People with REM sleep behavior disorder will often grind their teeth, scream or engage in violent behaviors during the rapid eye movement (REM) sleep phase. According to experts, this disease is common in men over 50 years old, rarely in women and children.
Patients with REM sleep behavior disorder often talk and act violently during sleep
What is REM Sleep Behavior Disorder?
Based on the results of specialized studies, it has been agreed that sleep will be divided into two specific stages, namely NREM (non rapid eye movement) and REM (rapid eye movement). Normally, REM sleep will occur in about 1.5 to 2 hours of a normal sleep. When sleep has reached the REM sleep cycle, the body will temporarily fall into a state of paralysis.
Accordingly, people with REM sleep behavior disorder (RBD) will not maintain this paralysis well or it may be absent from sleep altogether. Therefore, patients tend to realize their own dreams, sometimes they tend to be violent, expressed in a dramatic way. The temporary lack of paralysis in REM sleep causes many people to become physically more agitated, experts say. The person may scream, talk, move his arms and legs, swing his arms and legs very hard, and fight while sleeping.
In some cases, people with REM sleep behavior disorder may commit violent acts that hurt themselves or those around them. In particular, violent acts can be real and increase in intensity if the person is experiencing a violent dream or a terrible nightmare. And after waking up, they may remember the content of the dream but will not be aware of the actions they have performed in reality.
On average, activity during REM sleep occurs about four times per night. However, there are also cases that appear only once a week or once a month. This activity will tend to occur in the morning when REM sleep occurs more often.
Causes of REM sleep behavior disorder
Based on statistics, it is found that REM sleep behavior disorder syndrome will often appear in men over 50 years old and very rarely in children and women. For those who have or are suffering from diseases related to central nervous system degeneration such as dementia, multiple system atrophy, Parkinson’s disease, Alzheimer’s disease, synaptic cartilage degeneration, etc. higher-than-normal risk of disease.
According to experts, REM sleep behavior disorder will often start before neurodegeneration, often by several years. This issue has also been specifically explored and proven through a scientific study. The results found that about 38% of patients were diagnosed with RBD 12 to 13 years after developing Parkinson’s disease. In contrast, more than 69% of patients with multisystem atrophy or Parkinson’s disease present with symptoms of REM sleep behavior disorder.
REM sleep behavior disorder is more common in men over 50 years old
However, until now, there has not been any specific identification of the cause of REM sleep behavior disorder. Based on a survey on subjects who have had the disease, it has been found that up to 45% of cases of illness are related to the abuse of stimulants, alcohol, and medications such as antidepressants. tricyclics, sedatives, selective serotonin reuptake drugs (fluoxetine, sertraline, or paroxet), other antidepressants such as mirtazapine.
In addition, some experts also share that this disorder can be related to and developed by narcolepsy. This is one of the most common sleep disorders characterized by excessive daytime sleepiness, accompanied by a sudden loss of muscle tone. Several other studies have also found a relationship between RBD and history of head trauma or frequent exposure to pesticides.
Signs of REM sleep behavior disorder
REM sleep is a state of deep sleep, temporary paralysis of the limbs, loss of muscle tone along with rapid eye movements or sometimes dreams. However, when suffering from REM sleep behavior disorder syndrome, the patient does not completely lose tone in the limbs. Therefore, instead of falling asleep normally, the patient will develop behaviors to cope with and react to the content that exists in dreams and nightmares.
Some common symptoms in patients with REM sleep behavior disorder include:
- The patient may repeatedly punch, kick, swing his arms and legs, even roll over and get out of bed. These are often behaviors to react and protect yourself from situations of beating, violence, and chasing that appear in a dream.
- After waking up, the patient can still remember the contents of the dream, but they will completely forget or be unaware of what they did during sleep. While normal people only partially remember or even completely forget their dreams, people with RBD will remember in a very detailed and realistic way.
- During sleep, the patient can express very real emotions such as laughing, crying, emotional, screaming, cursing according to the content of the dream.
- Symptoms of REM sleep behavior disorder can be gradual or come on suddenly without warning. It can appear several times a night or a few times a week or a month. If the disease symptoms are not detected and treated early, it will affect the health and life of the patient.
Because of the symptoms that RBD causes, there may be injuries on the body of the person because of the violent behavior that occurs during sleep. The limbs may be scratched, bruised, bleeding, etc. If the sick person sleeps with someone, that person is likely to be woken up by loud noises or sometimes may be injured by the behavior. patient violence.
Is REM sleep behavior disorder dangerous?
As shared above, the common symptom of people with REM sleep behavior disorder is screaming, violent, and agitated behavior that occurs during sleep. At this time, the patient is completely unable to control his own actions and emotions, so he can cause harmful behaviors to himself and the sleeper.
In some cases, after realizing their own illness, they will find a way to separate and isolate themselves from those next to them, choosing to sleep separately to ensure the safety of their loved ones. However, if the people around do not understand and understand their health status, it can cause them to face pressures, stress and more risk of developing depression and anxiety disorders.
RBD can cause people to commit violent acts that hurt themselves and their sleepers
In addition, due to the uncomfortable symptoms and physical damage that RBD can cause, many patients tend to turn to alcohol and stimulants to relieve their mood. At the same time, they are also likely to abuse sleeping pills and sedatives to limit violent behaviors that can occur in REM sleep. However, alcohol only has a temporary effect on emotional release, but it causes a series of other serious health effects and can increase violent behavior, even causing death. they appear with greater frequency.
According to research, REM sleep behavior disorder syndrome is also more likely to be related to central nervous system depression, such as dementia, Parkinson’s disease (statistics found that there are up to approx. 38% of RBD cases develop Parkinson’s symptoms after about 12 to 13 years).
Because of the effects that RBD can cause, as soon as you notice the telltale signs of the disease, you need to actively conduct examination and diagnosis at specialized facilities. Being able to apply appropriate treatment measures will help patients quickly overcome dangerous symptoms and prevent the development of serious mental illnesses.
Diagnosis of REM sleep behavior disorder
If a person is suspected of having REM sleep behavior disorder, the specialist will first conduct an investigation and assessment of the patient’s history. At the same time, they will exploit the symptoms that the patient is experiencing, chat directly with the person sleeping with them to have a more objective view.
The RBD assessment process will include:
- Physical and neurological exam: The specialist will conduct a physical and neurological exam to assess the risk of REM sleep behavior disorder along with other sleep disorders. Because RBD also has symptoms similar to some other sleep disorders or it can also coexist with sleep disorders, especially sleep apnea caused by sleep apnea. obstruction or droopy causes.
- Talk and discuss with your partner who is sleeping with the suspect: Because you yourself will not be able to remember or be aware of the behaviors that you perform while sleeping. So to get the most accurate assessment, your doctor will ask some questions with your sleeping partner. They will be asked if they have ever seen you perform unusual behaviors while sleeping, such as waving arms and legs, moving hands aimlessly, shouting, cursing, etc. You can also ask your partner to record some of the necessary information to do a questionnaire about your sleep behaviors.
- Conduct a nocturnal sleep study: Your doctor may ask you to do a nocturnal study in the lab. During this test, your doctor will use sensors to monitor details of your brain, lungs, heart, breathing patterns, limb movements, voice, and oxygen levels. blood when you have fallen into a deep sleep. Often you will be videotaped to get a clear picture of your behavior during the REM sleep cycle.
To diagnose a person with REM sleep behavior disorder syndrome or not, it is necessary to rely on the following criteria:
- You can remember the content of the dream related to the movements and sounds that you have made.
- During sleep, you have agitated and uncontrolled behaviors and words that are often repeated. Especially actions and words related to the content of the dream.
- If someone wakes you up or you yourself wake up in this dream, you can still be awake, not confused or disoriented.
- During REM sleep, your muscles will increase in activity.
- Your sleep disturbance is not caused by the use of drugs, substances or other sleep disorders or mental health disorders.
Treatment for REM sleep behavior disorder
Up to now, there is no specific treatment for REM sleep behavior disorder syndrome. Often, experts will prioritize the use of drugs and sleep habits to protect the patient and the co-sleeper from violent behavior and noise that disrupt sleep quality.
Depending on the condition of each person, the specialist will consider to prescribe medicine and guide some appropriate remedies. Specifically like:
1. Drug treatment
Currently, there are no drugs that have been specifically proven to be effective in treating REM sleep behavior disorder. The main purpose of using drugs in the treatment process is to relieve the symptoms of the disease, help the patient limit violent behaviors during sleep. At the same time, some drugs also work to improve sleep quality, help patients sleep more deeply, and limit nightmares.
Using drugs will help people with RBD limit violent behaviors and improve sleep quality
Some medications commonly prescribed for RBD patients include:
Clonazepam: Usually, patients will be prescribed a dose of 0.5 to 2mg before going to bed. This drug is used to reduce abusive behaviors that hurt the patient and those who sleep with them. However, the level of absorption and tolerance of the drug is quite low, so it is necessary to use it for a long time to promote the desired effects. In fact, almost 90% of REM sleep behavior disorder cases have been successfully improved with the use of low doses of clonazepam.
Preparations containing melatonin: This is a hormone produced by the pineal gland with the purpose of creating a feeling of sleepiness and helping you get a deeper sleep. In the results of several specialist studies, it has been found that the use of certain medications or supplements containing melatonin helps to reduce and control RBD. Melatonin-containing preparations have similar effects to clonazepam drugs, but with fewer side effects.
However, these drugs all have the potential to cause some unwanted side effects. Therefore, patients need to be very careful during use, strictly comply with the prescription of the doctor. If during the treatment period, there are any strange signs, it is necessary to notify the specialist as soon as possible for timely treatment instructions.
2. Adjust sleep habits and protect sleep
REM sleep behavior disorder is a syndrome related to sleep, so to improve the symptoms of the disease, you need to quickly change your sleeping habits, helping to improve sleep. For adults, it is necessary to maintain enough sleep from 7 to 8 hours and focus on sleeping at night.
Changing your sleep habits is a necessary way to help you overcome RBD well
To improve sleep quality and limit negative behaviors caused by RBD, patients need to pay attention to some of the following:
- Choose a comfortable, quiet sleeping space, avoid decorating or arranging too many things in the room.
- Priority should be given to placing the floor mattress and bed close to each other.
- Arrange the furniture in the bedroom very neatly, regularly clean the bedroom neat and clean.
- To minimize the situation of walking in sleep, you should arrange fences or obstacles right next to the bed.
- Remove all sharp objects and objects that can cause injury from the bedroom.
- Priority is given to the bedroom on the ground floor to ensure safety if there is a move.
- Before sleeping, it is necessary to check the door lock carefully, make sure that the main door and window are locked securely.
- It is best for sick people to sleep separately from loved ones to avoid causing unnecessary injuries and affecting their sleep.
The above article has helped readers to know some useful information about REM sleep behavior disorder syndrome. This condition, if not detected early and with appropriate interventions, will cause many serious consequences. Therefore, as soon as you notice the warning signs, you need to conduct an early examination for timely treatment.
