REM Behavior Disorder

REM behavior disorder (RBD) occurs during a stage of sleep known as Rapid Eye Movement (REM) sleep. The characteristic behaviors of this sleep disorder can sometimes be violent and may cause injury, if left untreated.

During the dreaming state, people are normally paralyzed during their dreams and cannot act out their behaviors. Someone with REM behavior disorder is able to act out his dreams due to the loss of muscle atonia.

This particular disorder can be an inherited trait, but tends to present in males more often than females. Sometimes medications such as antidepressants, can cause REM behavior disorder. In these situations the prescribing physician would need to address the situation.


Individuals who experience REM behavior disorder may call out or talk out loud and yell during sleep. Other symptoms may include:

  • Acting out violent behaviors, such as hitting or thrashing about in or out of the bed,
  • Sleepiness during the daytime,
  • Awakening with injury such as lacerations, bleeding, bumps or bruises and/or
  • Vivid dreams.


Patients will have a history and physical evaluation performed by one of the sleep medicine physicians. Because a clinical history alone is insufficient to make the diagnosis, the sleep center physician may decide to proceed with a sleep study or polysomnography.

A sleep study will monitor a patient’s sleep, particularly REM sleep and will help in making an accurate diagnosis. Video monitoring and/or a full montage EEG may be performed along with the sleep study to differentiate the unusual behaviors during sleep.


Once the diagnosis has been made, the sleep center physician will counsel the patient regarding a treatment plan. Many times medication can help suppress REM sleep and the behaviors associated with this diagnosis. The sleep specialist will also make recommendations for safety measures to be put in place that will help prevent the patient from getting injured during sleep periods.