Comedian Mike Birbiglia nearly died when he jumped out of a hotel window. Retired grocer Donald Dorff slammed hard into his bedroom dresser. Brian Thomas from Wales strangled his wife to death.

These three men all had one thing in common. They were suffering from Rapid Eye Movement Sleep Behavior Disorder (RBD).

People afflicted with RBD act out violent or action-filled dreams, mostly by yelling, kicking and punching. The problem affects around one person out of thirty to fifty – the stats on this aren’t very precise. Most of the victims are middle-aged or older.

While this can be hazardous for themselves and their sleeping companions, RBD has a much more sinister aspect. It increases the risk of developing dementia or Parkinson’s disease. Here’s the full story. . .

Strong Link to Mental and Psychological Issues

Most dreams take place during Rapid Eye Movement (REM) sleep, a time when the brain can be as active as it is when conscious. When a sleeper is in the REM phase, the brain stops sending out signals to the muscles, effectively paralyzing the body so dreams aren’t acted out.

For those with RBD, this doesn’t happen.

Seeking to learn more about this phenomenon, researchers from the Department of Neurology and Neurosurgery at McGill University in Montreal, Canada looked at 30,097 people aged 45 to 85.

The subjects were screened for many types of health condition and were questioned regarding lifestyle and behavioral, psychological, social and economic factors. They were also asked whether they acted out their dreams.

Out of the group, 958 were identified as perhaps having RBD.

After excluding those with sleep apnea and neurological diseases, the researchers found that members of the RBD group, compared to those without the disorder, were:

  • 2½ times more likely to be taking antidepressant medication
  • 2½ times more likely to be suffering with post-traumatic stress disorder
  • Twice as likely to suffer from a mental illness
  • 1½ times more likely to have psychological distress
  • 25% more likely to be moderate-to-heavy drinkers

The researchers also found that victims were twice as likely to be male as female. Putting the math another way, two-thirds were male.

Those with RBD were also somewhat less educated (four months less schooling), had lower incomes and were more likely to be or to have been smokers.

80 Percent Develop Neurological Disease

Most people who experience RBD think their behavior is normal. Only one in eight asks a physician about it. Some only do so when they hurt themselves or someone else.

They are making a mistake. RBD signals a serious problem. About four out of five people with RBD will develop either Parkinson’s or a type of dementia called dementia with Lewy bodies, so RBD could be an early marker of neurological disease.

Dr. Ronald Postuma, who led the research, said, “Our hope is that our findings will help guide future research, especially because REM sleep behavior disorder is such a strong sign of future neurodegenerative disease. The more we understand about REM sleep behavior disorder, the better positioned we will be to eventually prevent neurologic conditions like Parkinson’s disease.”

Dr. Postuma also has some simple advice for those who thrash around during their sleep. “If you’re an older person acting out your dreams at night, that’s not normal. Go see your doctor.”

Physicians may recommend melatonin or anti-anxiety medication. They are also likely to suggest making the sleep environment safer by, for example, padding the floor around the bed, placing barriers around the side of the bed, and removing any sharp or dangerous objects from the bedroom.

I would observe that at least two RBD risk factors are controllable – taking pharmaceutical sleeping pills and drinking a lot of alcohol. Both are a bad idea.


  1. https://www.ncbi.nlm.nih.gov/pubmed/30587514
  2. https://www.eurekalert.org/pub_releases/2018-12/aaon-kyd122118.php

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