How REM Sleep Behavior Disorder Affects Me as a Parkinson’s Patient

23 September 2022

rem sleep behavior disorder and parkinson's | Parkinson's News Today | main graphic for column "Embrace for Shake," by Samantha Felder, depicting an orange wave offset by a fantasy scene with a castle and a rainbow

As I close my eyes, my body gears up for the night’s adventures, which begin to appear in a whirlwind of color. Buildings tower above me, reflecting the warm sun in the sky. I see people walking in and out of them. I feel as if I am actually in the scene.

This occurs while I am in a state of rapid eye movement (REM) sleep. During REM sleep, blood pressure rises, breathing becomes faster, and dreams become more intense. Additionally, the body effectively goes into a state of temporary paralysis, allowing people to dream safely.

However, for people like me who have REM sleep behavior disorder (RBD), that’s not what happens. Our dreams are incredibly vivid and lifelike, and many happen to be nightmares. But our body does not go into that state of paralysis, allowing us to move freely and act out our dreams. While scientists don’t know what causes RBD, the Sleep Foundation notes that it’s one of several sleep disorders associated with neurodegenerative disorders like Parkinson’s disease.

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I have been told that I talk in my sleep, shouting out random words that make no sense. For others, talking in their sleep can range from whispering to all-out screaming. Some people with RBD have even been known to laugh and sing.

Managing RBD

Fortunately, I am able to live without medical intervention, though others with RBD may benefit from medication.

The Sleep Foundation’s website explains that doctors generally recommend either melatonin or clonazepam for people with this sleep disorder. Melatonin is more commonly prescribed, since it has fewer side effects and is generally safer for older adults. While clonazepam can help reduce RBD symptoms in 50-80% of patients, it may cause more significant side effects, including sleepiness, forgetfulness, and impaired balance.

Some people, myself included, may be able to manage their RBD through lifestyle changes, such as going to bed around the same time each night, limiting alcohol consumption, and not exercising within six hours of bedtime. Even if you don’t have RBD, many Parkinson’s patients can benefit from practicing good sleep hygiene.

Those with RBD are also encouraged to try injury prevention techniques to ensure the safety of patients, caregivers, and loved ones. A Michigan Medicine article recommends various safety measures, including placing padding on the floor, putting up padded bed rails to prevent a patient from falling out of bed, and making sure there is no clutter near the bed or on the floor. I have found that having silkier sheets helps me, as the fabric is less restrictive and allows me to slide around in bed without getting tangled or trapped.

It’s also suggested that if a partner feels unsafe being in bed with the patient, they should consider sleeping in a separate bed or even another room until their loved one’s symptoms are under control.

If you or your partner are showing signs of RBD, be sure to bring up your concerns to a doctor. They may recommend a sleep specialist to obtain a proper diagnosis and treatment plan.

Sleep well, and remember to “Embrace the Shake.”


Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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