Chronic behavioral disorders of human REM sleep: a new category of parasomnia.
Sleep June 1, 1986 C H Schenck, S R Bundlie, M G Ettinger et al.
Four men aged 67-72 with histories of injuring themselves or their spouses during sleep, often while enacting dreams, and a woman with disruptive but nonviolent sleep behaviors all showed REM sleep pathology on polysomnography: loss of chin muscle atonia, increased limb twitching, and elevated REM eye movements. Videotaped behaviors included punches, kicks, and dream movements. Slow-wave sleep was elevated for age; harmful behaviors did not occur during non-REM sleep. Four patients had serious neurological disorders (olivo-ponto-cerebellar degeneration, Guillain-Barré syndrome, subarachnoid hemorrhage, atypical dementia). Clonazepam and desipramine suppressed the behaviors, which returned when drugs were stopped. These REM sleep disorders replicate findings from cats with pontine lesions and offer insights into human behavior and dream phenomenology.