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When Dreams Turn Violent: The Reality of REM Sleep Behavior Disorder

LifestyleWhen Dreams Turn Violent: The Reality of REM Sleep Behavior Disorder

Humans spend about one-third of their lives sleeping. Poor sleep can lead to decreased focus, impaired memory, and emotional instability. If someone shouts or kicks during sleep, it may be a sign of REM Sleep Behavior Disorder (RBD).

According to medical experts, REM (Rapid Eye Movement) sleep is a stage of sleep characterized by rapid eye movements. It accounts for 20-25% of total sleep time. People typically experience REM sleep 5-7 times per night, and when awakened during this phase, they often report dreaming.

While the body is at rest, this sleep phase organizes mental activities from the day. Most dreams occur during this stage. While the brain perceives dreams as reality, the muscles are paralyzed to prevent movement. Insufficient REM sleep can result in memory problems, anxiety, and depression.

RBD is like a car with faulty brake pads, allowing dream actions to manifest physically due to a lack of muscle inhibition. It involves increased muscle tension and is more common in older adults, particularly men. Because it often occurs in older people, sometimes called “elderly sleep talking.”

Unlike sleepwalking, which involves simple actions unrelated to dreams during non-REM sleep, RBD consists of acting out violent dreams, such as fighting or fleeing.

Severe cases can involve yelling or limb movements, potentially injuring the individual or their bed partner. Sleep-related injuries range from bruises and scrapes to rare instances of fractures or brain hemorrhages.

While the exact cause remains unclear, researchers suspect issues with the brainstem’s motor control during REM sleep. RBD may be linked to neurodegenerative brain diseases such as dementia and Parkinson’s disease, which occur as brain neurons lose functionality over time.

Studies suggest RBD patients have a higher risk of developing dementia. Talking or moving while dreaming indicates weakened brain control over the body.

The prevalence of RBD in South Korea is 2.01%. Recent studies show that 15.9% of Koreans aged 50-80 may be in the early stages of RBD, exhibiting either loss of muscle relaxation during REM sleep or dream enactment behavior.

Diagnosis typically begins with a medical history review, followed by polysomnography, if necessary. This comprehensive evaluation measures brain waves, muscle activity, and breathing patterns, often revealing increased muscle tension during REM sleep on electromyography and abnormal REM sleep behavior.

There is no definitive cure or treatment to eliminate the condition. Maintenance therapy, which involves adjusting the type and dosage of medication based on symptom progression, is the primary approach. Given the potential progression to degenerative brain diseases, prompt treatment is crucial if symptoms arise.

Dr. Kim Jin Hee, a neurologist at Seran Hospital, notes that a decreased sense of smell can also indicate early-stage dementia or Parkinson’s. Individuals experiencing both RBD and reduced olfactory function should promptly seek medical attention and undergo sleep studies.

Professor Yoon Ho-kyung of the Department of Psychiatry at Korea University Ansan Hospital emphasizes, “RBD patients often experience worse sleep quality and increased depression compared to the general population. Proactive treatment is essential to ensure the safety of both the patient and those sharing their sleeping space.”

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