Parkinson’s Disease

Does Rapid Eye Movement Sleep Disorder Cause Parkinson’s?

The cause of Parkinson’s disease is not fully known. Research has pointed to a number of potential risk factors for developing this neurological disorder. Risk factors such as age, sex, and certain genetic issues have been identified and linked to the potential development of Parkinson’s disease. This disease affects the person’s motor functions and can leave them more susceptible to other neurological disorders, such as Alzheimer’s disease. The disorder Rapid Eye Movement (REM) Sleep Behavior Disorder has been the focus of new research that may be a factor in this neurological disorder.

What exactly is REM Sleep Behavior Disorder?

You have probably heard about this stage of sleep referred to as REM sleep. REM or Rapid Eye Movement is the final stage of the sleep cycle in humans. It is characterized by quick movements by the eye (hence the rapid eye movement part) and can be sometimes referred to as paradoxical sleep. Each sleep cycle in humans lasts about 90 minutes and cycles between REM sleep and other non-REM stages of sleep. As the sleep cycles continue, a higher proportion of the sleep cycle becomes REM sleep. REM sleep behavior disorder (RSBD) is characterized by the subject acting out physically in vivid or even unpleasant dreams that are accompanied by sound and physical movements during REM sleep. During your normal REM sleep cycle you don’t move physically, but during RSBD these movements can be quite animated and potentially harmful to those around us. The onset of this disorder can be subtle and gradually get worse over time. Due to the neurological issues related to Parkinson’s disease, many who suffer from Parkinson’s can experience these physical acting out of dreams related to REM Behavior Disorder. The part of the brain that regulates movement is affected by Parkinson’s disease and this can lead to the movement of arms, legs, and other negative effects of RSBD.

What are the symptoms of REM Behavior Disorder?

During normal REM sleep, you should have lowered muscle tone and even a normal temporary paralysis of your limbs. This disorder means you physically act out your dreams with your arms and legs and even vocal outbursts. According to the Mayo Clinic, some of the symptoms of Rapid Movement Sleep Behavior Disorder are:

• Physical Movement: During RSBD, the normal temporary neurological paralysis of muscles during REM sleep doesn’t happen and sufferers can act out physical aspects (sometimes violent) of the dream with their arms and/or legs potentially harming themselves or their bedmates.
• Vocal Noise: In episodes of REM Sleep Behavior Disorder vocal outbursts are possible during the REM sleep cycle. This can lead to interrupted sleep for you or your partner.
• Dream Recollection: Often those with Rapid Movement Sleep Behavior Disorder can vividly recall their dream even if they wake up during the episode.

Rapid Eye Movement Sleep Behavior Disorder is thought to be caused by nerve pathways in the brain that no longer work properly to provide muscle paralysis during REM sleep. This leads to you physically acting out your dreams. Other causes can be prescription medications such as antidepressants and beta-blockers. Also, approximately 30% of those suffering from narcolepsy can experience symptoms of Rapid Eye Movement Sleep Behavior Disorder. Some risk factors include:

• Over 50 years old and male
• Neurodegenerative Disorders
• Narcolepsy
• Certain medications

How to treat Rapid Eye Movement Sleep Behavior Disorder?

• Medication: The primary medication used for RBD is clonazepam (Klonopin), a type of benzodiazepine that helps suppress muscle activity during REM sleep. Other medications such as melatonin, pramipexole, or low-dose antidepressants may also be prescribed in some cases.
• Safety Measures: Creating a safe sleep environment is crucial to prevent injuries to oneself or sleep partners. This can include removing sharp or dangerous objects from the bedroom, using padded bed rails, or placing mattresses on the floor to minimize the risk of falls.
• Adjusting Sleep Environment: Ensuring a conducive sleep environment can help reduce the occurrence of RBD episodes. This includes maintaining a regular sleep schedule, promoting a relaxing bedtime routine, and creating a dark, quiet, and comfortable sleep environment.

  

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• Avoiding Triggers: Identifying and avoiding triggers that may worsen RBD symptoms is important. These triggers can vary from person to person but may include stress, certain medications, alcohol, and sleep deprivation. Minimizing or eliminating these triggers can help manage RBD symptoms.
• Cognitive Behavioral Therapy (CBT): CBT techniques, such as relaxation exercises and imagery rehearsal therapy, can be helpful in managing RBD. These therapies aim to modify thought patterns, promote relaxation, and reduce anxiety, potentially decreasing the occurrence of RBD episodes.
• Regular Follow-ups: It is essential to maintain regular follow-ups with a healthcare professional, such as a sleep specialist or neurologist, to monitor the progression of RBD and adjust treatment as needed.

 

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