What is REM sleep behavior disorder?

Updated: Oct 09, 2018
  • Author: Sufen Chiu, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

REM sleep behavior disorder

REM sleep behavior disorder as defined by DSM-5 involves repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors. Since these behaviors arise during REM sleep, they usually occur more than 90 minutes after sleep onset and occur more frequent during the later part of sleep period. It usually does not occur during daytime naps.

Upon awakening from these episodes, the individual is completely awake, alert, and oriented. One of following also needs to be present: REM sleep without atonia on polysomnographic recording or a history if symptoms with an established synucleinopathy diagnosis (Parkinson disease, multiple system atrophy). The vocalizations or complex motor behaviors are usually responses to action-filled or violent dreams and are sometimes termed dream-enacting behaviors.

Nocturnal seizures may mimic REM sleep behavior disorder. However, these behaviors are more stereotyped. Symptoms in young individuals are usually an indication of narcolepsy or medication-induced REM sleep behavior disorder. Symptoms in young females are more likely to be caused by narcolepsy.


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