🕷️ Crawler Inspector

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Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 37 (from laksa180)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa037.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx","crawl_time":1774909568,"first_indexed_time":1500582076,"http_code":200,"src_unparsed":"com,everydayhealth!www,\/sleep\/other-disorders\/rem-behavior-disorder.aspx s443","src_root_hash":"6011348653682764837","history_drop_reason":null,"meta_title":"What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment","meta_descriptions":["Learn about REM sleep behavior disorder, a rare condition in which individuals physically act out their dreams during REM sleep. Understand its symptoms, causes, diagnosis, treatment options, and potential link to neurodegenerative diseases."],"attrs_boilerpipe_text":"Have you found yourself kicking, punching, or even leaping out of bed in the middle of a vivid dream? For people with REM sleep behavior disorder, dreams don’t just stay in their minds. \nREM sleep behavior disorder (RBD) is a rare parasomnia in which you physically act out your dreams while you’re in the rapid eye movement (REM) stage of sleep, according to the\nCleveland Clinic\n.\nREM sleep is typically when we dream. Our blood pressure rises, our breathing deepens, and our eyes dart in all directions. During normal REM sleep, we don’t move. Our bodies go into temporary muscle paralysis, called atonia, while our brains are\n    wide awake with activity, according to a study published in the\nAnnals of the New York Academy of Sciences\n.\nHowever, for people with REM sleep behavior disorder, this normal muscle paralysis doesn’t happen. Instead, they experience everything from small muscle twitches and whispering to punching, kicking, shouting, and jumping out of bed. They may\n    even hurt themselves or others.\n“The way we describe it clinically is when you act out your dreams. Most people don’t realize that they’re doing these behaviors — it is usually reported by their bed partners,” says\nMichael Breus, PhD\n, a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine.\nThere are two main types of REM sleep behavior disorder, according to John Cline, PhD, a Connecticut-based licensed clinical psychologist specializing\n    in sleep medicine and a diplomate of the American Board of Sleep Medicine.\nIsolated (Idiopathic) RBD\nIn these cases, the condition doesn’t have an underlying cause. But it may be an early warning sign of a neurodegenerative condition such as Parkinson’s disease,\nLewy body dementia\n,\n or multiple system atrophy, according to the Cleveland Clinic.\nSymptomatic (Secondary) RBD\nThese cases have an underlying cause such as narcolepsy or a drug side effect.\nSigns and Symptoms of REM Sleep Behavior Disorder\nThe main symptom of REM sleep behavior disorder is physically acting out your dreams, because your body isn’t immobilized like it should be during REM sleep. It may start suddenly or come on gradually but typically gets worse over time. You may have episodes every once in a while or several times in a night.\nOther symptoms, according to the\nMayo Clinic\n, include:\nMaking noises like talking, laughing, shouting, or yelling for help\nBeing easy to awaken during an episode, coherent afterward, and able to recall the dream \nUnpleasant dream content like arguments, accidents, or attacks\n“Typically, these are violent dreams,” says Dr. Cline. “One patient was waving their hands because they dreamt they were swarmed by bees, and then, more rarely, there are situations where people have done complex things like diving out of bed because they dreamt they were on a diving board.”\nEpisodes often happen in the second half of the night into the morning, when you experience longer phases of REM sleep, according to the\nSleep Foundation\n.\nCauses and Risk Factors of REM Sleep Behavior Disorder\nRBD appears to come from a problem with certain nerve pathways in your brain. But it isn’t clear why it happens.\n“We don’t know the exact cause, but what appears to be happening is that when you are in REM sleep, you should be in a state of atonia, or paralysis, specifically so you do not act out your dreams. And this mechanism appears to be not working,” Dr. Breus says.\nCertain things make you more likely to develop it, according to the Sleep Foundation:\nBeing male and over 50 years old\nHaving a neurological disorder like Parkinson’s disease, Lewy body dementia, or multiple system atrophy\nHaving narcolepsy\nUsing antidepressants\nUsing or withdrawing from drugs or alcohol\nThe Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. “As a general guideline we do tend to see this in our older sleepers,” Breus says.\nSleep deprivation, smoking, head injury, and exposure to pesticides may also be risk factors.\nHow Is REM Sleep Behavior Disorder Diagnosed?\nMore often than not, RBD is first reported by a patient’s bed partner, then it’s formally diagnosed with a sleep study, Breus says.\nAccording to the American Academy of Sleep Medicine, a patient must meet the following\nfour criteria\n:\nYou have repeatedly experienced episodes of acting out your dreams with vocalizations or arm and leg movements that correspond to what’s taking place in your dream.\nEpisodes occur during REM sleep, as confirmed by a sleep study or your clinical history.\nYou experience REM sleep without atonia, as confirmed by a sleep study.\nThe episodes aren’t caused by another sleep or mental health disorder, a side effect of medication, or substance abuse.\nIf you often act out your dreams, talk to your doctor. They’ll ask about your sleep behavior and may have you keep a sleep diary to document how often you have episodes and what goes on during them. They’ll also consider your medical history, medications you're taking, and other factors like alcohol intake.\nThey may refer you to a sleep specialist for an overnight sleep study, or polysomnogram. During this test, sensors will monitor your breathing, eye movements, arm and leg movements, and brain and heart activity. The polysomnogram will also record any dream enactment behavior.\nTreatment and Medication Options for REM Sleep Behavior Disorder\nWhile there is no cure for REM sleep behavior disorder, treatment may include options such as lifestyle changes, medication, and protecting you — and your bed partner — from harm.\nLifestyle and Behavioral Changes That Can Help\nAvoid triggers.\nAlcohol and certain antidepressants are linked to RBD. Talk to your doctor about whether your meds may be causing your episodes and  if your prescription can be changed or adjusted. Keep track of when you drink before bedtime and if this increases your risk. “Alcohol seems to play a role for some patients so avoiding it is key,” Breus says.\nPractice sleep hygiene.\nThe Sleep Foundation recommends good sleep habits, which include following a consistent sleep schedule,  eliminating outside noise, and sleeping in a cool, dark room. “I will tell you that the more sleep-deprived a person is, the more likely they are to have episodes. So having both good quality and quantity sleep is always important,” Breus says.\nSafeguard your bedroom\n.\nFrom bruises and cuts to broken bones or even head trauma, injury is a serious risk to you and anyone you sleep with. “It can be really serious. We’ve had people come in where they look beaten up because they’ve jumped out of bed and crashed into things,” Cline says. Establish a safe sleeping environment by:\nKeeping sharp objects and weapons out of the bedroom\nPlacing padding on the floor in case you fall off the bed\nInstalling padded bedrails or even moving your mattress onto the floor\nMoving furniture, clutter, and other trip hazards away from the bed\nSleeping alone until your symptoms are controlled\nMedication Options\nTalk with your doctor to determine whether medication may be helpful to treat your RBD, Cline says.\nThe Mayo Clinic suggests:\nClonazepam (Klonopin)\nThis is a prescription medication is usually used to treat anxiety. However, it can help with REM sleep behavior disorder by suppressing muscle activity during REM sleep. It can cause side effects including daytime sleepiness, loss of balance, and worsening of sleep apnea.\nMelatonin\nYour doctor may prescribe a supplement called melatonin, which can help regulate your sleep cycle. It may be as effective for RBD as clonazepam, with fewer side effects.\nComplications of REM Sleep Behavior Disorder\nBesides injuries, the main risk tied to REM sleep behavior disorder is that it could be a very early symptom of a neurodegenerative disorder. Many people who have it go on to develop Parkinson’s disease, Lewy body dementia, or multiple system atrophy.\n“RBD is a serious situation and not just something funny that a family member does. Talk to your doctor about it as soon as possible. It could be an early warning sign,” Breus warns.\nOne almost 30-year study\nfound that over 80 percent of a group of men age 50 or older with RBD eventually developed a neurological condition, usually within 13 years of the start of their sleep symptoms. Another\nslightly larger study\nfound that 30 percent of participants were diagnosed with Parkinson’s disease or dementia three years or less after the onset of REM sleep behavior disorder and 66 percent developed those conditions within eight years of the study.\n“It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD,” Cline says.\nResearch and Statistics: How Many People Have REM Sleep Behavior Disorder?\nCline says that REM sleep behavior disorder is rare. Less than 0.5 percent of the general population has RBD, although the prevalence is higher in people with certain neurocognitive disorders such as Parkinson’s disease or dementia. It may be as high\n    as 30 percent in people who also have narcolepsy, according to\nPsychology Today\n.\nThe Takeaway\nPeople with REM sleep behavior disorder tend to act out their dreams, rather than having their muscles be at rest during sleep.\nCommon symptoms include making noises, awakening easily, or having violent dreams.\nGood sleep hygiene, like maintaining a regular bedtime routine and avoiding alcohol or other triggers, may help ease  symptoms.\nOnce you confirm your diagnosis with a sleep doctor and determine the root cause — such as medication, anxiety, or a neurological condition — you may be prescribed a medication like Klonopin that can suppress your muscle movements while you sleep.\nFAQ\nWhat is REM sleep behavior disorder?\nREM sleep behavior disorder is a parasomnia that causes people to physically act out their dreams while they’re in the rapid eye movement (REM) stage of sleep. \nHow common is REM sleep behavior disorder?\nIt’s rare, affecting less than 0.5 percent of the general population. The prevalence is higher in people who have narcolepsy and certain neurocognitive disorders such as Parkinson’s disease and dementia.\nWhat are the symptoms of REM sleep behavior disorder?\nThe most common symptom of REM sleep behavior disorder is movement such as kicking, punching, arm flailing, or jumping out of bed — all in response to an action-filled or violent dream such as being chased or defending yourself from an attack. You may also talk, laugh, or yell.\nIs there a cure for REM sleep behavior disorder?\nNo, there is no cure for REM sleep behavior disorder, but it can be managed through options such as medicine, cutting back on alcohol, and creating a safe sleeping environment for you and your bed partner.\nWhat is the top concern for people with REM sleep behavior disorder?\nResearch suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia. One study found that 30 percent of people with RBD developed Parkinson’s disease or dementia within three years of sleep symptoms and 66 percent did within eight years.\nResources We Trust\nMayo Clinic: \nREM Sleep Disorder Doubles Risk of Mild Cognitive Impairment, Parkinson’s\nCleveland Clinic:\nParasomnias and Disruptive Sleep Disorders\nNAPS Consortium for REM Sleep Behavior Disorder: \nAre You Living With RBD?\nParkinson's Foundation:\nSleep Disorders\nFrontiers in Neurology\n:\nA Neurologist’s Guide to REM Sleep Behavior Disorder\nMeet Our Experts\nSee Our Editorial Policy\nMeet Our Health Expert Network\nAlex Dimitriu, MD\nMedical Reviewer\nAlex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine.  He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work.\nDr. Dimitriu has been  recognized by\nThe New York Times\n,\nDiscover\n magazine,\nMen’s Health\n,\nCosmopolitan\n, and NBC News, among other media outlets. He is a medical reviewer for\nBusiness Insider\nand the Sleep Foundation, and is a contributing author to the\nEncyclopedia of Sleep Medicine\n.\nSee full bio\nCarmen Chai\nAuthor\nCarmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s.\nChai was a national health reporter at Global News in Toronto for 5 years, where she won multiple  awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the\nToronto Star\n,\nVancouver Province,\nand the\nNational Post\n. She received a bachelor’s degree in journalism from Ryerson University in Toronto.\nSee full bio\nSee Our Editorial Policy\nMeet Our Health Expert Network\nEDITORIAL SOURCES\nEveryday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our\neditorial policy\n. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.\nAdditional Sources\nREM Sleep Behavior Disorder.\nCleveland Clinic\n. \nBoeve B. REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions.\nAnnals of the New York Academy of Sciences\n. January 2010.\nREM Sleep Behavior Disorder.\nMayo Clinic\n. January 18, 2018.\nREM Sleep Behavior Disorder.\nSleep Foundation\n. October 26, 2023.\nRoguski A et al. A Neurologist’s Guide to REM Sleep Behavior Disorder.\nFrontiers in Neurology\n. July 2020.\nSchenck CH et al. Delayed Emergence of a Parkinsonian Disorder or Dementia in 81% of Older Men Initially Diagnosed With Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A 16-Year Update on a Previously Reported Series.\nSleep Medicine\n.\n2013.\nPostuma RB et al. Parkinson Risk in Idiopathic REM Sleep Behavior Disorder: Preparing for Neuroprotective Trials.\nNeurology\n. March 2015.\nRapid Eye Movement Sleep Behavior Disorder.\nPsychology Today\n. 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Learn how to get better sleep, why sleep is important, and the risks of sleeping poorly over time.\n\n[LEARN MORE](https:\/\/www.everydayhealth.com\/sleep-health-hygiene\/)\n\n- [1Sleep 101: The Ultimate Guide to a Better Night’s Sleep](https:\/\/www.everydayhealth.com\/sleep-disorders\/sleep\/sleep-101-ultimate-guide-on-how-get-better-nights-sleep\/)\n- [2What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx)\n- [3What Is Sleepwalking? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https:\/\/www.everydayhealth.com\/sleepwalking\/guide\/)\n- [4What Is Sleep Paralysis? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https:\/\/www.everydayhealth.com\/sleep-paralysis\/guide\/)\n- [5What Is Hypersomnia? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https:\/\/www.everydayhealth.com\/sleep\/excessive-daytime-sleepiness-facts\/)\n- [6What Is Sexsomnia? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https:\/\/www.everydayhealth.com\/sleep\/what-is-sexsomnia.aspx)\n- [7All About Sleep Cycles and the Stages of Sleep](https:\/\/www.everydayhealth.com\/sleep\/sleep-cycles-and-the-stages-of-sleep\/)\n- [8Sleep Calculator: How Much Sleep Do You Really Need Each Night?](https:\/\/www.everydayhealth.com\/sleep\/101\/how-much-sleep-do-you-need.aspx)\n\n[SEE MORE](https:\/\/www.everydayhealth.com\/sleep-health-hygiene\/)\n\n# What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment\n![What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment](https:\/\/images.everydayhealth.com\/images\/sleep-disorders\/sleep\/what-is-rem-sleep-behavior-disorder-symptoms-causes-diagnosis-treatment-alt-1440x810.jpg?w=508)\n\nAdobe Stock\n\nBy\n\n[Carmen Chai](https:\/\/www.everydayhealth.com\/authors\/carmen-chai\/)\n\nUpdated on December 6, 2023\n\nMedically Reviewed\n\nby\n\n[Alex Dimitriu, MD](https:\/\/www.everydayhealth.com\/authors\/alex-dimitriu\/)\n\nON THIS PAGE\n\n- [Symptoms](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#symptoms)\n- [Causes](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#causes)\n- [Diagnosis](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#diagnosis)\n- [Treatment](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#treatment)\n- [Complications](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#complications)\n- [Research and Statistics](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#research-and-statistics)\n- [FAQ](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#faq)\n\n[Sleep Health & Hygiene]()\n\nON THIS PAGE\n\n- [Symptoms](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#symptoms)\n- [Causes](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#causes)\n- [Diagnosis](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#diagnosis)\n- [Treatment](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#treatment)\n- [Complications](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#complications)\n- [Research and Statistics](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#research-and-statistics)\n- [FAQ](https:\/\/www.everydayhealth.com\/sleep\/other-disorders\/rem-behavior-disorder.aspx#faq)\n\nHave you found yourself kicking, punching, or even leaping out of bed in the middle of a vivid dream? For people with REM sleep behavior disorder, dreams don’t just stay in their minds.\n\nREM sleep behavior disorder (RBD) is a rare parasomnia in which you physically act out your dreams while you’re in the rapid eye movement (REM) stage of sleep, according to the [Cleveland Clinic](https:\/\/my.clevelandclinic.org\/health\/diseases\/24465-rem-sleep-behavior-disorder-rbd).\n\nREM sleep is typically when we dream. Our blood pressure rises, our breathing deepens, and our eyes dart in all directions. During normal REM sleep, we don’t move. Our bodies go into temporary muscle paralysis, called atonia, while our brains are wide awake with activity, according to a study published in the [*Annals of the New York Academy of Sciences*](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2902006\/).\n\nHowever, for people with REM sleep behavior disorder, this normal muscle paralysis doesn’t happen. Instead, they experience everything from small muscle twitches and whispering to punching, kicking, shouting, and jumping out of bed. They may even hurt themselves or others.\n\n“The way we describe it clinically is when you act out your dreams. Most people don’t realize that they’re doing these behaviors — it is usually reported by their bed partners,” says [Michael Breus, PhD](https:\/\/sleepdoctor.com\/pages\/dr-michael-breus), a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine.\n\nThere are two main types of REM sleep behavior disorder, according to John Cline, PhD, a Connecticut-based licensed clinical psychologist specializing in sleep medicine and a diplomate of the American Board of Sleep Medicine.\n\n- **Isolated (Idiopathic) RBD** In these cases, the condition doesn’t have an underlying cause. But it may be an early warning sign of a neurodegenerative condition such as Parkinson’s disease, [Lewy body dementia](https:\/\/www.everydayhealth.com\/dementia\/lewy-body-dementia\/), or multiple system atrophy, according to the Cleveland Clinic.\n- **Symptomatic (Secondary) RBD** These cases have an underlying cause such as narcolepsy or a drug side effect.\n\n## Signs and Symptoms of REM Sleep Behavior Disorder\nThe main symptom of REM sleep behavior disorder is physically acting out your dreams, because your body isn’t immobilized like it should be during REM sleep. It may start suddenly or come on gradually but typically gets worse over time. You may have episodes every once in a while or several times in a night.\n\nOther symptoms, according to the [Mayo Clinic](https:\/\/www.mayoclinic.org\/diseases-conditions\/rem-sleep-behavior-disorder\/symptoms-causes\/syc-20352920), include:\n\n- Making noises like talking, laughing, shouting, or yelling for help\n- Being easy to awaken during an episode, coherent afterward, and able to recall the dream\n- Unpleasant dream content like arguments, accidents, or attacks\n\n“Typically, these are violent dreams,” says Dr. Cline. “One patient was waving their hands because they dreamt they were swarmed by bees, and then, more rarely, there are situations where people have done complex things like diving out of bed because they dreamt they were on a diving board.”\n\nEpisodes often happen in the second half of the night into the morning, when you experience longer phases of REM sleep, according to the [Sleep Foundation](https:\/\/www.sleepfoundation.org\/parasomnias\/rem-sleep-behavior-disorder).\n\n## Causes and Risk Factors of REM Sleep Behavior Disorder\nRBD appears to come from a problem with certain nerve pathways in your brain. But it isn’t clear why it happens.\n\n“We don’t know the exact cause, but what appears to be happening is that when you are in REM sleep, you should be in a state of atonia, or paralysis, specifically so you do not act out your dreams. And this mechanism appears to be not working,” Dr. Breus says.\n\nCertain things make you more likely to develop it, according to the Sleep Foundation:\n\n- Being male and over 50 years old\n- Having a neurological disorder like Parkinson’s disease, Lewy body dementia, or multiple system atrophy\n- Having narcolepsy\n- Using antidepressants\n- Using or withdrawing from drugs or alcohol\n\nThe Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. “As a general guideline we do tend to see this in our older sleepers,” Breus says.\n\nSleep deprivation, smoking, head injury, and exposure to pesticides may also be risk factors.\n\n## How Is REM Sleep Behavior Disorder Diagnosed?\nMore often than not, RBD is first reported by a patient’s bed partner, then it’s formally diagnosed with a sleep study, Breus says.\n\nAccording to the American Academy of Sleep Medicine, a patient must meet the following [four criteria](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7360679\/):\n\n- You have repeatedly experienced episodes of acting out your dreams with vocalizations or arm and leg movements that correspond to what’s taking place in your dream.\n- Episodes occur during REM sleep, as confirmed by a sleep study or your clinical history.\n- You experience REM sleep without atonia, as confirmed by a sleep study.\n- The episodes aren’t caused by another sleep or mental health disorder, a side effect of medication, or substance abuse.\n\nIf you often act out your dreams, talk to your doctor. They’ll ask about your sleep behavior and may have you keep a sleep diary to document how often you have episodes and what goes on during them. They’ll also consider your medical history, medications you're taking, and other factors like alcohol intake.\n\nThey may refer you to a sleep specialist for an overnight sleep study, or polysomnogram. During this test, sensors will monitor your breathing, eye movements, arm and leg movements, and brain and heart activity. The polysomnogram will also record any dream enactment behavior.\n\n## Treatment and Medication Options for REM Sleep Behavior Disorder\nWhile there is no cure for REM sleep behavior disorder, treatment may include options such as lifestyle changes, medication, and protecting you — and your bed partner — from harm.\n\n### Lifestyle and Behavioral Changes That Can Help\n**Avoid triggers.** Alcohol and certain antidepressants are linked to RBD. Talk to your doctor about whether your meds may be causing your episodes and if your prescription can be changed or adjusted. Keep track of when you drink before bedtime and if this increases your risk. “Alcohol seems to play a role for some patients so avoiding it is key,” Breus says.\n\n**Practice sleep hygiene.** The Sleep Foundation recommends good sleep habits, which include following a consistent sleep schedule, eliminating outside noise, and sleeping in a cool, dark room. “I will tell you that the more sleep-deprived a person is, the more likely they are to have episodes. So having both good quality and quantity sleep is always important,” Breus says.\n\n**Safeguard your bedroom****.** From bruises and cuts to broken bones or even head trauma, injury is a serious risk to you and anyone you sleep with. “It can be really serious. We’ve had people come in where they look beaten up because they’ve jumped out of bed and crashed into things,” Cline says. Establish a safe sleeping environment by:\n\n- Keeping sharp objects and weapons out of the bedroom\n- Placing padding on the floor in case you fall off the bed\n- Installing padded bedrails or even moving your mattress onto the floor\n- Moving furniture, clutter, and other trip hazards away from the bed\n- Sleeping alone until your symptoms are controlled\n### Medication Options\nTalk with your doctor to determine whether medication may be helpful to treat your RBD, Cline says.\n\nThe Mayo Clinic suggests:\n\n- **Clonazepam (Klonopin)** This is a prescription medication is usually used to treat anxiety. However, it can help with REM sleep behavior disorder by suppressing muscle activity during REM sleep. It can cause side effects including daytime sleepiness, loss of balance, and worsening of sleep apnea.\n- **Melatonin** Your doctor may prescribe a supplement called melatonin, which can help regulate your sleep cycle. It may be as effective for RBD as clonazepam, with fewer side effects.\n\n## Complications of REM Sleep Behavior Disorder\nBesides injuries, the main risk tied to REM sleep behavior disorder is that it could be a very early symptom of a neurodegenerative disorder. Many people who have it go on to develop Parkinson’s disease, Lewy body dementia, or multiple system atrophy.\n\n“RBD is a serious situation and not just something funny that a family member does. Talk to your doctor about it as soon as possible. It could be an early warning sign,” Breus warns.\n\n[One almost 30-year study](https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1389945712003814?via%3Dihub) found that over 80 percent of a group of men age 50 or older with RBD eventually developed a neurological condition, usually within 13 years of the start of their sleep symptoms. Another [slightly larger study](https:\/\/pubmed.ncbi.nlm.nih.gov\/25681454\/) found that 30 percent of participants were diagnosed with Parkinson’s disease or dementia three years or less after the onset of REM sleep behavior disorder and 66 percent developed those conditions within eight years of the study.\n\n“It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD,” Cline says.\n\n## Research and Statistics: How Many People Have REM Sleep Behavior Disorder?\nCline says that REM sleep behavior disorder is rare. Less than 0.5 percent of the general population has RBD, although the prevalence is higher in people with certain neurocognitive disorders such as Parkinson’s disease or dementia. It may be as high as 30 percent in people who also have narcolepsy, according to [*Psychology Today*](https:\/\/www.psychologytoday.com\/us\/conditions\/rapid-eye-movement-sleep-behavior-disorder).\n\n## The Takeaway\n- People with REM sleep behavior disorder tend to act out their dreams, rather than having their muscles be at rest during sleep.\n- Common symptoms include making noises, awakening easily, or having violent dreams.\n- Good sleep hygiene, like maintaining a regular bedtime routine and avoiding alcohol or other triggers, may help ease symptoms.\n- Once you confirm your diagnosis with a sleep doctor and determine the root cause — such as medication, anxiety, or a neurological condition — you may be prescribed a medication like Klonopin that can suppress your muscle movements while you sleep.\n\n### FAQ\nWhat is REM sleep behavior disorder?\n\nREM sleep behavior disorder is a parasomnia that causes people to physically act out their dreams while they’re in the rapid eye movement (REM) stage of sleep.\n\nHow common is REM sleep behavior disorder?\n\nIt’s rare, affecting less than 0.5 percent of the general population. The prevalence is higher in people who have narcolepsy and certain neurocognitive disorders such as Parkinson’s disease and dementia.\n\nWhat are the symptoms of REM sleep behavior disorder?\n\nThe most common symptom of REM sleep behavior disorder is movement such as kicking, punching, arm flailing, or jumping out of bed — all in response to an action-filled or violent dream such as being chased or defending yourself from an attack. You may also talk, laugh, or yell.\n\nIs there a cure for REM sleep behavior disorder?\n\nNo, there is no cure for REM sleep behavior disorder, but it can be managed through options such as medicine, cutting back on alcohol, and creating a safe sleeping environment for you and your bed partner.\n\nWhat is the top concern for people with REM sleep behavior disorder?\n\nResearch suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia. One study found that 30 percent of people with RBD developed Parkinson’s disease or dementia within three years of sleep symptoms and 66 percent did within eight years.\n\n## Resources We Trust\nShare\n\nShare on Facebook\n\nShare on X\n\nShare on Pinterest\n\nCopy Link\n\n- **Mayo Clinic:** [REM Sleep Disorder Doubles Risk of Mild Cognitive Impairment, Parkinson’s](https:\/\/newsnetwork.mayoclinic.org\/discussion\/mayo-clinic-rem-sleep-disorder-doubles-risk-of-mild-cognitive-impairment-parkinsons\/)\n- **Cleveland Clinic:** [Parasomnias and Disruptive Sleep Disorders](https:\/\/my.clevelandclinic.org\/health\/diseases\/12133-parasomnias--disruptive-sleep-disorders)\n- **NAPS Consortium for REM Sleep Behavior Disorder:** [Are You Living With RBD?](https:\/\/www.naps-rbd.org\/rbd)\n- **Parkinson's Foundation:** [Sleep Disorders](https:\/\/www.parkinson.org\/understanding-parkinsons\/non-movement-symptoms\/sleep-disorders)\n- ***Frontiers in Neurology*:** [A Neurologist’s Guide to REM Sleep Behavior Disorder](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7360679\/)\n\nMeet Our Experts\n\n[See Our Editorial Policy](https:\/\/www.everydayhealth.com\/editorial-policies\/)\n\n[Meet Our Health Expert Network](https:\/\/www.everydayhealth.com\/health-expert-network\/)\n\n![alex-dimitriu-bio](https:\/\/images.everydayhealth.com\/images\/site-images\/most-recent-default-img.jpg?w=120)\n\n![alex-dimitriu-bio](https:\/\/images.everydayhealth.com\/images\/bio-photos\/alex-dimitriu-bio.jpg?sfvrsn=83e2a736_0)\n\n#### Alex Dimitriu, MD\n##### Medical Reviewer\nAlex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work.   \n  \nDr. Dimitriu has been recognized by *The New York Times*, *Discover* magazine, *Men’s Health*, *Cosmopolitan*, and NBC News, among other media outlets. He is a medical reviewer for *Business Insider* and the Sleep Foundation, and is a contributing author to the *Encyclopedia of Sleep Medicine*.\n\n[See full bio](https:\/\/www.everydayhealth.com\/authors\/alex-dimitriu\/)\n\n![carmen-chai-bio](https:\/\/images.everydayhealth.com\/images\/site-images\/most-recent-default-img.jpg?w=120)\n\n![carmen-chai-bio](https:\/\/images.everydayhealth.com\/images\/bio-photos\/carmen-chai-bio.jpg?sfvrsn=411f0fdf_0)\n\n#### Carmen Chai\n##### Author\nCarmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s.   \n  \nChai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the *Toronto Star*, *Vancouver Province,* and the *National Post*. She received a bachelor’s degree in journalism from Ryerson University in Toronto.\n\n[See full bio](https:\/\/www.everydayhealth.com\/authors\/carmen-chai\/)\n\n[See Our Editorial Policy](https:\/\/www.everydayhealth.com\/editorial-policies\/)\n\n[Meet Our Health Expert Network](https:\/\/www.everydayhealth.com\/health-expert-network\/)\n\nEDITORIAL SOURCES\n\nEveryday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our [editorial policy](https:\/\/www.everydayhealth.com\/editorial-policies\/). We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.\n\nSources\n\nAdditional Sources\n\n- REM Sleep Behavior Disorder. [Cleveland Clinic](https:\/\/my.clevelandclinic.org\/health\/diseases\/24465-rem-sleep-behavior-disorder-rbd).\n- Boeve B. REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions. [*Annals of the New York Academy of Sciences*](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2902006\/). January 2010.\n- REM Sleep Behavior Disorder. [Mayo Clinic](https:\/\/www.mayoclinic.org\/diseases-conditions\/rem-sleep-behavior-disorder\/symptoms-causes\/syc-20352920). January 18, 2018.\n- REM Sleep Behavior Disorder. [Sleep Foundation](https:\/\/www.sleepfoundation.org\/parasomnias\/rem-sleep-behavior-disorder). October 26, 2023.\n- Roguski A et al. A Neurologist’s Guide to REM Sleep Behavior Disorder. [*Frontiers in Neurology*](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7360679\/). July 2020.\n- Schenck CH et al. Delayed Emergence of a Parkinsonian Disorder or Dementia in 81% of Older Men Initially Diagnosed With Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A 16-Year Update on a Previously Reported Series. [*Sleep Medicine*](https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1389945712003814?via%3Dihub14)*.* 2013\\.\n- Postuma RB et al. Parkinson Risk in Idiopathic REM Sleep Behavior Disorder: Preparing for Neuroprotective Trials. [*Neurology*](https:\/\/pubmed.ncbi.nlm.nih.gov\/25681454\/). March 2015.\n- Rapid Eye Movement Sleep Behavior Disorder. [*Psychology Today*](https:\/\/www.psychologytoday.com\/us\/conditions\/rapid-eye-movement-sleep-behavior-disorder). 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Symptoms, Causes, Diagnosis, Treatment, and Prevention\n\nMedically Reviewed by Chester Wu, MD \\| Feb 23, 2023\n\n[Who Should Be on Your Narcolepsy Healthcare Team?](https:\/\/www.everydayhealth.com\/narcolepsy\/healthcare-team\/)\n\n![doctor](https:\/\/images.everydayhealth.com\/images\/site-images\/most-recent-default-img.jpg?w=172)\n\nNarcolepsyWho Should Be on Your Narcolepsy Healthcare Team?\n\nMedically Reviewed by Sanjai Sinha, MD \\| Aug 25, 2022\n\n[4 Narcolepsy Symptoms That Can Impact Your Life — and How to Manage Them](https:\/\/www.everydayhealth.com\/narcolepsy\/symptoms-that-impact-life\/)\n\n![man tired during the day](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)\n\nNarcolepsy4 Narcolepsy Symptoms That Can Impact Your Life — and How to Manage Them\n\nMedically Reviewed by Sanjai Sinha, MD \\| Aug 25, 2022\n\n[9 Common Myths and Misunderstandings About Narcolepsy](https:\/\/www.everydayhealth.com\/narcolepsy\/myths-and-facts\/)\n\n![woman tired yawning with narcolepsy](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)\n\nNarcolepsy9 Common Myths and Misunderstandings About Narcolepsy\n\nMedically Reviewed by Sanjai Sinha, MD \\| Aug 25, 2022\n\n[Everyday Health’s Sleep Twitter Chat: Here’s What You Missed](https:\/\/www.everydayhealth.com\/sleep\/everyday-health-sleep-twitter-chat\/)\n\n![Everyday Health Twitter Bird](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)\n\nSleep Health & HygieneEveryday Health’s Sleep Twitter Chat: Here’s What You Missed\n\nPublished on Apr 08, 2022\n\n[All About Sleep Cycles and the Stages of Sleep](https:\/\/www.everydayhealth.com\/sleep\/sleep-cycles-and-the-stages-of-sleep\/)\n\n![woman asleep during REM cycle](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)\n\nSleep Health & HygieneAll About Sleep Cycles and the Stages of Sleep\n\nMedically Reviewed by Jason Paul Chua, MD, PhD \\| Mar 01, 2022\n\n[How Well Are You Managing Narcolepsy?](https:\/\/www.everydayhealth.com\/narcolepsy\/symptom-management-quiz\/)\n\n![00-Quiz-How-Well-Is-Your-Narcolepsy-Managed-Intro-1440x810](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)\n\nNarcolepsyHow Well Are You Managing Narcolepsy?\n\nMedically Reviewed by Sanjai Sinha, MD \\| Jan 04, 2022\n\nWellness inspired. Wellness enabled.\n\nFacebook\n\nX\n\nInstagram\n\nPinterest\n\nYoutube\n\nTikTok\n\nA PROPERTY OF\n\n[![Everyday Health Group](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)![Everyday Health Group](https:\/\/images.everydayhealth.com\/react-component-images\/everydayhealthgrouplogo-long-white.png?w=120)EHGLogo](https:\/\/www.everydayhealthgroup.com\/ \"Everyday Health Group\")\n\n- [About Us](https:\/\/www.everydayhealth.com\/about-us\/)\n- [Privacy Policy](https:\/\/www.everydayhealth.com\/privacyterms\/#everyday_health_privacy_policy)\n- [Editorial Policy](https:\/\/www.everydayhealth.com\/editorial-policies\/)\n- [Terms of Use](https:\/\/www.everydayhealth.com\/privacyterms\/#everyday-health-terms-of-use)\n- [Meet Our Health Expert Network](https:\/\/www.everydayhealth.com\/health-expert-network\/)\n- [Consumer Health Data Privacy Policy](https:\/\/www.everydayhealth.com\/privacyterms\/#consumer-health-data-privacy-policy)\n- [Careers](https:\/\/jobs.jobvite.com\/everyday-health-consumer)\n- [Accessibility Statement](https:\/\/www.everydayhealth.com\/accessibility-statement\/)\n- [Do Not Sell My Personal Information](https:\/\/www.everydayhealth.com\/ccpa-privacy-policy\/)\n- [Contact Us](https:\/\/everydayhealthgrouphelp.zendesk.com\/hc\/en-us)\n- [Press Center](https:\/\/www.everydayhealth.com\/press-center\/)\n- [All Health Topics](https:\/\/www.everydayhealth.com\/all-health-topics\/)\n- [Popular Topics](https:\/\/www.everydayhealth.com\/most-popular\/)\n- [Drugs & Supplements](https:\/\/www.everydayhealth.com\/all-drugs-supplements\/)\n- AdChoices\n\nNEWSLETTERS\n\nGet the best in health and wellness\n\n© 1996-2026 Everyday Health, Inc., a Ziff Davis company. All rights reserved. Everyday Health is among the federally registered trademarks of Everyday Health, Inc. and may not be used by third parties without explicit permission.All information on the Everyday Health website is for informational purposes only, and is not intended to be used for medical advice, diagnosis, or treatment. For more details, see Everyday Health's [Terms of Use](https:\/\/www.everydayhealth.com\/privacyterms\/#everyday-health-terms-of-use).\n\n[![TRUSTe Verified Privacy](https:\/\/images.everydayhealth.com\/react-component-images\/image-src-placeholder-16x9288625876.png)![TRUSTe Verified Privacy](https:\/\/privacy-policy.truste.com\/privacy-seal\/seal?rid=01b0263e-277d-4e52-9ddd-86550128ec1a)Badges](https:\/\/privacy.truste.com\/privacy-seal\/validation?rid=01b0263e-277d-4e52-9ddd-86550128ec1a \"TRUSTe Verified Privacy\")","attrs_readable_markdown":"Have you found yourself kicking, punching, or even leaping out of bed in the middle of a vivid dream? For people with REM sleep behavior disorder, dreams don’t just stay in their minds.\n\nREM sleep behavior disorder (RBD) is a rare parasomnia in which you physically act out your dreams while you’re in the rapid eye movement (REM) stage of sleep, according to the [Cleveland Clinic](https:\/\/my.clevelandclinic.org\/health\/diseases\/24465-rem-sleep-behavior-disorder-rbd).\n\nREM sleep is typically when we dream. Our blood pressure rises, our breathing deepens, and our eyes dart in all directions. During normal REM sleep, we don’t move. Our bodies go into temporary muscle paralysis, called atonia, while our brains are wide awake with activity, according to a study published in the [*Annals of the New York Academy of Sciences*](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2902006\/).\n\nHowever, for people with REM sleep behavior disorder, this normal muscle paralysis doesn’t happen. Instead, they experience everything from small muscle twitches and whispering to punching, kicking, shouting, and jumping out of bed. They may even hurt themselves or others.\n\n“The way we describe it clinically is when you act out your dreams. Most people don’t realize that they’re doing these behaviors — it is usually reported by their bed partners,” says [Michael Breus, PhD](https:\/\/sleepdoctor.com\/pages\/dr-michael-breus), a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine.\n\nThere are two main types of REM sleep behavior disorder, according to John Cline, PhD, a Connecticut-based licensed clinical psychologist specializing in sleep medicine and a diplomate of the American Board of Sleep Medicine.\n\n- **Isolated (Idiopathic) RBD** In these cases, the condition doesn’t have an underlying cause. But it may be an early warning sign of a neurodegenerative condition such as Parkinson’s disease, [Lewy body dementia](https:\/\/www.everydayhealth.com\/dementia\/lewy-body-dementia\/), or multiple system atrophy, according to the Cleveland Clinic.\n- **Symptomatic (Secondary) RBD** These cases have an underlying cause such as narcolepsy or a drug side effect.\n\n## Signs and Symptoms of REM Sleep Behavior Disorder\nThe main symptom of REM sleep behavior disorder is physically acting out your dreams, because your body isn’t immobilized like it should be during REM sleep. It may start suddenly or come on gradually but typically gets worse over time. You may have episodes every once in a while or several times in a night.\n\nOther symptoms, according to the [Mayo Clinic](https:\/\/www.mayoclinic.org\/diseases-conditions\/rem-sleep-behavior-disorder\/symptoms-causes\/syc-20352920), include:\n\n- Making noises like talking, laughing, shouting, or yelling for help\n- Being easy to awaken during an episode, coherent afterward, and able to recall the dream\n- Unpleasant dream content like arguments, accidents, or attacks\n\n“Typically, these are violent dreams,” says Dr. Cline. “One patient was waving their hands because they dreamt they were swarmed by bees, and then, more rarely, there are situations where people have done complex things like diving out of bed because they dreamt they were on a diving board.”\n\nEpisodes often happen in the second half of the night into the morning, when you experience longer phases of REM sleep, according to the [Sleep Foundation](https:\/\/www.sleepfoundation.org\/parasomnias\/rem-sleep-behavior-disorder).\n\n## Causes and Risk Factors of REM Sleep Behavior Disorder\nRBD appears to come from a problem with certain nerve pathways in your brain. But it isn’t clear why it happens.\n\n“We don’t know the exact cause, but what appears to be happening is that when you are in REM sleep, you should be in a state of atonia, or paralysis, specifically so you do not act out your dreams. And this mechanism appears to be not working,” Dr. Breus says.\n\nCertain things make you more likely to develop it, according to the Sleep Foundation:\n\n- Being male and over 50 years old\n- Having a neurological disorder like Parkinson’s disease, Lewy body dementia, or multiple system atrophy\n- Having narcolepsy\n- Using antidepressants\n- Using or withdrawing from drugs or alcohol\n\nThe Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. “As a general guideline we do tend to see this in our older sleepers,” Breus says.\n\nSleep deprivation, smoking, head injury, and exposure to pesticides may also be risk factors.\n\n## How Is REM Sleep Behavior Disorder Diagnosed?\nMore often than not, RBD is first reported by a patient’s bed partner, then it’s formally diagnosed with a sleep study, Breus says.\n\nAccording to the American Academy of Sleep Medicine, a patient must meet the following [four criteria](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7360679\/):\n\n- You have repeatedly experienced episodes of acting out your dreams with vocalizations or arm and leg movements that correspond to what’s taking place in your dream.\n- Episodes occur during REM sleep, as confirmed by a sleep study or your clinical history.\n- You experience REM sleep without atonia, as confirmed by a sleep study.\n- The episodes aren’t caused by another sleep or mental health disorder, a side effect of medication, or substance abuse.\n\nIf you often act out your dreams, talk to your doctor. They’ll ask about your sleep behavior and may have you keep a sleep diary to document how often you have episodes and what goes on during them. They’ll also consider your medical history, medications you're taking, and other factors like alcohol intake.\n\nThey may refer you to a sleep specialist for an overnight sleep study, or polysomnogram. During this test, sensors will monitor your breathing, eye movements, arm and leg movements, and brain and heart activity. The polysomnogram will also record any dream enactment behavior.\n\n## Treatment and Medication Options for REM Sleep Behavior Disorder\nWhile there is no cure for REM sleep behavior disorder, treatment may include options such as lifestyle changes, medication, and protecting you — and your bed partner — from harm.\n\n### Lifestyle and Behavioral Changes That Can Help\n**Avoid triggers.** Alcohol and certain antidepressants are linked to RBD. Talk to your doctor about whether your meds may be causing your episodes and if your prescription can be changed or adjusted. Keep track of when you drink before bedtime and if this increases your risk. “Alcohol seems to play a role for some patients so avoiding it is key,” Breus says.\n\n**Practice sleep hygiene.** The Sleep Foundation recommends good sleep habits, which include following a consistent sleep schedule, eliminating outside noise, and sleeping in a cool, dark room. “I will tell you that the more sleep-deprived a person is, the more likely they are to have episodes. So having both good quality and quantity sleep is always important,” Breus says.\n\n**Safeguard your bedroom****.** From bruises and cuts to broken bones or even head trauma, injury is a serious risk to you and anyone you sleep with. “It can be really serious. We’ve had people come in where they look beaten up because they’ve jumped out of bed and crashed into things,” Cline says. Establish a safe sleeping environment by:\n\n- Keeping sharp objects and weapons out of the bedroom\n- Placing padding on the floor in case you fall off the bed\n- Installing padded bedrails or even moving your mattress onto the floor\n- Moving furniture, clutter, and other trip hazards away from the bed\n- Sleeping alone until your symptoms are controlled\n### Medication Options\nTalk with your doctor to determine whether medication may be helpful to treat your RBD, Cline says.\n\nThe Mayo Clinic suggests:\n\n- **Clonazepam (Klonopin)** This is a prescription medication is usually used to treat anxiety. However, it can help with REM sleep behavior disorder by suppressing muscle activity during REM sleep. It can cause side effects including daytime sleepiness, loss of balance, and worsening of sleep apnea.\n- **Melatonin** Your doctor may prescribe a supplement called melatonin, which can help regulate your sleep cycle. It may be as effective for RBD as clonazepam, with fewer side effects.\n\n## Complications of REM Sleep Behavior Disorder\nBesides injuries, the main risk tied to REM sleep behavior disorder is that it could be a very early symptom of a neurodegenerative disorder. Many people who have it go on to develop Parkinson’s disease, Lewy body dementia, or multiple system atrophy.\n\n“RBD is a serious situation and not just something funny that a family member does. Talk to your doctor about it as soon as possible. It could be an early warning sign,” Breus warns.\n\n[One almost 30-year study](https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1389945712003814?via%3Dihub) found that over 80 percent of a group of men age 50 or older with RBD eventually developed a neurological condition, usually within 13 years of the start of their sleep symptoms. Another [slightly larger study](https:\/\/pubmed.ncbi.nlm.nih.gov\/25681454\/) found that 30 percent of participants were diagnosed with Parkinson’s disease or dementia three years or less after the onset of REM sleep behavior disorder and 66 percent developed those conditions within eight years of the study.\n\n“It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD,” Cline says.\n\n## Research and Statistics: How Many People Have REM Sleep Behavior Disorder?\nCline says that REM sleep behavior disorder is rare. Less than 0.5 percent of the general population has RBD, although the prevalence is higher in people with certain neurocognitive disorders such as Parkinson’s disease or dementia. It may be as high as 30 percent in people who also have narcolepsy, according to [*Psychology Today*](https:\/\/www.psychologytoday.com\/us\/conditions\/rapid-eye-movement-sleep-behavior-disorder).\n\n## The Takeaway\n- People with REM sleep behavior disorder tend to act out their dreams, rather than having their muscles be at rest during sleep.\n- Common symptoms include making noises, awakening easily, or having violent dreams.\n- Good sleep hygiene, like maintaining a regular bedtime routine and avoiding alcohol or other triggers, may help ease symptoms.\n- Once you confirm your diagnosis with a sleep doctor and determine the root cause — such as medication, anxiety, or a neurological condition — you may be prescribed a medication like Klonopin that can suppress your muscle movements while you sleep.\n\nFAQ\n\nWhat is REM sleep behavior disorder?\n\nREM sleep behavior disorder is a parasomnia that causes people to physically act out their dreams while they’re in the rapid eye movement (REM) stage of sleep.\n\nHow common is REM sleep behavior disorder?\n\nIt’s rare, affecting less than 0.5 percent of the general population. The prevalence is higher in people who have narcolepsy and certain neurocognitive disorders such as Parkinson’s disease and dementia.\n\nWhat are the symptoms of REM sleep behavior disorder?\n\nThe most common symptom of REM sleep behavior disorder is movement such as kicking, punching, arm flailing, or jumping out of bed — all in response to an action-filled or violent dream such as being chased or defending yourself from an attack. You may also talk, laugh, or yell.\n\nIs there a cure for REM sleep behavior disorder?\n\nNo, there is no cure for REM sleep behavior disorder, but it can be managed through options such as medicine, cutting back on alcohol, and creating a safe sleeping environment for you and your bed partner.\n\nWhat is the top concern for people with REM sleep behavior disorder?\n\nResearch suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia. One study found that 30 percent of people with RBD developed Parkinson’s disease or dementia within three years of sleep symptoms and 66 percent did within eight years.\n\n## Resources We Trust\n- **Mayo Clinic:** [REM Sleep Disorder Doubles Risk of Mild Cognitive Impairment, Parkinson’s](https:\/\/newsnetwork.mayoclinic.org\/discussion\/mayo-clinic-rem-sleep-disorder-doubles-risk-of-mild-cognitive-impairment-parkinsons\/)\n- **Cleveland Clinic:** [Parasomnias and Disruptive Sleep Disorders](https:\/\/my.clevelandclinic.org\/health\/diseases\/12133-parasomnias--disruptive-sleep-disorders)\n- **NAPS Consortium for REM Sleep Behavior Disorder:** [Are You Living With RBD?](https:\/\/www.naps-rbd.org\/rbd)\n- **Parkinson's Foundation:** [Sleep Disorders](https:\/\/www.parkinson.org\/understanding-parkinsons\/non-movement-symptoms\/sleep-disorders)\n- ***Frontiers in Neurology*:** [A Neurologist’s Guide to REM Sleep Behavior Disorder](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7360679\/)\n\nMeet Our Experts\n\n[See Our Editorial Policy](https:\/\/www.everydayhealth.com\/editorial-policies\/)[Meet Our Health Expert Network](https:\/\/www.everydayhealth.com\/health-expert-network\/)\n\n![alex-dimitriu-bio](https:\/\/images.everydayhealth.com\/images\/site-images\/most-recent-default-img.jpg?w=120)\n\n#### Alex Dimitriu, MD\n##### Medical Reviewer\nAlex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work.\n\nDr. Dimitriu has been recognized by *The New York Times*, *Discover* magazine, *Men’s Health*, *Cosmopolitan*, and NBC News, among other media outlets. He is a medical reviewer for *Business Insider* and the Sleep Foundation, and is a contributing author to the *Encyclopedia of Sleep Medicine*.\n\n[See full bio](https:\/\/www.everydayhealth.com\/authors\/alex-dimitriu\/)\n\n![carmen-chai-bio](https:\/\/images.everydayhealth.com\/images\/site-images\/most-recent-default-img.jpg?w=120)\n\n#### Carmen Chai\n##### Author\nCarmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s.\n\nChai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the *Toronto Star*, *Vancouver Province,* and the *National Post*. She received a bachelor’s degree in journalism from Ryerson University in Toronto.\n\n[See full bio](https:\/\/www.everydayhealth.com\/authors\/carmen-chai\/)\n\n[See Our Editorial Policy](https:\/\/www.everydayhealth.com\/editorial-policies\/)[Meet Our Health Expert Network](https:\/\/www.everydayhealth.com\/health-expert-network\/)\n\nEDITORIAL SOURCES\n\nEveryday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our [editorial policy](https:\/\/www.everydayhealth.com\/editorial-policies\/). We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.\n\nAdditional Sources\n\n- REM Sleep Behavior Disorder. [Cleveland Clinic](https:\/\/my.clevelandclinic.org\/health\/diseases\/24465-rem-sleep-behavior-disorder-rbd).\n- Boeve B. REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions. [*Annals of the New York Academy of Sciences*](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2902006\/). January 2010.\n- REM Sleep Behavior Disorder. [Mayo Clinic](https:\/\/www.mayoclinic.org\/diseases-conditions\/rem-sleep-behavior-disorder\/symptoms-causes\/syc-20352920). January 18, 2018.\n- REM Sleep Behavior Disorder. [Sleep Foundation](https:\/\/www.sleepfoundation.org\/parasomnias\/rem-sleep-behavior-disorder). October 26, 2023.\n- Roguski A et al. A Neurologist’s Guide to REM Sleep Behavior Disorder. [*Frontiers in Neurology*](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7360679\/). July 2020.\n- Schenck CH et al. Delayed Emergence of a Parkinsonian Disorder or Dementia in 81% of Older Men Initially Diagnosed With Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A 16-Year Update on a Previously Reported Series. [*Sleep Medicine*](https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1389945712003814?via%3Dihub14)*.* 2013\\.\n- Postuma RB et al. Parkinson Risk in Idiopathic REM Sleep Behavior Disorder: Preparing for Neuroprotective Trials. [*Neurology*](https:\/\/pubmed.ncbi.nlm.nih.gov\/25681454\/). March 2015.\n- Rapid Eye Movement Sleep Behavior Disorder. [*Psychology Today*](https:\/\/www.psychologytoday.com\/us\/conditions\/rapid-eye-movement-sleep-behavior-disorder). March 17, 2022.","meta_canonical":null}

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Meta Title	What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment
Meta Description	Learn about REM sleep behavior disorder, a rare condition in which individuals physically act out their dreams during REM sleep. Understand its symptoms, causes, diagnosis, treatment options, and potential link to neurodegenerative diseases.
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Boilerpipe Text	Have you found yourself kicking, punching, or even leaping out of bed in the middle of a vivid dream? For people with REM sleep behavior disorder, dreams don’t just stay in their minds. REM sleep behavior disorder (RBD) is a rare parasomnia in which you physically act out your dreams while you’re in the rapid eye movement (REM) stage of sleep, according to the Cleveland Clinic . REM sleep is typically when we dream. Our blood pressure rises, our breathing deepens, and our eyes dart in all directions. During normal REM sleep, we don’t move. Our bodies go into temporary muscle paralysis, called atonia, while our brains are wide awake with activity, according to a study published in the Annals of the New York Academy of Sciences . However, for people with REM sleep behavior disorder, this normal muscle paralysis doesn’t happen. Instead, they experience everything from small muscle twitches and whispering to punching, kicking, shouting, and jumping out of bed. They may even hurt themselves or others. “The way we describe it clinically is when you act out your dreams. Most people don’t realize that they’re doing these behaviors — it is usually reported by their bed partners,” says Michael Breus, PhD , a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine. There are two main types of REM sleep behavior disorder, according to John Cline, PhD, a Connecticut-based licensed clinical psychologist specializing in sleep medicine and a diplomate of the American Board of Sleep Medicine. Isolated (Idiopathic) RBD In these cases, the condition doesn’t have an underlying cause. But it may be an early warning sign of a neurodegenerative condition such as Parkinson’s disease, Lewy body dementia , or multiple system atrophy, according to the Cleveland Clinic. Symptomatic (Secondary) RBD These cases have an underlying cause such as narcolepsy or a drug side effect. Signs and Symptoms of REM Sleep Behavior Disorder The main symptom of REM sleep behavior disorder is physically acting out your dreams, because your body isn’t immobilized like it should be during REM sleep. It may start suddenly or come on gradually but typically gets worse over time. You may have episodes every once in a while or several times in a night. Other symptoms, according to the Mayo Clinic , include: Making noises like talking, laughing, shouting, or yelling for help Being easy to awaken during an episode, coherent afterward, and able to recall the dream Unpleasant dream content like arguments, accidents, or attacks “Typically, these are violent dreams,” says Dr. Cline. “One patient was waving their hands because they dreamt they were swarmed by bees, and then, more rarely, there are situations where people have done complex things like diving out of bed because they dreamt they were on a diving board.” Episodes often happen in the second half of the night into the morning, when you experience longer phases of REM sleep, according to the Sleep Foundation . Causes and Risk Factors of REM Sleep Behavior Disorder RBD appears to come from a problem with certain nerve pathways in your brain. But it isn’t clear why it happens. “We don’t know the exact cause, but what appears to be happening is that when you are in REM sleep, you should be in a state of atonia, or paralysis, specifically so you do not act out your dreams. And this mechanism appears to be not working,” Dr. Breus says. Certain things make you more likely to develop it, according to the Sleep Foundation: Being male and over 50 years old Having a neurological disorder like Parkinson’s disease, Lewy body dementia, or multiple system atrophy Having narcolepsy Using antidepressants Using or withdrawing from drugs or alcohol The Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. “As a general guideline we do tend to see this in our older sleepers,” Breus says. Sleep deprivation, smoking, head injury, and exposure to pesticides may also be risk factors. How Is REM Sleep Behavior Disorder Diagnosed? More often than not, RBD is first reported by a patient’s bed partner, then it’s formally diagnosed with a sleep study, Breus says. According to the American Academy of Sleep Medicine, a patient must meet the following four criteria : You have repeatedly experienced episodes of acting out your dreams with vocalizations or arm and leg movements that correspond to what’s taking place in your dream. Episodes occur during REM sleep, as confirmed by a sleep study or your clinical history. You experience REM sleep without atonia, as confirmed by a sleep study. The episodes aren’t caused by another sleep or mental health disorder, a side effect of medication, or substance abuse. If you often act out your dreams, talk to your doctor. They’ll ask about your sleep behavior and may have you keep a sleep diary to document how often you have episodes and what goes on during them. They’ll also consider your medical history, medications you're taking, and other factors like alcohol intake. They may refer you to a sleep specialist for an overnight sleep study, or polysomnogram. During this test, sensors will monitor your breathing, eye movements, arm and leg movements, and brain and heart activity. The polysomnogram will also record any dream enactment behavior. Treatment and Medication Options for REM Sleep Behavior Disorder While there is no cure for REM sleep behavior disorder, treatment may include options such as lifestyle changes, medication, and protecting you — and your bed partner — from harm. Lifestyle and Behavioral Changes That Can Help Avoid triggers. Alcohol and certain antidepressants are linked to RBD. Talk to your doctor about whether your meds may be causing your episodes and if your prescription can be changed or adjusted. Keep track of when you drink before bedtime and if this increases your risk. “Alcohol seems to play a role for some patients so avoiding it is key,” Breus says. Practice sleep hygiene. The Sleep Foundation recommends good sleep habits, which include following a consistent sleep schedule, eliminating outside noise, and sleeping in a cool, dark room. “I will tell you that the more sleep-deprived a person is, the more likely they are to have episodes. So having both good quality and quantity sleep is always important,” Breus says. Safeguard your bedroom . From bruises and cuts to broken bones or even head trauma, injury is a serious risk to you and anyone you sleep with. “It can be really serious. We’ve had people come in where they look beaten up because they’ve jumped out of bed and crashed into things,” Cline says. Establish a safe sleeping environment by: Keeping sharp objects and weapons out of the bedroom Placing padding on the floor in case you fall off the bed Installing padded bedrails or even moving your mattress onto the floor Moving furniture, clutter, and other trip hazards away from the bed Sleeping alone until your symptoms are controlled Medication Options Talk with your doctor to determine whether medication may be helpful to treat your RBD, Cline says. The Mayo Clinic suggests: Clonazepam (Klonopin) This is a prescription medication is usually used to treat anxiety. However, it can help with REM sleep behavior disorder by suppressing muscle activity during REM sleep. It can cause side effects including daytime sleepiness, loss of balance, and worsening of sleep apnea. Melatonin Your doctor may prescribe a supplement called melatonin, which can help regulate your sleep cycle. It may be as effective for RBD as clonazepam, with fewer side effects. Complications of REM Sleep Behavior Disorder Besides injuries, the main risk tied to REM sleep behavior disorder is that it could be a very early symptom of a neurodegenerative disorder. Many people who have it go on to develop Parkinson’s disease, Lewy body dementia, or multiple system atrophy. “RBD is a serious situation and not just something funny that a family member does. Talk to your doctor about it as soon as possible. It could be an early warning sign,” Breus warns. One almost 30-year study found that over 80 percent of a group of men age 50 or older with RBD eventually developed a neurological condition, usually within 13 years of the start of their sleep symptoms. Another slightly larger study found that 30 percent of participants were diagnosed with Parkinson’s disease or dementia three years or less after the onset of REM sleep behavior disorder and 66 percent developed those conditions within eight years of the study. “It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD,” Cline says. Research and Statistics: How Many People Have REM Sleep Behavior Disorder? Cline says that REM sleep behavior disorder is rare. Less than 0.5 percent of the general population has RBD, although the prevalence is higher in people with certain neurocognitive disorders such as Parkinson’s disease or dementia. It may be as high as 30 percent in people who also have narcolepsy, according to Psychology Today . The Takeaway People with REM sleep behavior disorder tend to act out their dreams, rather than having their muscles be at rest during sleep. Common symptoms include making noises, awakening easily, or having violent dreams. Good sleep hygiene, like maintaining a regular bedtime routine and avoiding alcohol or other triggers, may help ease symptoms. Once you confirm your diagnosis with a sleep doctor and determine the root cause — such as medication, anxiety, or a neurological condition — you may be prescribed a medication like Klonopin that can suppress your muscle movements while you sleep. FAQ What is REM sleep behavior disorder? REM sleep behavior disorder is a parasomnia that causes people to physically act out their dreams while they’re in the rapid eye movement (REM) stage of sleep. How common is REM sleep behavior disorder? It’s rare, affecting less than 0.5 percent of the general population. The prevalence is higher in people who have narcolepsy and certain neurocognitive disorders such as Parkinson’s disease and dementia. What are the symptoms of REM sleep behavior disorder? The most common symptom of REM sleep behavior disorder is movement such as kicking, punching, arm flailing, or jumping out of bed — all in response to an action-filled or violent dream such as being chased or defending yourself from an attack. You may also talk, laugh, or yell. Is there a cure for REM sleep behavior disorder? No, there is no cure for REM sleep behavior disorder, but it can be managed through options such as medicine, cutting back on alcohol, and creating a safe sleeping environment for you and your bed partner. What is the top concern for people with REM sleep behavior disorder? Research suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia. One study found that 30 percent of people with RBD developed Parkinson’s disease or dementia within three years of sleep symptoms and 66 percent did within eight years. Resources We Trust Mayo Clinic: REM Sleep Disorder Doubles Risk of Mild Cognitive Impairment, Parkinson’s Cleveland Clinic: Parasomnias and Disruptive Sleep Disorders NAPS Consortium for REM Sleep Behavior Disorder: Are You Living With RBD? Parkinson's Foundation: Sleep Disorders Frontiers in Neurology : A Neurologist’s Guide to REM Sleep Behavior Disorder Meet Our Experts See Our Editorial Policy Meet Our Health Expert Network Alex Dimitriu, MD Medical Reviewer Alex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work. Dr. Dimitriu has been recognized by The New York Times , Discover magazine, Men’s Health , Cosmopolitan , and NBC News, among other media outlets. He is a medical reviewer for Business Insider and the Sleep Foundation, and is a contributing author to the Encyclopedia of Sleep Medicine . See full bio Carmen Chai Author Carmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s. Chai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the Toronto Star , Vancouver Province, and the National Post . She received a bachelor’s degree in journalism from Ryerson University in Toronto. See full bio See Our Editorial Policy Meet Our Health Expert Network EDITORIAL SOURCES Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions. Additional Sources REM Sleep Behavior Disorder. Cleveland Clinic . Boeve B. REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions. Annals of the New York Academy of Sciences . January 2010. REM Sleep Behavior Disorder. Mayo Clinic . January 18, 2018. REM Sleep Behavior Disorder. Sleep Foundation . October 26, 2023. Roguski A et al. A Neurologist’s Guide to REM Sleep Behavior Disorder. Frontiers in Neurology . July 2020. Schenck CH et al. Delayed Emergence of a Parkinsonian Disorder or Dementia in 81% of Older Men Initially Diagnosed With Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A 16-Year Update on a Previously Reported Series. Sleep Medicine . 2013. Postuma RB et al. Parkinson Risk in Idiopathic REM Sleep Behavior Disorder: Preparing for Neuroprotective Trials. Neurology . March 2015. Rapid Eye Movement Sleep Behavior Disorder. Psychology Today . March 17, 2022.
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Learn how to get better sleep, why sleep is important, and the risks of sleeping poorly over time. [LEARN MORE](https://www.everydayhealth.com/sleep-health-hygiene/) - [1Sleep 101: The Ultimate Guide to a Better Night’s Sleep](https://www.everydayhealth.com/sleep-disorders/sleep/sleep-101-ultimate-guide-on-how-get-better-nights-sleep/) - [2What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx) - [3What Is Sleepwalking? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https://www.everydayhealth.com/sleepwalking/guide/) - [4What Is Sleep Paralysis? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https://www.everydayhealth.com/sleep-paralysis/guide/) - [5What Is Hypersomnia? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https://www.everydayhealth.com/sleep/excessive-daytime-sleepiness-facts/) - [6What Is Sexsomnia? Symptoms, Causes, Diagnosis, Treatment, and Prevention](https://www.everydayhealth.com/sleep/what-is-sexsomnia.aspx) - [7All About Sleep Cycles and the Stages of Sleep](https://www.everydayhealth.com/sleep/sleep-cycles-and-the-stages-of-sleep/) - [8Sleep Calculator: How Much Sleep Do You Really Need Each Night?](https://www.everydayhealth.com/sleep/101/how-much-sleep-do-you-need.aspx) [SEE MORE](https://www.everydayhealth.com/sleep-health-hygiene/) # What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment ![What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment](https://images.everydayhealth.com/images/sleep-disorders/sleep/what-is-rem-sleep-behavior-disorder-symptoms-causes-diagnosis-treatment-alt-1440x810.jpg?w=508) Adobe Stock By [Carmen Chai](https://www.everydayhealth.com/authors/carmen-chai/) Updated on December 6, 2023 Medically Reviewed by [Alex Dimitriu, MD](https://www.everydayhealth.com/authors/alex-dimitriu/) ON THIS PAGE - [Symptoms](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#symptoms) - [Causes](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#causes) - [Diagnosis](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#diagnosis) - [Treatment](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#treatment) - [Complications](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#complications) - [Research and Statistics](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#research-and-statistics) - [FAQ](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#faq) [Sleep Health & Hygiene]() ON THIS PAGE - [Symptoms](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#symptoms) - [Causes](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#causes) - [Diagnosis](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#diagnosis) - [Treatment](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#treatment) - [Complications](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#complications) - [Research and Statistics](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#research-and-statistics) - [FAQ](https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx#faq) Have you found yourself kicking, punching, or even leaping out of bed in the middle of a vivid dream? For people with REM sleep behavior disorder, dreams don’t just stay in their minds. REM sleep behavior disorder (RBD) is a rare parasomnia in which you physically act out your dreams while you’re in the rapid eye movement (REM) stage of sleep, according to the [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd). REM sleep is typically when we dream. Our blood pressure rises, our breathing deepens, and our eyes dart in all directions. During normal REM sleep, we don’t move. Our bodies go into temporary muscle paralysis, called atonia, while our brains are wide awake with activity, according to a study published in the [Annals of the New York Academy of Sciences](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902006/). However, for people with REM sleep behavior disorder, this normal muscle paralysis doesn’t happen. Instead, they experience everything from small muscle twitches and whispering to punching, kicking, shouting, and jumping out of bed. They may even hurt themselves or others. “The way we describe it clinically is when you act out your dreams. Most people don’t realize that they’re doing these behaviors — it is usually reported by their bed partners,” says [Michael Breus, PhD](https://sleepdoctor.com/pages/dr-michael-breus), a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine. There are two main types of REM sleep behavior disorder, according to John Cline, PhD, a Connecticut-based licensed clinical psychologist specializing in sleep medicine and a diplomate of the American Board of Sleep Medicine. - Isolated (Idiopathic) RBD In these cases, the condition doesn’t have an underlying cause. But it may be an early warning sign of a neurodegenerative condition such as Parkinson’s disease, [Lewy body dementia](https://www.everydayhealth.com/dementia/lewy-body-dementia/), or multiple system atrophy, according to the Cleveland Clinic. - Symptomatic (Secondary) RBD These cases have an underlying cause such as narcolepsy or a drug side effect. ## Signs and Symptoms of REM Sleep Behavior Disorder The main symptom of REM sleep behavior disorder is physically acting out your dreams, because your body isn’t immobilized like it should be during REM sleep. It may start suddenly or come on gradually but typically gets worse over time. You may have episodes every once in a while or several times in a night. Other symptoms, according to the [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920), include: - Making noises like talking, laughing, shouting, or yelling for help - Being easy to awaken during an episode, coherent afterward, and able to recall the dream - Unpleasant dream content like arguments, accidents, or attacks “Typically, these are violent dreams,” says Dr. Cline. “One patient was waving their hands because they dreamt they were swarmed by bees, and then, more rarely, there are situations where people have done complex things like diving out of bed because they dreamt they were on a diving board.” Episodes often happen in the second half of the night into the morning, when you experience longer phases of REM sleep, according to the [Sleep Foundation](https://www.sleepfoundation.org/parasomnias/rem-sleep-behavior-disorder). ## Causes and Risk Factors of REM Sleep Behavior Disorder RBD appears to come from a problem with certain nerve pathways in your brain. But it isn’t clear why it happens. “We don’t know the exact cause, but what appears to be happening is that when you are in REM sleep, you should be in a state of atonia, or paralysis, specifically so you do not act out your dreams. And this mechanism appears to be not working,” Dr. Breus says. Certain things make you more likely to develop it, according to the Sleep Foundation: - Being male and over 50 years old - Having a neurological disorder like Parkinson’s disease, Lewy body dementia, or multiple system atrophy - Having narcolepsy - Using antidepressants - Using or withdrawing from drugs or alcohol The Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. “As a general guideline we do tend to see this in our older sleepers,” Breus says. Sleep deprivation, smoking, head injury, and exposure to pesticides may also be risk factors. ## How Is REM Sleep Behavior Disorder Diagnosed? More often than not, RBD is first reported by a patient’s bed partner, then it’s formally diagnosed with a sleep study, Breus says. According to the American Academy of Sleep Medicine, a patient must meet the following [four criteria](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360679/): - You have repeatedly experienced episodes of acting out your dreams with vocalizations or arm and leg movements that correspond to what’s taking place in your dream. - Episodes occur during REM sleep, as confirmed by a sleep study or your clinical history. - You experience REM sleep without atonia, as confirmed by a sleep study. - The episodes aren’t caused by another sleep or mental health disorder, a side effect of medication, or substance abuse. If you often act out your dreams, talk to your doctor. They’ll ask about your sleep behavior and may have you keep a sleep diary to document how often you have episodes and what goes on during them. They’ll also consider your medical history, medications you're taking, and other factors like alcohol intake. They may refer you to a sleep specialist for an overnight sleep study, or polysomnogram. During this test, sensors will monitor your breathing, eye movements, arm and leg movements, and brain and heart activity. The polysomnogram will also record any dream enactment behavior. ## Treatment and Medication Options for REM Sleep Behavior Disorder While there is no cure for REM sleep behavior disorder, treatment may include options such as lifestyle changes, medication, and protecting you — and your bed partner — from harm. ### Lifestyle and Behavioral Changes That Can Help Avoid triggers. Alcohol and certain antidepressants are linked to RBD. Talk to your doctor about whether your meds may be causing your episodes and if your prescription can be changed or adjusted. Keep track of when you drink before bedtime and if this increases your risk. “Alcohol seems to play a role for some patients so avoiding it is key,” Breus says. Practice sleep hygiene. The Sleep Foundation recommends good sleep habits, which include following a consistent sleep schedule, eliminating outside noise, and sleeping in a cool, dark room. “I will tell you that the more sleep-deprived a person is, the more likely they are to have episodes. So having both good quality and quantity sleep is always important,” Breus says. Safeguard your bedroom. From bruises and cuts to broken bones or even head trauma, injury is a serious risk to you and anyone you sleep with. “It can be really serious. We’ve had people come in where they look beaten up because they’ve jumped out of bed and crashed into things,” Cline says. Establish a safe sleeping environment by: - Keeping sharp objects and weapons out of the bedroom - Placing padding on the floor in case you fall off the bed - Installing padded bedrails or even moving your mattress onto the floor - Moving furniture, clutter, and other trip hazards away from the bed - Sleeping alone until your symptoms are controlled ### Medication Options Talk with your doctor to determine whether medication may be helpful to treat your RBD, Cline says. The Mayo Clinic suggests: - Clonazepam (Klonopin) This is a prescription medication is usually used to treat anxiety. However, it can help with REM sleep behavior disorder by suppressing muscle activity during REM sleep. It can cause side effects including daytime sleepiness, loss of balance, and worsening of sleep apnea. - Melatonin Your doctor may prescribe a supplement called melatonin, which can help regulate your sleep cycle. It may be as effective for RBD as clonazepam, with fewer side effects. ## Complications of REM Sleep Behavior Disorder Besides injuries, the main risk tied to REM sleep behavior disorder is that it could be a very early symptom of a neurodegenerative disorder. Many people who have it go on to develop Parkinson’s disease, Lewy body dementia, or multiple system atrophy. “RBD is a serious situation and not just something funny that a family member does. Talk to your doctor about it as soon as possible. It could be an early warning sign,” Breus warns. [One almost 30-year study](https://www.sciencedirect.com/science/article/abs/pii/S1389945712003814?via%3Dihub) found that over 80 percent of a group of men age 50 or older with RBD eventually developed a neurological condition, usually within 13 years of the start of their sleep symptoms. Another [slightly larger study](https://pubmed.ncbi.nlm.nih.gov/25681454/) found that 30 percent of participants were diagnosed with Parkinson’s disease or dementia three years or less after the onset of REM sleep behavior disorder and 66 percent developed those conditions within eight years of the study. “It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD,” Cline says. ## Research and Statistics: How Many People Have REM Sleep Behavior Disorder? Cline says that REM sleep behavior disorder is rare. Less than 0.5 percent of the general population has RBD, although the prevalence is higher in people with certain neurocognitive disorders such as Parkinson’s disease or dementia. It may be as high as 30 percent in people who also have narcolepsy, according to [Psychology Today](https://www.psychologytoday.com/us/conditions/rapid-eye-movement-sleep-behavior-disorder). ## The Takeaway - People with REM sleep behavior disorder tend to act out their dreams, rather than having their muscles be at rest during sleep. - Common symptoms include making noises, awakening easily, or having violent dreams. - Good sleep hygiene, like maintaining a regular bedtime routine and avoiding alcohol or other triggers, may help ease symptoms. - Once you confirm your diagnosis with a sleep doctor and determine the root cause — such as medication, anxiety, or a neurological condition — you may be prescribed a medication like Klonopin that can suppress your muscle movements while you sleep. ### FAQ What is REM sleep behavior disorder? REM sleep behavior disorder is a parasomnia that causes people to physically act out their dreams while they’re in the rapid eye movement (REM) stage of sleep. How common is REM sleep behavior disorder? It’s rare, affecting less than 0.5 percent of the general population. The prevalence is higher in people who have narcolepsy and certain neurocognitive disorders such as Parkinson’s disease and dementia. What are the symptoms of REM sleep behavior disorder? The most common symptom of REM sleep behavior disorder is movement such as kicking, punching, arm flailing, or jumping out of bed — all in response to an action-filled or violent dream such as being chased or defending yourself from an attack. You may also talk, laugh, or yell. Is there a cure for REM sleep behavior disorder? No, there is no cure for REM sleep behavior disorder, but it can be managed through options such as medicine, cutting back on alcohol, and creating a safe sleeping environment for you and your bed partner. What is the top concern for people with REM sleep behavior disorder? Research suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia. One study found that 30 percent of people with RBD developed Parkinson’s disease or dementia within three years of sleep symptoms and 66 percent did within eight years. ## Resources We Trust Share Share on Facebook Share on X Share on Pinterest Copy Link - Mayo Clinic: [REM Sleep Disorder Doubles Risk of Mild Cognitive Impairment, Parkinson’s](https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-rem-sleep-disorder-doubles-risk-of-mild-cognitive-impairment-parkinsons/) - Cleveland Clinic: [Parasomnias and Disruptive Sleep Disorders](https://my.clevelandclinic.org/health/diseases/12133-parasomnias--disruptive-sleep-disorders) - NAPS Consortium for REM Sleep Behavior Disorder: [Are You Living With RBD?](https://www.naps-rbd.org/rbd) - Parkinson's Foundation: [Sleep Disorders](https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/sleep-disorders) - **Frontiers in Neurology:** [A Neurologist’s Guide to REM Sleep Behavior Disorder](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360679/) Meet Our Experts [See Our Editorial Policy](https://www.everydayhealth.com/editorial-policies/) [Meet Our Health Expert Network](https://www.everydayhealth.com/health-expert-network/) ![alex-dimitriu-bio](https://images.everydayhealth.com/images/site-images/most-recent-default-img.jpg?w=120) ![alex-dimitriu-bio](https://images.everydayhealth.com/images/bio-photos/alex-dimitriu-bio.jpg?sfvrsn=83e2a736_0) #### Alex Dimitriu, MD ##### Medical Reviewer Alex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work. Dr. Dimitriu has been recognized by The New York Times, Discover magazine, Men’s Health, Cosmopolitan, and NBC News, among other media outlets. He is a medical reviewer for Business Insider and the Sleep Foundation, and is a contributing author to the Encyclopedia of Sleep Medicine. [See full bio](https://www.everydayhealth.com/authors/alex-dimitriu/) ![carmen-chai-bio](https://images.everydayhealth.com/images/site-images/most-recent-default-img.jpg?w=120) ![carmen-chai-bio](https://images.everydayhealth.com/images/bio-photos/carmen-chai-bio.jpg?sfvrsn=411f0fdf_0) #### Carmen Chai ##### Author Carmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s. Chai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the Toronto Star, Vancouver Province, and the National Post. She received a bachelor’s degree in journalism from Ryerson University in Toronto. [See full bio](https://www.everydayhealth.com/authors/carmen-chai/) [See Our Editorial Policy](https://www.everydayhealth.com/editorial-policies/) [Meet Our Health Expert Network](https://www.everydayhealth.com/health-expert-network/) EDITORIAL SOURCES Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our [editorial policy](https://www.everydayhealth.com/editorial-policies/). We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions. Sources Additional Sources - REM Sleep Behavior Disorder. [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd). - Boeve B. REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions. [Annals of the New York Academy of Sciences](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902006/). January 2010. - REM Sleep Behavior Disorder. [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920). January 18, 2018. - REM Sleep Behavior Disorder. [Sleep Foundation](https://www.sleepfoundation.org/parasomnias/rem-sleep-behavior-disorder). October 26, 2023. - Roguski A et al. A Neurologist’s Guide to REM Sleep Behavior Disorder. [Frontiers in Neurology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360679/). July 2020. - Schenck CH et al. Delayed Emergence of a Parkinsonian Disorder or Dementia in 81% of Older Men Initially Diagnosed With Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A 16-Year Update on a Previously Reported Series. [Sleep Medicine](https://www.sciencedirect.com/science/article/abs/pii/S1389945712003814?via%3Dihub14). 2013\. - Postuma RB et al. Parkinson Risk in Idiopathic REM Sleep Behavior Disorder: Preparing for Neuroprotective Trials. [Neurology](https://pubmed.ncbi.nlm.nih.gov/25681454/). March 2015. - Rapid Eye Movement Sleep Behavior Disorder. [Psychology Today](https://www.psychologytoday.com/us/conditions/rapid-eye-movement-sleep-behavior-disorder). 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Readable Markdown	Have you found yourself kicking, punching, or even leaping out of bed in the middle of a vivid dream? For people with REM sleep behavior disorder, dreams don’t just stay in their minds. REM sleep behavior disorder (RBD) is a rare parasomnia in which you physically act out your dreams while you’re in the rapid eye movement (REM) stage of sleep, according to the [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd). REM sleep is typically when we dream. Our blood pressure rises, our breathing deepens, and our eyes dart in all directions. During normal REM sleep, we don’t move. Our bodies go into temporary muscle paralysis, called atonia, while our brains are wide awake with activity, according to a study published in the [Annals of the New York Academy of Sciences](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902006/). However, for people with REM sleep behavior disorder, this normal muscle paralysis doesn’t happen. Instead, they experience everything from small muscle twitches and whispering to punching, kicking, shouting, and jumping out of bed. They may even hurt themselves or others. “The way we describe it clinically is when you act out your dreams. Most people don’t realize that they’re doing these behaviors — it is usually reported by their bed partners,” says [Michael Breus, PhD](https://sleepdoctor.com/pages/dr-michael-breus), a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine. There are two main types of REM sleep behavior disorder, according to John Cline, PhD, a Connecticut-based licensed clinical psychologist specializing in sleep medicine and a diplomate of the American Board of Sleep Medicine. - Isolated (Idiopathic) RBD In these cases, the condition doesn’t have an underlying cause. But it may be an early warning sign of a neurodegenerative condition such as Parkinson’s disease, [Lewy body dementia](https://www.everydayhealth.com/dementia/lewy-body-dementia/), or multiple system atrophy, according to the Cleveland Clinic. - Symptomatic (Secondary) RBD These cases have an underlying cause such as narcolepsy or a drug side effect. ## Signs and Symptoms of REM Sleep Behavior Disorder The main symptom of REM sleep behavior disorder is physically acting out your dreams, because your body isn’t immobilized like it should be during REM sleep. It may start suddenly or come on gradually but typically gets worse over time. You may have episodes every once in a while or several times in a night. Other symptoms, according to the [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920), include: - Making noises like talking, laughing, shouting, or yelling for help - Being easy to awaken during an episode, coherent afterward, and able to recall the dream - Unpleasant dream content like arguments, accidents, or attacks “Typically, these are violent dreams,” says Dr. Cline. “One patient was waving their hands because they dreamt they were swarmed by bees, and then, more rarely, there are situations where people have done complex things like diving out of bed because they dreamt they were on a diving board.” Episodes often happen in the second half of the night into the morning, when you experience longer phases of REM sleep, according to the [Sleep Foundation](https://www.sleepfoundation.org/parasomnias/rem-sleep-behavior-disorder). ## Causes and Risk Factors of REM Sleep Behavior Disorder RBD appears to come from a problem with certain nerve pathways in your brain. But it isn’t clear why it happens. “We don’t know the exact cause, but what appears to be happening is that when you are in REM sleep, you should be in a state of atonia, or paralysis, specifically so you do not act out your dreams. And this mechanism appears to be not working,” Dr. Breus says. Certain things make you more likely to develop it, according to the Sleep Foundation: - Being male and over 50 years old - Having a neurological disorder like Parkinson’s disease, Lewy body dementia, or multiple system atrophy - Having narcolepsy - Using antidepressants - Using or withdrawing from drugs or alcohol The Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. “As a general guideline we do tend to see this in our older sleepers,” Breus says. Sleep deprivation, smoking, head injury, and exposure to pesticides may also be risk factors. ## How Is REM Sleep Behavior Disorder Diagnosed? More often than not, RBD is first reported by a patient’s bed partner, then it’s formally diagnosed with a sleep study, Breus says. According to the American Academy of Sleep Medicine, a patient must meet the following [four criteria](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360679/): - You have repeatedly experienced episodes of acting out your dreams with vocalizations or arm and leg movements that correspond to what’s taking place in your dream. - Episodes occur during REM sleep, as confirmed by a sleep study or your clinical history. - You experience REM sleep without atonia, as confirmed by a sleep study. - The episodes aren’t caused by another sleep or mental health disorder, a side effect of medication, or substance abuse. If you often act out your dreams, talk to your doctor. They’ll ask about your sleep behavior and may have you keep a sleep diary to document how often you have episodes and what goes on during them. They’ll also consider your medical history, medications you're taking, and other factors like alcohol intake. They may refer you to a sleep specialist for an overnight sleep study, or polysomnogram. During this test, sensors will monitor your breathing, eye movements, arm and leg movements, and brain and heart activity. The polysomnogram will also record any dream enactment behavior. ## Treatment and Medication Options for REM Sleep Behavior Disorder While there is no cure for REM sleep behavior disorder, treatment may include options such as lifestyle changes, medication, and protecting you — and your bed partner — from harm. ### Lifestyle and Behavioral Changes That Can Help Avoid triggers. Alcohol and certain antidepressants are linked to RBD. Talk to your doctor about whether your meds may be causing your episodes and if your prescription can be changed or adjusted. Keep track of when you drink before bedtime and if this increases your risk. “Alcohol seems to play a role for some patients so avoiding it is key,” Breus says. Practice sleep hygiene. The Sleep Foundation recommends good sleep habits, which include following a consistent sleep schedule, eliminating outside noise, and sleeping in a cool, dark room. “I will tell you that the more sleep-deprived a person is, the more likely they are to have episodes. So having both good quality and quantity sleep is always important,” Breus says. Safeguard your bedroom. From bruises and cuts to broken bones or even head trauma, injury is a serious risk to you and anyone you sleep with. “It can be really serious. We’ve had people come in where they look beaten up because they’ve jumped out of bed and crashed into things,” Cline says. Establish a safe sleeping environment by: - Keeping sharp objects and weapons out of the bedroom - Placing padding on the floor in case you fall off the bed - Installing padded bedrails or even moving your mattress onto the floor - Moving furniture, clutter, and other trip hazards away from the bed - Sleeping alone until your symptoms are controlled ### Medication Options Talk with your doctor to determine whether medication may be helpful to treat your RBD, Cline says. The Mayo Clinic suggests: - Clonazepam (Klonopin) This is a prescription medication is usually used to treat anxiety. However, it can help with REM sleep behavior disorder by suppressing muscle activity during REM sleep. It can cause side effects including daytime sleepiness, loss of balance, and worsening of sleep apnea. - Melatonin Your doctor may prescribe a supplement called melatonin, which can help regulate your sleep cycle. It may be as effective for RBD as clonazepam, with fewer side effects. ## Complications of REM Sleep Behavior Disorder Besides injuries, the main risk tied to REM sleep behavior disorder is that it could be a very early symptom of a neurodegenerative disorder. Many people who have it go on to develop Parkinson’s disease, Lewy body dementia, or multiple system atrophy. “RBD is a serious situation and not just something funny that a family member does. Talk to your doctor about it as soon as possible. It could be an early warning sign,” Breus warns. [One almost 30-year study](https://www.sciencedirect.com/science/article/abs/pii/S1389945712003814?via%3Dihub) found that over 80 percent of a group of men age 50 or older with RBD eventually developed a neurological condition, usually within 13 years of the start of their sleep symptoms. Another [slightly larger study](https://pubmed.ncbi.nlm.nih.gov/25681454/) found that 30 percent of participants were diagnosed with Parkinson’s disease or dementia three years or less after the onset of REM sleep behavior disorder and 66 percent developed those conditions within eight years of the study. “It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD,” Cline says. ## Research and Statistics: How Many People Have REM Sleep Behavior Disorder? Cline says that REM sleep behavior disorder is rare. Less than 0.5 percent of the general population has RBD, although the prevalence is higher in people with certain neurocognitive disorders such as Parkinson’s disease or dementia. It may be as high as 30 percent in people who also have narcolepsy, according to [Psychology Today](https://www.psychologytoday.com/us/conditions/rapid-eye-movement-sleep-behavior-disorder). ## The Takeaway - People with REM sleep behavior disorder tend to act out their dreams, rather than having their muscles be at rest during sleep. - Common symptoms include making noises, awakening easily, or having violent dreams. - Good sleep hygiene, like maintaining a regular bedtime routine and avoiding alcohol or other triggers, may help ease symptoms. - Once you confirm your diagnosis with a sleep doctor and determine the root cause — such as medication, anxiety, or a neurological condition — you may be prescribed a medication like Klonopin that can suppress your muscle movements while you sleep. FAQ What is REM sleep behavior disorder? REM sleep behavior disorder is a parasomnia that causes people to physically act out their dreams while they’re in the rapid eye movement (REM) stage of sleep. How common is REM sleep behavior disorder? It’s rare, affecting less than 0.5 percent of the general population. The prevalence is higher in people who have narcolepsy and certain neurocognitive disorders such as Parkinson’s disease and dementia. What are the symptoms of REM sleep behavior disorder? The most common symptom of REM sleep behavior disorder is movement such as kicking, punching, arm flailing, or jumping out of bed — all in response to an action-filled or violent dream such as being chased or defending yourself from an attack. You may also talk, laugh, or yell. Is there a cure for REM sleep behavior disorder? No, there is no cure for REM sleep behavior disorder, but it can be managed through options such as medicine, cutting back on alcohol, and creating a safe sleeping environment for you and your bed partner. What is the top concern for people with REM sleep behavior disorder? Research suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia. One study found that 30 percent of people with RBD developed Parkinson’s disease or dementia within three years of sleep symptoms and 66 percent did within eight years. ## Resources We Trust - Mayo Clinic: [REM Sleep Disorder Doubles Risk of Mild Cognitive Impairment, Parkinson’s](https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-rem-sleep-disorder-doubles-risk-of-mild-cognitive-impairment-parkinsons/) - Cleveland Clinic: [Parasomnias and Disruptive Sleep Disorders](https://my.clevelandclinic.org/health/diseases/12133-parasomnias--disruptive-sleep-disorders) - NAPS Consortium for REM Sleep Behavior Disorder: [Are You Living With RBD?](https://www.naps-rbd.org/rbd) - Parkinson's Foundation: [Sleep Disorders](https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/sleep-disorders) - **Frontiers in Neurology:** [A Neurologist’s Guide to REM Sleep Behavior Disorder](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360679/) Meet Our Experts [See Our Editorial Policy](https://www.everydayhealth.com/editorial-policies/)[Meet Our Health Expert Network](https://www.everydayhealth.com/health-expert-network/) ![alex-dimitriu-bio](https://images.everydayhealth.com/images/site-images/most-recent-default-img.jpg?w=120) #### Alex Dimitriu, MD ##### Medical Reviewer Alex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work. Dr. Dimitriu has been recognized by The New York Times, Discover magazine, Men’s Health, Cosmopolitan, and NBC News, among other media outlets. He is a medical reviewer for Business Insider and the Sleep Foundation, and is a contributing author to the Encyclopedia of Sleep Medicine. [See full bio](https://www.everydayhealth.com/authors/alex-dimitriu/) ![carmen-chai-bio](https://images.everydayhealth.com/images/site-images/most-recent-default-img.jpg?w=120) #### Carmen Chai ##### Author Carmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s. Chai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the Toronto Star, Vancouver Province, and the National Post. She received a bachelor’s degree in journalism from Ryerson University in Toronto. [See full bio](https://www.everydayhealth.com/authors/carmen-chai/) [See Our Editorial Policy](https://www.everydayhealth.com/editorial-policies/)[Meet Our Health Expert Network](https://www.everydayhealth.com/health-expert-network/) EDITORIAL SOURCES Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our [editorial policy](https://www.everydayhealth.com/editorial-policies/). We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions. Additional Sources - REM Sleep Behavior Disorder. [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd). - Boeve B. REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions. [Annals of the New York Academy of Sciences](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902006/). January 2010. - REM Sleep Behavior Disorder. [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920). January 18, 2018. - REM Sleep Behavior Disorder. [Sleep Foundation](https://www.sleepfoundation.org/parasomnias/rem-sleep-behavior-disorder). October 26, 2023. - Roguski A et al. A Neurologist’s Guide to REM Sleep Behavior Disorder. [Frontiers in Neurology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360679/). July 2020. - Schenck CH et al. Delayed Emergence of a Parkinsonian Disorder or Dementia in 81% of Older Men Initially Diagnosed With Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A 16-Year Update on a Previously Reported Series. [Sleep Medicine](https://www.sciencedirect.com/science/article/abs/pii/S1389945712003814?via%3Dihub14). 2013\. - Postuma RB et al. Parkinson Risk in Idiopathic REM Sleep Behavior Disorder: Preparing for Neuroprotective Trials. [Neurology](https://pubmed.ncbi.nlm.nih.gov/25681454/). March 2015. - Rapid Eye Movement Sleep Behavior Disorder. [Psychology Today](https://www.psychologytoday.com/us/conditions/rapid-eye-movement-sleep-behavior-disorder). March 17, 2022.
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