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| Sleep |  |
REM Behavior Disorder
REM behavior disorder, in many aspects, is the opposite of narcolepsy. For instance, in narcolepsy, the muscle paralysis of REM sleep extends into waking life. In REM behavior disorder, muscles that should be paralyzed during REM sleep are not. The body acts out the brain's dream in the absence of the muscle control typical of healthy sleepers. Injuries to the dreamer and the dreamer's spouse are common.
Over 90 percent of REM behavior disorder patients are male. The disorder usually strikes after the age of 50. However, patients as young as 9 were seen with this disorder.
The disorder seems to be progressive. In older patients, a degenerative neurologic condition, such as Parkinson's disease, usually accompanies REM behavior disorder.
Other Characteristics of REM Behavior Disorder
 | REM Behavior Disorder can affect people who are almost never violent in daily life. |
| People who have had a violent outburst during the night usually wake up the next day feeling completely refreshed, as if they'd enjoyed a great night's sleep. |
| The autonomic nervous system, which governs heart rate, breathing, and other vital functions, seems to remain unaffected by the violent outbursts associated with this disorder. Continuous recordings of patients' heart rate, breathing, and blood pressure show that they can thrash violently, swear, or jump around the room while the heartbeat remains at 60 beats a minute, the normal resting rate. |
Clonazepam is the first line treatment for REM behavior disorder. It is a benzodiazapine that curtails or eliminates the disorder in about 9 out of 10 cases. People don't usually grow tolerant of clonazepam at the proper dosage, even when it is taken over a period of years. Antidepressants are prescribed only in cases in which clonazepam doesn't work.
Make the bedroom safe, eliminating all sharp and breakable objects. Some patients sleep in a bare room with only a mattress on the floor, covering the windows with heavy curtains. Many couples resort to separate bedrooms.
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