Dream enactment behavior: review for the clinician
Journal of Clinical Sleep Medicine August 3, 2020 M. Baltzan, C. Yao, D. Rizzo et al.
Dream enactment behavior—physically acting out dreams—occurs occasionally in normal children and adults, but disruptive or frequent episodes warrant clinical attention. The behavior often begins with emotionally charged dream content that breaks through normal REM sleep muscle paralysis. Temporary disruption of REM motor suppression can arise from circadian disruption, sleep apnea, or medications. Chronic, severe dream enactment results from neurological damage in degenerative, autoimmune, or infectious disorders. Evaluation requires a structured sleep history, physical exam, and selected testing. Understanding the context and cause guides effective therapy.