Some may have heard about the unbelievable stories of sleepwalkers driving cars in the middle of the night or walking for miles without ever being conscious of it. Maybe, these stories sound a little out there, however the symptoms and side-effects of sleep disorders vary largely from person to person, and while some are more milder in nature, others are quite serious. RBD is categorized under a series of sleep disorders called Parasomnias, which involve atypical movement or behaviors that can occur during various sleep stages.
The individual exhibiting REM Sleep Behavior Disorder, or RBD, is typically acting out a vivid or intense dream either physically, vocally, or a combination of both. Because individuals with RBD are incapable of always utilizing the paralysis function during sleep, they often flail their arms, kick, scream or yell, jump up in bed, sleepwalk, or even become violent. Healthy individuals who do not typically experience noticeable disturbances during sleep are able to enter a “paralyzed” physical state when unconscious. This condition can unfortunately worsen over time and create great distress or tension between their partner, family members and friends.
How does REM Sleep Behavior Disorder relate to Parkinson’s Disease?
Recent studies have claimed links between RBD and Parkinson’s Disease; in fact, many researchers believe that RBD is an early sign of Parkinson’s disease and that chronic RBD sufferers will almost always develop Parkinson’s disease within a decade of their RBD diagnosis.
If they do not become afflicted with Parkinson’s disease, individuals with RBD will typically develop another form of a neurological disorder instead. According to Live Science, a staggering 81 to 90 percent of patients with RBD develop a degenerative brain disease. However, it is also important to note that not everyone with Parkinson’s disease will display RBD in its early stages.
Parkinson’s disease and REM Sleep Behavior Disorder
A team of researchers at Aarhus University in Denmark have worked to find the potential common factors between Parkinson’s disease and RBD. Dopamine-producing neurons begin to deteriorate in Parkinson’s patients, and RBD patients also suffer from a lack of dopamine as well. Additionally, inflammation of the brain has found to be typical in patients with Parkinson’s disease. More importantly, this inflammation has been found to activate Microglia, which is a collective of macrophage cells that play a large role in our immune response within the central nervous system.
The Aarhus University researchers investigated whether this inflammation was also occurring in patients with RBD as well or not by carrying out a small case-control study using PET scans. When compared to healthy control subjects, all of the medically diagnosed RBD patients exhibited similar Parkinson’s-like inflammation and microglial activation the brain. Ultimately, both RBD and Parkinson’s patients were likely to exhibit inflammation in regions where dopamine-producing cells were lacking in the brain. Although this study involved only a small sample size, it is a stepping stone for future studies to form a solidified link between RBD and the onset of Parkinson’s disease.
Is there a cure for RBD?
Understandably, people suffering from RBD may become frightened or concerned about developing more severe neurodegenerative disorders like Parkinson's disease in the future. Unfortunately, there is currently no cure for REM Sleep Behavior Disorder. Anxiety medications such as Clonazepam or even anti-depressants and melatonin, however, have worked to alleviate some of the intense symptoms of RBD. Clonazepam in particular has helped many people afflicted with RBD get a much better night’s sleep with less reported symptoms throughout the night.
Another benefit of Clonazepam is its low likelihood to become addicting or causing a development of high tolerance. These options do not eliminate RBD, nor do they prevent the potential development of Parkinson’s disease in the future. Aside from medications, physical safeguards are also available to help alleviate a few of the fears that may come with violent or abrupt disturbances in the middle of the night.
Your doctor may suggest extra padding for the floor, removing potentially dangerous or sharp objects from the bedroom, covering your windows, or even sleeping in a separate room from your partner. While these methods may sound extreme or even hurtful, they are recommended in order to maintain the safety of both the afflicted patient and their loved ones until symptoms are reduced. It is also highly recommended to visit a neurologist at least once a year to better understand you or your loved one’s progression of the disorder and if there are options available for treatment.
RBD patients who develop Parkinson’s: The next steps
According to the Neurology Advisor, about 60% of Parkinson’s disease patients currently also suffer from RBD, and the Neurology Advisor also notes that many Parkinson’s patients diagnosed with RBD experience a much faster deterioration of motor and cognitive functions. While these statistics and information may sound extremely daunting and hopeless, there is still hope for you or your loved one to live as normal life as you can before symptoms progress into the later stage. Avoiding triggers such as caffeine and alcohol can tremendously help reduce RBD incidents. Creating a safe household with minimal clutter or sharp objects can also reduce the risk of violent or dangerous accidents.
If screened early, Parkinson’s disease patients who develop RBD, or vice versa, can participate in up and coming clinical trials that may provide greater relief as well. In some instances, medical cannabis has also shown to relieve Parkinson’s-related sleep incidents and other symptoms. While neither of these illnesses are diagnosable, studies have shown that particular strains of cannabis have the potential to relax muscles during sleep and help patients who suffer from violent and terrifying nightmares.
It is also crucial to remember that there is no single solution or medication that works for every Parkinson’s and/or RBD patient. While one treatment may work for one individual, the same treatment may worsen symptoms in another. No matter which route you or your loved one choose to take, it is always recommended to consult with a doctor first for the best possible outcome.