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Little-Known Sleep Disorder Linked to Dementia
REM sleep behavior disorder may be an early sign of neurodegenerative diseases like Parkinson's and Lewy body dementia.
Apr. 11, 2026 at 2:05pm
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A translucent X-ray image reveals the intricate inner workings of the brain, hinting at the complex neurological changes underlying REM sleep behavior disorder.University of Virginia TodayREM sleep behavior disorder (RBD) is a little-understood sleep disorder that affects around 1% of the general population and 2% of adults over 65. It is characterized by acting out dreams, including shouting, kicking, and punching during sleep. RBD has been linked to an increased risk of developing neurodegenerative diseases like Parkinson's and dementia with Lewy bodies.
Why it matters
RBD may be one of the earliest signs of neurodegenerative diseases, providing a critical window for early intervention and potential prevention. Understanding the links between RBD and these disorders could lead to new therapies and better outcomes for patients.
The details
RBD occurs during the rapid eye movement (REM) stage of sleep, when the brain is active but the body's muscles are paralyzed. In RBD, this paralysis is lost, allowing patients to physically act out their often violent dreams. This can lead to injuries for the patient and their bed partner. While the exact causes of RBD are not well understood, it is often associated with the buildup of the protein alpha-synuclein in the brain, a hallmark of Parkinson's, Lewy body dementia, and other neurodegenerative disorders.
- RBD usually starts affecting people in their 40s and 50s.
- In a long-term study, 73.5% of RBD patients developed a neurodegenerative disorder within 12 years.
The players
Anelyssa D'Abreu
A neurologist who specializes in geriatric neurology and was interviewed for this article.
What they’re saying
“REM sleep behavior disorder may be the first symptom of Parkinson's disease or dementia with Lewy bodies.”
— Anelyssa D'Abreu, Neurologist
“For most neurodegenerative disorders, there is a phase that may last for decades in which brain changes are taking place but the patient either remains asymptomatic or develops symptoms without the full expression of the disease. RBD, in that scenario, is an early sign of those disorders.”
— Anelyssa D'Abreu, Neurologist
What’s next
Researchers are studying how RBD progresses in the brain in order to develop therapies that could slow or prevent the onset of neurodegenerative diseases in those with the sleep disorder.
The takeaway
REM sleep behavior disorder is an important early indicator of serious neurodegenerative diseases like Parkinson's and Lewy body dementia. Understanding this link could lead to earlier diagnosis and new treatment approaches to help prevent or delay the onset of these debilitating conditions.
