Imagine that you act out when you’re asleep (maybe you really do!). Sleep researchers have a name for this – REM Behaviour Disorder.
To recap, there are five basic parts to sleep:
- N1 – Light Sleep where your drowsy and likely think you’re still awake. You might notice some minor leg are arm movements when you’re in this phase.
- N2 – which is still Light Sleep, but has some interesting phenomenon like sleep spindles and K-complexes.
- N3 - Deep Sleep
- REM – Rapid Eye Movement Sleep
- Awake – Yes, you do wake up during the night, even if you don’t know it
For most of us, when we are asleep at night, we dream. And when we dream, it’s mostly in REM. During REM, the muscles that are under voluntary, concious control (like our arms, legs, and fingers) are paralysed. The paralysis during REM is probably an evolved way of preventing us from hurting ourselves or others during sleep. Acting out a dream with your arms and legs could get dangerous (if you have this problem, I’m sure your partner would agree).
It’s taken us a long time to actually figure out the mechanism for this paralysis – and it appears to be quite involved. Recent research tells us that GABA and glycine receptors in our brain are likely responsible. It’s an interesting mechanism that we haven’t completely figured out yet (as with most things concerning sleep).
REM Behaviour Disorder
Somehow, that paralysis doesn’t happen to people with REM Behaviour Disorder. Their voluntary muscles still work when they are in REM. They are capable of motion during REM – so they are dangerous to themselves and to others.
The current recommended treatment is an anti-psychotic drug, Clonazepam (Klonopin in the USA), which suppresses these muscles.
Other than the drug downside/side-effect to manage REM Behaviour Disorder, there is another dreadful outcome. Almost 80% of sufferers go on to develop a neurodegenerative disease like Parkinson’s.
There is a glimmer of light though for REM Disorders. The same findings that led to the GABA/glycine discovery is the current thread doctors are unravelling, and are hopeful that it leads to both a better way to manage the problem and circumvent the neurodegenerative outcome.
Leave me a comment if you either suffer from this (horrible) REM disorder, or are interesting in finding out more about the research….