4 Questions to Ask About Acting Out Dreams During Sleep

Acting out dreams during sleep is a key symptom of REM sleep behavior disorder, known as RBD for short. During normal REM (rapid eye movement) sleep, the body experiences temporary muscle paralysis, preventing you from physically acting out your dreams. However, in people who have RBD, this doesn’t happen, allowing the person to move, talk, shout, or even make aggressive gestures that align with what they’re dreaming.

RBD has also been associated with neurodegenerative conditions like Parkinson’s disease, Lewy body dementia, or multiple system atrophy (MSA). While not always an immediate cause for concern, symptoms of RBD can sometimes serve as an early warning sign of these disorders.

Other sleep disorders, such as sleepwalking (somnambulism) or night terrors, also involve physical movement during sleep, though they typically occur in non-REM sleep stages. Therefore, it’s crucial to distinguish the nature and timing of your parasomnia episodes to identify the specific disorder.

If you or a loved one is acting out dreams regularly, it’s important to consult a doctor specializing in sleep medicine to receive a proper evaluation.

While research on the exact cause of RBD is still ongoing, certain factors increase the risk of developing such symptoms. These include:

● Medication side effects – Certain medications, particularly antidepressants and other psychoactive drugs, can affect REM sleep and may trigger RBD.

● Neurodegenerative diseases – A significant number of RBD cases are associated with neurological conditions like Parkinson’s disease and Lewy body dementia. In fact, RBD can sometimes precede the onset of these conditions by years, serving as an early indicator.

● Sleep deprivation and stress – Poor sleep hygiene, sleep deprivation, and high levels of stress can worsen dream enactment behaviors. While not a direct cause, these factors can intensify existing sleep disorders, making symptoms more bothersome.

● Withdrawal from substances – Withdrawal from alcohol, sedatives, or other substances that affect the central nervous system can disrupt sleep patterns and lead to episodes of acting out dreams.

If you or a loved one is acting out dreams regularly, seeing a sleep expert is the first step to managing the symptoms. During your diagnostic visit, the doctor will discuss your concerns and may recommend a sleep study (polysomnography) to monitor brain activity, muscle movements, and other vital signs during sleep to make an accurate diagnosis.

Once a diagnosis is made, the specialist will create a personalized strategy to address your concerns. Medications can be highly effective for managing RBD. One of the most common treatments is clonazepam, a medication that helps to reduce muscle activity during sleep. For some people, melatonin supplements can also be beneficial, and they come with fewer side effects.

Aside from medications, making your sleep environment safer is crucial if you are diagnosed with RBD. This could mean removing sharp objects, padding the corners of furniture, and even placing the mattress on the floor to prevent injuries during episodes.

Navigating RBD can be challenging, but our experts are here to support you in managing this sleep disorder. To get personalized and comprehensive care, book your visit with one of our reputable experts.

Yes, acting out dreams can pose risks to both the individual experiencing the episode and their bed partner. During an RBD episode, it’s common for people to kick, punch, thrash around, or even fall out of bed. This can result in injuries like bruises, cuts, or even more serious harm, especially if there are sharp objects or hard furniture nearby. Sleeping partners are also at risk, as they may be accidentally struck during the night.

Due to risks, creating a safer sleep environment is an essential step in managing RBD. In some cases, couples choose to sleep in separate beds or rooms to minimize the risk of harm. Your sleep doctor can provide you with guidance on how to make your sleep environment as safe as possible.