REM Sleep Behavior Disorder Clinical Presentation

Updated: Mar 10, 2019
  • Author: Syed M S Ahmed, MD; Chief Editor: Selim R Benbadis, MD  more...
  • Print


Routine medical history should include questions that screen for abnormal sleep movements and altered dreams.

The presenting complaint is violent dream-enacting behaviors during REM sleep, often causing self-injury or injury to the bed partner. [29] The dream-enacting behaviors are usually nondirected and may include punching, kicking, leaping, crying out, or running from bed while still in REM sleep. [30] For example, a man may dream that he is rescuing his wife from an attack, while in reality, at that moment, he actually is striking her. Some patients may strangle their bed partner. Directed behavior, such as homicide, has not been reported.

The patient may be wakened or may wake spontaneously during an attack and recall vividly the dream that corresponds to the physical action.

In some cases, an extended prodrome of prominent limb and body movements occurs before the development of RBD.