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Many couples love sleeping in the same bed. Sometimes if one of them develops a sleep disorder such as snoring, the other may choose to sleep separately. One reader has a more serious problem, but she does not want to sleep apart. What can be done to help her husband’s unusual sleep disorder?
What Will Help REM Sleep Behavior Disorder?
Q. My husband was recently diagnosed with REM sleep behavior disorder (RBD). This was after he punched me while we were sleeping. He had been dreaming and lashed out.
The sleep expert recommended melatonin. Can something so simple really help?
Will Melatonin Help?
A. RBD is a serious sleep disorder. Instead of having limp muscles during rapid eye movement (REM) dreaming sleep, patients may flail, punch or kick. They become a danger to themselves and their bed partners when they act out scary dreams.
Some doctors prescribe clonazepam (Klonopin) for this condition, but side effects such as dizziness, unsteadiness and confusion can be troublesome. You can read what we have written about this medication here.
Melatonin is a natural hormone made by the pineal gland in the brain. It regulates the sleep wake cycle. While not a cure for his sleep disorder, it may be helpful in keeping your husband from hitting you when he is dreaming (Sleep Medicine, Jan. 2015).
Jennifer
Orange County, CA
I am beside myself. My husband of a year and a half punched me repeatedly last night until I screamed for him to stop. Not the first instance, but certainly the worst. Today, he expressed no remorse for hurting me and is angry that I moved to another bed until he can get treatment. He doesn’t want to see a doctor about it and thinks I should just learn to live with it because he didn’t do it intentionally. I can’t believe he thinks this way, and I’m considering leaving. Totally devastated at this person I’m married to. If it were the other way around, I’d be horrified if I hurt him, even unintentionally.
Christine
Carmel, Indiana
Hi, here is my solution for restless leg syndrome at night. I tried the soap under the bed sheet idea, because I could not tolerate the med. Requip. It helped some. Now, instead of putting soap under the sheet, I used nylon ankle highs, put soap pieces in them, and placed them into light socks to wear at night, right at the sole of both feet. This really works!
Sarah
Charleston, SC
When my husband was alive he went through a period of having dreams where he thought I was being threatened, so he would lash out with his arms trying to keep the “bad people” from getting to me. This also caused bed tables knocked over, lamps broken, etc. Turned out to be one of his medications! Changed meds, and it stopped.
Art
Texas
I am a Vietnam combat veteran who suffers from PTSD. For many, many years I have experienced horrific nightmares and at times have hit my wife as I flail my arms and legs. She wakes up when this is happening and gets up out of the way. Sometimes she has tried to calm me down and wake me up to no avail. There are times that she is able to wake me up and I feel my heart pounding. I am 74 and both my shoulders are troublesome which makes it difficult to sleep on either side. I have also had problems staying asleep or going back to sleep after getting up during the night to urinate. I found out that taking half of a 10 mg muscle relaxant (cyclobenzaprine) allows me to sleep all night. Sometimes, I’ll wake up for a trip to the bathroom and I will fall asleep right away. The problem is that I feel very drowsy the next day until around noon time. Also, I believe that medication exacerbates the probability of my having a nightmare. My wife and I have been married 55 years and do not like the idea of sleeping in separate bedrooms. Needless to say, I feel extremely guilty when I have one of those episodes and she tells me (in the morning) that I had a bad night.
I am going to try taking Melatonin and hope that will help me with this problem.
marge
sturgis, mi
write an article about sleep apnea and having that done and not pills and does it really help
Ruth
WA
Another thing to consider…REM violent sleep behavior is now recognized as often a precursor of Parkinson’s Disease, so the person needs to be evaluated by a neurologist that is a movement or Parkinson’s Disease specialist. We know because my husband has Parkinson’s and we stay up on the latest information and advances.
Early detection via several precursor markers can, with medication, results in often slowed down or even reversing the onset of the disease symptoms, so should definitely be pursued.
Virginia Tedder
Greensboro nc
I found that melatonin caused me to have vivid (not restful) dreams & did not keep my asleep longer than my usual 4-5 hrs.
Waltswife
Tampa
Hello, my husband has the same disorder. Even though he never played sports growing up, he started “playing soccer” in his sleep. Sometimes he would leap right over me and land on the floor on the opposite side of the bed. A few times were also cases where he would be hurting me and it took me yelling his name to wake him to get him to stop.
He went to a sleep therapist. First test showed a very low level in vitamin iron count. After a regimen of increasing iron supplements, it improved his sleep issues to about 75% better. The doctor has recommended him to take a drug called pramipexole. But he is worried to take this along with a aheart medicine is Generic Norpace, for heart rhythm, and a blood thinner, eliquois too. I suggested melatonin or 5htp. Maybe someone can help with this part.
Katie
Texas
My husband also had the same problem with kicking while sleeping. It turned to be caused by taking Lipator at night. When he starting taking his statin in the morning, the vivid dreams and kicking stopped.
Jo
Lyons, GA
My husband got more and more violent in his sleep for the last couple of years. At an office visit with his pulmonologist, I was asked if there was anything unusual they needed to check out. I mentioned the talking, hitting, kicking and other erratic behavior. It had been getting worse all the time.
He was diagnosed with REM Sleep Disorder and given a prescription for 0.5 mg Klonopin and told to take 1/2 a pill each night before going to sleep. It made a huge difference from the first night! After 36 years we can still sleep in the same bed, thanks to Klonopin.
Laura
West coast
My 68-year-old husband was diagnosed with RBD and moderate sleep apnea several years ago. After a complete sleep study, he was prescribed a CPAP, along with clonazepam and melatonin. Melatonin alone did not make a substantial improvement. He needs to take the maximum doses of both in order to suppress his nighttime activity, but he also needs to use the CPAP because of the dangers of the medication stopping his heart.
And even with these interventions, the disorder is not completely extinguished. He feels groggy for much of the mornings, and it is a huge inconvenience to have to take the CPAP with us whenever we travel. This disorder is devastating in so many ways. We travel less. I rarely have a night of uninterrupted sleep. I have been kicked, hit, choked, and more in his sleep. He is depressed and appalled by the actions he does in his sleep, over which he has no control or even awareness.
In his awake life, he is loving, funny, and sweet, so the anger and violence of his sleep life are horrifying to him. The disorder is gradually worsening, despite the treatments. Plus, the probability of this disorder being a precursor to Parkinson’s is high. So, I found your response to the wife’s question to be so casual as to be dismissive, and, I felt, insensitive.
My husband is under the care of a neurologist who specializes in sleep disorders, and this treatment regimen is all that the medical world can offer us. We have searched desperately for additional treatment modalities. We do yoga and meditation. We find that the condition tends to respond positively to regular exercise and fitness regimens. We practice good sleep hygiene by having no television in the bedroom, and we limit our evening exposure to blue-screen light sources (iPhones, iPads, computers). We continue to hope for a “cure,” but we also try to live our lives fully in the moment, in the face of this disorder which is little-known, but which affects its victims so profoundly.
It is invisible to the rest of the world, making those of us who live with it feel isolated and alone. In conclusion, I will say that I am a loyal follower of People’s Pharmacy, and will continue to be, but this particular response hit a very raw nerve, and disappointed me.
BriCorn
IA
Is it from having served in the military? Not so uncommon for veterans…
Elaine
My husband does this to me as well but it is usually related to workday stress and when he exercises to relieve stress the thrashing goes away.
Pearl Raz
Pennsylvania
This behaviour can be a precursor to Parkinson Disease.
Laura
Richmond, Va
Not to scare these folks, but R.E.M. Sleep Behavior Disorder (RBD) is often a precursor (by many years) to Lewy Body Dementia. They should not take this sleep disorder lightly.
Terran D.
California
How about muscle relaxing and sleep inducing herbal tinctures, like sculcap or pedicularis?
Jan
Barron WI
Having been the abused partner of a REM Sleep Behavior Disorder [RBF] husband for the last 12yrs I can give some input on this subject. Our wonderful neurologist recommended the book ‘ Paradox Lost, Midnight in the Battleground of Sleep and Dream’ by Dr Carlos H Schenck from the Minnesota Regional Sleep Disorders Ctr & UofM Medical School. You will learn more about RBD and other sleep disorders.
Adding melatonin to my husband’s night time meds has reduced the dosage of clonazepam from 4mg to just 2mg. Clonazepam is the only drug available that can turn on the switch in his head to paralyze him when he dreams. If he doesn’t have enough in his system not only am I at risk but so is he … example: chasing after something in his dreams he flew out of bed face first into the wall breaking his nose & teeth.
RBD can also be a precursor for Parkinsons disease and Lewy Bodies dementia as it is my husband’s case. It is very important to find a neurologist that specializes in sleep disorders for everyone’s safety and future health of the person afflicted.
Mary
Carmel, In
RBD can be an early sign of Parkinson’s. My husband suffered from RBD for years undiagnosed before being diagnosed with the Parkinson’s.