Do you sleep next to (or barely sleep because of) someone who acts out dreams—or has your bed partner told you that you’re the nasty bump in the night? If a nightly “wrestlemania” is just starting or getting worse over time, you may be chalking it up to aging. Don’t do that! Restless dreaming—that is, lots of physical movement, including sleep walking, during rapid eye movement (REM) sleep—is not a natural part of aging. It may be REM sleep behavior disorder, which researchers are now learning is a warning sign that dementia, Parkinson’s or another neurological disease may be coming to get you.
Consider this…a neurodegenerative disease will be diagnosed in 50% of people with REM sleep behavior disorder within five years and 80% within 15 years, according to a recent University of Toronto study. Within the years between diagnosis of REM sleep behavior disorder and a full-fledged neuro problem, subtle yet growing signs of neurodegeneration, such as difficulty recognizing smells and colors and not being able to think or walk straight, are likely to crop up. This might sound like a nightmare, but it might be a boon in more than one respect. It means scientists can even more fully study how neurodegenerative diseases begin and progress in people—and that means getting closer to cures for Alzheimer’s disease, Lewy body dementia, and Parkinson’s and Lou Gehrig’s diseases. It also means that, until a cure is found, you and an informed and forward-thinking doctor can take action to quickly recognize and slow down a neurodegenerative disease before it sets in.
WHAT TO DO
First, know what REM sleep behavior disorder is. It’s a condition in which the body’s safety catch that keeps us from physically acting out dreams doesn’t kick in properly. People with this disorder risk seriously hurting themselves or their bed partners. Instead of staying still, their bodies act out whatever they are doing in their dreams—be it picking flowers, fighting dragons or making love. So this is just another important reason not to ignore this annoyance if it is happening to you or someone dear to you. And given what we now know—that restless dreaming is closely tied to dementia and other neurological diseases—it is even more crucial not to delay getting a diagnosis for REM sleep behavior disorder.
If you know or suspect that you experience restless dreaming, your first step is to discuss it with a primary care physician, who will most likely refer you to a neurologist. The neurologist will set up a sleep study at a hospital or sleep disorders clinic. The essentials of a sleep study are a video polysomnogram, which videotapes you sleeping and records your brain waves, and an electromyogram, which records the electrical activity of your muscles to see whether the movements you make are consistent with those of REM sleep behavior disorder.
If it turns out that the neurologist says, yes, you have REM sleep behavior disorder, he or she may suggest a treatment that will reduce the symptoms, such as the antiseizure medication clonazepam or the sleep aid melatonin. If your neurologist doesn’t bring up the link between this sleep disorder and the very high risk of neurodegenerative disease down the road, you must bring up this link and make a plan with this neurologist—or another one you have confidence in, if necessary—for monitoring and staving off symptoms of neurodegeneration.
To learn more about REM sleep behavior disorder and other sleep disorders, visit the website of the National Sleep Foundation. And for lots of healthful, better-sleep ideas for everyone, see the Bottom Line Guide to Better Sleep—No Sleeping Pills Needed.