Carlos Schenck, MD, arrived for his first day of work at the Minnesota Regional Sleep Disorders Center in 1982 to find a man named Donald Dorff in the waiting room. Dorff, then 67, told him of "violent moving nightmares," Schenck recalls. Once, Dorff dreamed he was running, ball in hand, across the football field and leapt to tackle. He woke up in a pile of glass, a deep gash on his forehead, having smashed his dresser and broken the mirror.
Schenck ran an electroencephalogram (EEG) on Dorff during sleep. It showed when he was in REM sleep, though his arms and legs were clearly not at rest.
"In the beginning, we thought it was extremely rare, an interesting curiosity of nature," says Schenck, now a University of Minnesota psychiatry professor. Decades later and thanks to researchers, we know now that as many as 1 in 100 people have RBD. It's more common after age 50 and in men.
RBD is often tied to a brainstem tumor, stroke, or traumatic injury. It can happen in people with narcolepsy. Alcohol withdrawal and antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), can also trigger symptoms of RBD.
Most of the time, RBD is an early warning sign of a budding neurological disease.
Schenck and Howell have seen hundreds of patients over the years. Many have seriously hurt themselves or their bed partners. There was a 46-year-old man who cannonballed off his bed while dreaming of a pool party; he ended up in the ER. Another man grabbed his wife's neck with both hands. Later, he said he did this while dreaming he was snapping the neck of a deer he'd hunted.
After that, she slept in a different room, and he tied himself to the bed at night.
"The home remedies people come up with to protect themselves are incredible," Schenck says.