Respiratory and sleep medicine
REM sleep behaviour disorder
Dream enactment in the second half of the night, why video-polysomnography is required, mimics (OSA, NREM parasomnia, nocturnal seizures), antidepressant-induced RBD, bedroom safety, melatonin versus clonazepam, and counselling about the high risk of Parkinson disease and Lewy body dementia.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- RBD is dream enactment during REM sleep because the normal REM atonia is lost. Patients punch, kick, shout or fall out of bed, often injuring a bed partner.
- Typical patient: man over 50. It affects about 1% of older adults, and many never present.
- Diagnosis needs video-polysomnography showing REM sleep without atonia. The history alone overcalls it.
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Sources
- Clinical resources and guidelines for sleep disordersAU/NZAustralasian Sleep Association
- Therapeutic Guidelines: Neurology (sleep disorders)AU/NZTherapeutic Guidelines Ltd, current eTG edition (version not verified)
- Management of REM sleep behavior disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 2023;19:759-68American Academy of Sleep Medicine (Howell M et al), 2023
- Symptomatic treatment of REM sleep behavior disorder (RBD): a consensus from the International RBD Study Group treatment and trials working group. Sleep Med 2025;132International RBD Study Group (During EH et al), 2025
- Postuma RB et al. Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 2019;142:744-59Brain, 2019
- Gilat M et al. Melatonin for rapid eye movement sleep behavior disorder in Parkinson's disease: a randomised controlled trial. Mov Disord 2020;35:344-9Movement Disorders, 2020
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy