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Section 8: Information that Indicates REM Sleep Behavior Disorder

DSM-5-TR Code: G47.52

Prevalence = 0.30-0.5%

Common Specifiers:

  • None

Can this disorder legitimately be diagnosed by a Master’s level clinician?      No. This disorder, when suspected, calls for a referral to a sleep specialist for diagnosis and treatment.

Rapid Eye Movement (REM) Sleep Behavior Disorder occurs when there is a breakdown in the systems during REM sleep that normally create alpha motor neuron paralysis. As noted earlier, this phenomenon of muscular paralysis is designed to protect people from responding to the images in their dreams by engaging in physical behaviors.

Persons who suffer from REM Sleep Behavior Disorder will engage in numerous kinds of physical actions during the dream phases of their sleep. This may involve physical interactions with persons who share a bed with them, including some potentially violent behaviors in response to dreams they are having.

This disorder can be distinguished from Non-REM sleep disorders based upon when the actions occur during the dream cycle. Problematic physical actions with this disorder are likely to occur more than ninety minutes after sleep onset, and more commonly later in the sleep cycle during the second, third or fourth REM period. 

According to the Mayo Clinic, this disorder is more commonly seen in males over age 50, but may also be precipitated by various neurological diseases, such as a brain tumor or Parkinson’s Disease, or by injuries from chemicals, like pesticides or chemicals found in cigarettes, or by head trauma. It may also occur in conjunction with Narcolepsy, and may be triggered by use of or withdrawal from certain medications and psychoactive substances.

Treatment options include establishing safety precautions for possible physical behaviors, but this disorder may also be treated with clonazepam (Klonopin) or melatonin, a natural supplement that can be purchased over the counter. Diagnosis and treatment should only be undertaken by a physician who has experience in working with sleep disorders.