Sleep Disorders that can cause Violent Behavior in Sleep! By Paul Fulmer, MD

Are you sleeping with a “Wild Man?”  No really!  Does your partner tend to have erratic movements while sleeping?  There is a sleep disorder called, Rapid Eye Movement (REM) Sleep Behavior Disorder, which is characterized by people acting out their dreams while in REM sleep.  They can be mild, such as twitches and small leg movements, or as crazy as actually swinging or even choking their partner.   So obviously this can be dangerous.

What causes a person to start acting out their dreams?  During normal REM sleep the body transitions into a voluntary atonia (paralysis).  This is the deepest level of sleep where the body can actually rest, but also where we DREAM.  So in this sleep disorder, the body doesn’t fall into the normal paralysis that accompanies REM sleep.  Subsequently the person begins to dream allowing their muscles to follow through with their perceived actions.  If awoken, they will often remember their dreams, which often match their violent actions.

What can we do?  The easiest thing to do initially is to put the mattress on the floor and remove all sharp objects from the room.  I know this sounds silly, but avoidance can save the patient or spouse’s life.  If however the symptoms persist, then a thorough evaluation by a physician is needed.  The good news is we have several medications that can help quiet these symptoms.   But first, seeking medical attention ensures that there is not an underlying neurological problem (Parkinson’s Disease) or another sleep disorder (Sleep Apnea) disrupting their sleep and contributing to their symptoms.

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