Dr Fred Kavalier: A Question of Health

My problem occurs while I am asleep at three or four in the morning and I am totally unaware of it. Apparently my arms and/or my legs move violently and this is sometimes accompanied by talking or even shouting. In the morning I have no recollection of dreaming ­ or indeed anything. It occurs usually for three or four nights in succession and then does not occur for perhaps two or three weeks. I always sleep well. Is there anything available that might stop these unwelcome episodes?

My problem occurs while I am asleep at three or four in the morning and I am totally unaware of it. Apparently my arms and/or my legs move violently and this is sometimes accompanied by talking or even shouting. In the morning I have no recollection of dreaming ­ or indeed anything. It occurs usually for three or four nights in succession and then does not occur for perhaps two or three weeks. I always sleep well. Is there anything available that might stop these unwelcome episodes?

These episodes are a typical description of an unusual sleep disturbance known as Rapid eye movement sleep Behavioural Disturbance (RBD). Rapid eye movement sleep occurs at several times throughout the night. Normally the muscles of the body are "disconnected" from the brain and fully relaxed during this stage of sleep. In RBD this "disconnection" fails, and the muscles become active, particularly during dreams.You should ask to see a neurologist, who can confirm the diagnosis. Most people with RBD can control it if they take a drug called clonazepam. Sometimes RBD is associated with other problems such as Parkinson's disease or strokes, so it is important to have tests to look for these. Another possible diagnosis is an unusual form of epilepsy, but this is less likely.

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Please send your questions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions