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While You Are Dreaming

Disorders Associated with REM Sleep

A REM sleep disorder is an event that occurs while we dream, during rapid eye movement sleep. Mentally, REM sleep is the most active phase of the . A REM sleep disorder can be as simple as an isolated nightmare, or as serious as REM-associated sinus arrest.


Dreams and Child Development:
Nightmares are vivid, frightening dreams that cause people to wake suddenly, with feelings of fear, anxiety and foreboding. The dream is often recalled vividly, and it's often difficult to fall back asleep after a nightmare.

Children experience more nightmares that adults: scary dreams start as early as eighteen months, and increase over time. By age four or five, many children have nightmares as often as once or twice a week. This is a normal phase in child development, and generally does not require treatment. Children do, however, need comfort and reassurance after a nightmare.

Adult Nightmares:
Most people experience fewer nightmares as they age. Adult nightmares may occur during times of stress and anxiety, or after a traumatic event. The sudden withdrawal of antidepressants or other REM-altering medications can also lead to disturbing, frightening dreams.

Cognitive Behavior Therapy:
Weekly nightmares are a normal part of child development. Chronic nightmares, however, can disrupt the sleep cycle and cause sleep deprivation. In such cases, professional help may be required. Cognitive behavior therapy, which alters a person's established behavioral patterns in favor of more positive behavior, can reduce nightmare incidents. Adults can also benefit from cognitive behavior therapy, especially those whose nightmares can be traced to post-traumatic stress disorder.

REM Behavior Disorder (RBD)

Rapid eye movement behavior disorder, or RBD, is a serious REM sleep disorder that can cause injuries. The body usually experiences atonia, or a temporary paralysis, during dreaming. This is a safety precaution that prevents us from physically acting out our dreams. In RBD, this paralysis is either insufficient or entirely lacking, and the affected dreamer may act out exciting or violent dreams.

Men over the age of sixty are most at risk for RBD, but anyone can be affected. The exact cause for the disorder is unknown. People can usually remember their dreams, but have no awareness of moving around while asleep. As violent, intense dreaming often triggers RBD, the condition can cause injuries to both the dreamer and family members.

Most people experiencing RBD remain in bed, where they may thrash, moan or grunt as they dream. In extreme cases, people have left their bed, run down stairs, or even broken through windows.

RBD Treatment:
A polysomnography test is required to diagnosis RBD, and serious neurological conditions must be ruled out. Once diagnosed, many people's symptoms respond to clonazepam, an antidepressant that has anticonvulsant properties. Pregnant women and people with kidney problems should avoid clonazepam. Report all other medication you take to your doctor before starting treatment with clonazepam or any other drug.

If symptoms of RBD are severe enough, separate bedrooms may be required for the sufferer and their bed partner. Bedrooms should be on the ground floor to prevent the RBD sufferer from falling downstairs, and dangerous objects in the bedroom should be removed. Keeping the bedroom clear of obstacles helps prevent falls. Sudden cessation of medication, caffeine and alcohol can trigger the episodes.

Sleep Paralysis

During REM dreaming, the body experiences a temporary paralysis. Some people experience this paralysis while falling asleep or waking up. Being suddenly unable to move can be both frightening and discomforting. More information is available on our
Sleep Paralysis page.

Erection Difficulties

It is normal for men to have erections during REM sleep. The inability to sustain an erection during this stage of rest may indicate erectile dysfunction. Rarely, an intense erection that causes pain may jolt men out of sleep. The pain from the erection then makes it difficult to fall back asleep.

REM Sleep-Related Sinus Arrest

REM sinus arrest is a heart irregularity that occurs during REM sleep. The heart may stop beating for several seconds: sometimes as long as nine seconds. The cause of this condition is unknown; it is not, however, related to the cardiac arrest associated with obstructive sleep apnea.

Home | Arousal | Sleep-Wake Transition | REM Sleep | Other Parasomnias
Night Terrors | Sleep Paralysis | Teeth Grinding | SIDS
Arousal: Those that wake the sleeper; night terrors and sleepwalking.
Night Terrors
Sleep-Wake Transition: Those that cause partial arousal; sleep talking.
REM Sleep: Those that occur during REM; RBD and sleep paralysis.
Sleep Paralysis
Other Parasomnias: Bedwetting, teeth grinding and SIDS 
Teeth Grinding

Last modified 20 September 2006
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