REM sleep behavior disorder? Maybe you have it yourself?

Share your RBD story with us and our visitors. We would love
to hear about it--your thoughts and experiences are highly valued to us.

You go to sleep one night, exhausted from the day's activities. Over the course of the next few hours you have an incredibly vivid dream in which you walk, run, and jump all around your home. Even though you're asleep, your brain is wide awake and experiencing these activities. Every movement you make in-dream is accompanied by an equivalent instruction from your brain to the appropriate body part. And yet, when most people awaken the following morning, they remain safely in their beds. So what keeps them there?

The REM (rapid eye movement) phase of sleep is the most active time of night for the brain. Unsurprisingly, this is also the phase of sleep during which most vivid dreams occur.

During normal REM sleep, certain parts of the body experience muscular atonia: a temporary paralysis. This atonia prevents the instructions sent by the brain from being carried out by the body. In other words, you have atonia to thank every time you wake up exactly where you fell asleep.

REM sleep behavior disorder is characterized by the occasional failure of this atonia. The brains of patients who suffer from REM sleep behavior disorder have complete control over their sleeping bodies, allowing (often exaggerated) motor activity to occur in relation to what is happening in the dream.

The loss of paralysis can result in movement ranging from minor twitching to thrashing and/or leaping. In the most extreme cases, REM behavior disorder patients have been known to act out entire dreams. As alluded to when we mentioned the tragic deaths above, if the dream is violent in subject matter, the patient's actions can be harmful to him/her or those around him/her.

Incredible huh? What do you think about this? Let us know!

The severity of REM behavior disorder is determined based on the frequency of episodes and their duration, completeness, and tendency towards violence. Frequencies range from once every few weeks to multiple episodes per night. Episodes are typically between two and ten minutes in length.

REM Paralysis, or REM Atonia A rather complex diagram illustrating the neural explanation of REM paralysis

RBD is caused by a dysfunction of the brain stem mechanisms responsible for the normal suppression of muscle tone and paralysis in REM sleep. The condition is most prevalent in men over the age of fifty (though it has been observed in both men and women of all ages). It remains unknown why the condition appears to preferentially affect males. In all patients, the condition is chronic and progressive.

Fortunately, RBD is highly treatable with a variety of medications. Clonazepam, an anticonvulsant, muscle relaxant, and anxiolytic, is the most common prescription (1-2 mg at bedtime). Because episodes can occasionally overcome medication, dangerous objects should be removed from the patient's room and appropriate measures should be taken to ensure the safety of the patient and his/her sleeping partner.


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Have You Ever Been Affected By REM Sleep Behavior Disorder?

RBD is intuitively and scientifically extraordinary, but it can be even more extraordinarily disrupting to those who are affected by it.

Share your RBD-related story with the world below--your insight is sure to aid others who can relate to what you have experienced, and provide perspective to those who can't relate personally.

Enter the Title of Your Story (ex: "How REM Sleep Behaviour Disorder Influenced My Life")

Read Other Stories About REM Sleep Behavior Disorder

Click on the links below to read stories of others who have thoughts, experiences, and stories related to REM sleep behavior disorder. They were all written by other visitors to this page, just like you.

I Bit My Baby In My Sleep 
It was the scariest thing. I woke up because he was crying and instantly knew I was biting him. And remembered that I was biting down hard..I was fighting …

He Almost Strangled Me - My Then Husband's RBD 
My then husband was having a nightmare one night. He was 6'2" and 240 lbs., I was 5'7" and 135 lbs. As he lay sleeping on his stomach, I lay sleeping beside …

My Husband Attacked Me In My Sleep Due To REM Behavior Disorder And I'm Terrified 
My husband and I have had a great marriage. He's a wonderful man who wouldn't hurt a fly, and wouldn't let anyone hurt me, especially never himself. He's …

Painful Awakenings, How RBD Is Affecting Me 
My husband and i have been together for over 9 years. In the beginning of our relationship he would tell me of nights where he kicked the wall while sleeping. …

84 Year Old Man That Beats The Crap Out Of Himself At Night 
My husband's father, 84 years old, literally beats the hell out of himself at night. He sleeps in a chair and we can hear him kicking and screaming, thumping …

I Punched The Head Board 
One night I was dreaming that this guy and taken my candy bar right from my hand and proceeded to eat it right in front of me. After telling him to give …

My Story, My Head, My New Life 
All journeys start with the first step, so I thought it appropriate to start at the beginning, almost. No boring stories from my childhood, as they are …

Scared To Death To Sleep - Chatting About REM Sleep Disorder 
My name is Judy. I am 64 years old and have just been diagnosed with rem sleep disorder . This disorder has scared me to death. I would love to chat with …

Good Man By Day....Violent Man While Sleeping...Or Awakened... 
My boyfriend is a napper, sleeper etc. He takes a nap pretty much every day. He falls asleep and within minutes starts talking out loud a gibber jabber …

Long Ago Episode and Present Day Troubles 
Hi. Many years ago I had several incidents of REM Sleep Behaviour Disorder (never diagnosed but obviously this was it). In one of them I dreamed that …

Vivid Night Terrors All My Life - 28 y/o 
I’m a 28 year old female and have been suffering from night terrors and nightmares since as long as I can remember. This might get a little winded so bare …

How Treating My Sleep Apnea Helped My RBD 
I think I developed RBD in my late 30's early 40's. Until then I barely moved while I slept - I could tell because the sheets were always still neat in …

Worried By This Article! 
Especially worried about "In all patients, the condition is chronic and progressive." My husband has it, but he's not as yet convinced he has to seek …

Help Me To Understand 
My son's girlfriend told us that the round, red welt on my 10 month old grandson's head was from her dreaming about fighting with someone and in her dream …

My Fiance Runs Around Asleep 
My fiance has yet to go to the doctors to be diagnosed, though he promises me he will go this week! I believe he has REM Sleep Behaviour Disorder (RBD) …

My Nights Are A Living Hell 
First i want to say sorry for my english. I am from the Netherlands. I am 27 years old and i have RBD for several years now. The most terrible things …

Stuff Our Crazy Family Does In Our Sleep 
My mother talks in her sleep and you can converse with her, so you need to double check if she asks you to do something crazy. She flails. She bit my …

RBD - My Story 
I am a 28 year old female who has been diagnosed with RBD along with another sleeping disorder on top of it to make it even more complicated... Apparently …

Stitches, Bruises and Cuts, Oh My 
I am a 67 year old female with RBD . Am in excellent health other than this 'affliction'. Have had it for many years and just recently flew out of bed, …

How To Take Care Of Yourself After An RBD Episode 
There isn't much information available at all about RBD, and therefore, aftercare advice is nonexistent. As a victim of my own neurology, I have this to …

RBD Is Killing Me and Potentially My Wife! 
I'm almost age 70. I'm a retired business executive who used to have a very stressful job. Every night, I dream. Sometimes my dreams are about unimaginably …

Could I Have REM Sleep Behavior Disorder?  
Hi, I'm a 21 year old college student and I've recently been researching REM sleep behavior disorder . After reading many people's stories I'm not convinced …

Can I Have RBD This Young? 
I am an 18 year old female and I think I may have RBD . I'm not sure how often I experience it because I don't sleep in the same room with anyone but …

I'm Afraid Of Hurting My Wife While Sleeping! 
I've never been told that I talked in my sleep - not until now. I am in my mid-fifties, and a few years ago my wife noticed that I was starting to talk …

Click here to write your own.

Smoked Pot Everyday For 35 years, Then Quit And Had RBD 3 Weeks Later 
I have always slept like a champion, and have been a daily pot smoker for 35 years. I refer to pot as sleep therapy before bed. I have always slept like …

RBD Study - Volunteers Needed 
We are conducting a research study on REM sleep behavior disorder in Sunnyvale, CA. Please contact us for additional information.

Sleep Walker and Dream Actor - Until Klonopin Stopped My RBD 
I am a 41 year old female. I have always been a sleep walker, sleep talker, and sleep thrasher. My cousins always thought it was fun to spend the night …

Odd Acting Out of My Dream 
I dreamed one night that my bedroom was flooding with water, but the living room down the hall was dry. I took everything off of my bed, carried it into …

Bump In The Night - "I'm never surprised when I awake to find bruises or blood" 
I'm 28 and I've had REM Sleep Behavior Disorder since I was a child. I only today realized what the official diagnosis was. Everyone always called …

Wall v. Nose. A Cookie Story 
OK, so I'm not diagnosed, but i am at least 95% sure I have RBD . This is a funny story and one of the reasons I think I have it. So, i am dreaming …

I'm Too Young For This - Willing To Be An RBD Study Subject 
I'm 22, female, and I obviously have this. I take forever to go to sleep. I've had it for as long as I can remember. As a child I had night terrors, me …

Attacking Partner In Sleep-27 yrs old and very concerned 
For the last couple of weeks I have been experiencing vivid dreams, more vivid than usual. I have more & more regularly been talking out loud & waking …

Do I Have RBD? 
I will have a dream about struggling and fighting someone and if someone grabs my arm in my dream, I will wake up with a bruise on my arm from when I saw …

Possible REM Disorder 
I don't know if I quite fit the criteria because I've only had 4 episodes in the last 2yrs and 8mo, 2 have happened abroad and 2 have happened since being …

My Worst Experience of REM Sleep Behavior Disorder 
I BIT my sweet little granddaughter! How do you explain to your grown daughter that you bit her child while the two of you were napping together? It's …

RBD Not So Extreme In My Case 
I am a 32 year old female. I've had this all of my life as far as I can tell. My first college roommate was a sweetheart to put up with my talking, flailing, …

Going To Be Checked Out for REM Sleep Behavior Disorder 
I'm a 41 year old male and have a lifetime of "funny" episodes where I acted out dreams. I used to think I was just a "sleepwalker", and that it was just …

A Cure For The Symptoms Of REM Behavior Disorder 
I have had RBD for at least 15 years. I had violent dreams about 3 times a month. A doctor prescribed Lunesta. It does not work as a sleep aide, but …

Click here to write your own.

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