Mental Illness Heightens Risk of Violent Sleep Disorder

January 14, 2019

Having post-traumatic stress disorder (PTSD), depression treated with antidepressants, or mental illness in general is linked with an increased risk of rapid eye movement (REM) sleep behavior disorder, according to a study published online in Neurology.

The sometimes violent sleep disorder, which involves acting out violent or action-filled dreams while sleeping, occurs most often in men.

“While much is still unknown about REM sleep behavior disorder, it can be caused by medications or it may be an early sign of another neurologic condition like Parkinson’s disease, dementia with Lewy bodies, or multiple system atrophy,” said study author Ronald Postuma, MD, MSc, of McGill University, Montreal, Canada. “Identifying lifestyle and personal risk factors linked to this sleep disorder may lead to finding ways to reduce the chances of developing it.”

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Researchers looked at 30,097 adults aged 45 to 85 and, after excluding people with Parkinson’s disease, dementia, Alzheimer’s disease, and sleep apnea, identified possible REM sleep behavior disorder in 3.2% of the study population.

According to the findings, people with the sleep disorder were:

  • two and a half times as likely to report taking antidepressants for depression;

  • two and a half times as likely to have PTSD;

  • two times as likely to have mental illness; and

  • more than one and a half times as likely to have psychological distress, compared with people without the disorder.

People with possible REM sleep behavior disorder, compared with those without the disorder, were 25% more likely to report moderate to heavy alcohol use. They also had slightly less education (13.2 years compared with 13.6 years) and lower income, and were more likely to have smoked, researchers reported.

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Men were twice as likely as women to have REM sleep behavior disorder.

“Our research does not show that these risk factors cause REM sleep behavior disorder, it only shows they are linked,” Dr. Postuma said. “Our hope is that our findings will help guide future research, especially because REM sleep behavior disorder is such a strong sign of future neurodegenerative disease.”

—Jolynn Tumolo


Yao C, Fereshtehnejad SM, Keezer MR, Wolfson C, Pelletier A, Postuma RB. Risk factors for possible REM sleep behavior disorder: a CLSA population-based cohort study. Neurology. 2018 December 26;[Epub ahead of print].

Kicking, yelling during sleep? Study finds risk factors for violent sleep disorder [press release]. Minneapolis, Minnesota: American Academy of Neurology; December 26, 2018.