Sleep Problems

Disorders of REM Sleep

DISORDERS OF REM SLEEP: A CHANCE TO DREAM

OVERVIEW: Nothing is quite as refreshing as a good night's sleep. Researchers have determined that sleep is made up of 4 stages of non-REM sleep, and REM sleep. To be truly refreshing, sleep needs to include all of the stages. REM stands for "rapid eye movement." When a person is in REM sleep, you can see their eyes moving rapidly beneath their eyelids. It is during REM sleep that people generally dream. Non-REM sleep is important because it gives the body a chance to physically restore and heal itself. REM sleep seems to help the mind restore itself. Disorders of REM sleep include not getting enough of it, as well as a condition called REM sleep Behavior Disorder, or RBD, in which the body acts out the things going on in dreams.

CAUSES: The major cause of a lack of REM sleep is when sleep is routinely disturbed. Pain is one of the most common reasons that sleep is disrupted. A common sleep cycle goes through the stages of sleep, 1, 2, 3, 4, and back through 3, and 2, and then into REM sleep. It generally takes about 90 minutes to get through the stages and into REM sleep. If a person's sleep is disrupted by pain or noise every 90 minutes or so, they are bound to miss some needed REM sleep. Studies have shown that post-operative patients do not experience REM sleep for a few nights after surgery. This could be because of anesthetic drugs in their system. RBD is a different sort of disorder which sometimes is associated with alcohol and drug abuse as well as neurological diseases, such as Parkinson's.

SYMPTOMS: A person lacking REM sleep will show all the general symptoms of sleep deprivation, such as reduced productivity in the workplace, daytime sleepiness, and not handling stress well. Losing REM sleep makes people more sensitive to pain, too. In addition, REM sleep seems to be necessary for verbal skills. A lack of it will cause a person to not be as creative in using language, and they will not do too well on language tests. Normally a person will be somewhat paralyzed during REM sleep. In cases of RBD, the paralysis is not there. These patients act out their dreams, sometimes leaping out of bed or punching their sleeping partner.

DIAGNOSIS: Researchers are working on a blood test that can determine whether or not a patient is getting enough REM sleep. This can also be determined through a night in a sleep clinic, in which brain and muscle activity is monitored. A sleep clinic diagnosis is usually needed to determine that a person has RBD, too. When diagnosing REM sleep Behavior Disorder, the physician will examine the person thoroughly for signs of Parkinson's or similar neurological disorders.

TREATMENT OPTIONS: Sleeping well and getting plenty of REM sleep as well as the other deep stages of sleep requires good sleep hygiene. Taking a pill to get to sleep can backfire, because while it may increase the amount of total time you sleep, you probably won't spend much of that time in restorative REM sleep. An occasional sleeping pill might not hurt too much, and can give you some needed relief. It is better, though, to work toward good sleep habits, like not drinking caffeinated beverages after 4:00 p.m., getting adequate exercise before 6:00 p.m. or so, and doing relaxing things in the evening. RBD is generally treated with medication, but if you are caring for someone with RBD, you will want to take preventive measures to avoid injuries. For instance, put the mattress on the floor, and make sure the bedroom is on the first floor of the house.

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