REM sleep behavior disorder is characterized by what phenomenon?

• A. The person does not become paralyzed during REM sleep and acts out dreams
• B. Loss of dream recall
• C. Sleepwalking in non-REM sleep
• D. Insomnia with frequent awakenings

Answer: (D)

REM sleep normally includes a protective paralysis (atonia) that prevents us from acting out dreams. In REM sleep behavior disorder, this paralysis is lost or reduced, so the person physically enacts dreams during REM sleep, sometimes violently. That dream-enactment during REM is the defining phenomenon. Other options don’t fit: difficulty recalling dreams isn’t characteristic of RBD, sleepwalking occurs in non-REM sleep, and insomnia with frequent awakenings is a different sleep issue. Clinically, this condition is diagnosed with sleep studies showing REM without atonia, and management focuses on safety and medications like melatonin or clonazepam when appropriate.