REM Sleep Behavior Disorder

REM sleep behavior disorder (RBD) is a condition in which you physically and/or vocally act out your dreams while in the rapid eye movement (REM) stage of sleep. You’re unaware of your actions while you’re asleep. RBD is a parasomnia, which is a sleep disorder that involves unusual and undesirable physical events or experiences that disrupt your sleep.

REM sleep is when you tend to have vivid dreams. You have several REM cycles per night. The first REM cycle begins about 90 minutes after you fall asleep and lasts about 10 minutes. Each REM cycle that follows gets longer and longer.

There are two main types of RBD: isolated (idiopathic) and symptomatic (secondary).

Isolated or idiopathic RBD happens when the condition develops spontaneously without an underlying cause. Most people with idiopathic RBD will eventually develop a neurodegenerative condition — specifically, Parkinson’s disease, Lewy body dementia or multiple system atrophy (MSA). These conditions are called alpha-synucleinopathies.

Symptomatic or secondary RBD happens due to an underlying cause, such as Type 1 narcolepsy. When a person has both an alpha-synucleinopathy and RBD, it’s considered secondary RBD.

People who take certain antidepressants can develop RBD. This is called drug-induced RBD.

RBD can lead to accidental injury to yourself or your bed partner. Because of this, it’s important to seek treatment.

Who does REM sleep behavior disorder affect?

REM sleep behavior disorder (RBD) most commonly affects people over the age of 50. The average age of onset is 61 years. It can also affect children and younger adults, but this is rare.

Among people over age 50, men and people assigned male at birth are nine times more likely than women people assigned female at birth to have RBD.

RBD is strongly associated with certain neurodegenerative disorders. About 97% of people who have isolated (idiopathic) RBD will have Parkinson’s disease, Lewy body dementia or multiple system atrophy within 14 years of diagnosis.

Up to 36% of people with Type 1 narcolepsy have secondary (symptomatic) RBD. And about 6% of people who take antidepressants have drug-induced RBD.

How common is REM sleep behavior disorder?

REM sleep behavior disorder (RBD) is relatively rare. It affects about 1% of the general U.S. population and affects 2% of people aged 50 or older.

These rates may be higher in reality, as RBD can be difficult to officially diagnose, and almost half of people with the condition don’t realize they have it.