CPAP for REM behavioral disorder

I certain that my boyfriend has REM behavioral disorder. He is always acting out his dreams and I am afraid I will soon get hurt. He has had 2 sleep studies done. I want the Dr. to prescribe Clonazepam for him, but first, his Doctor, wants him to try a CPAP mask. I always thought that REM behavioral disorder was treated with medication. Can anyone tell me how a CPAP mask will help him with his problem? I know that my boyfriend will never be able to wear a mask throughout the night and every night I sleep with this man, I am afraid I will get hurt.

It seems like everybody in the Sleep Disorder business trys to sell CPAP machines. Are the Doctors and Sleep study centers working for the CPAP machine companies? Any suggestions?

Thanks,

Pam

Smart doc. He or she may need to check for, and sufficiently treat, OSA first. Then see.

Journal of Clinical Sleep Medicine, Vol.6, No. 1, 2010 wrote:Clonazepam is suggested for the treatment of RBD but should be used with caution in patients with dementia, gait disorders, or concomitant OSA. . . . Vigorous arousals in OSA can mimic RBD in clinical presentation; thus, some patients with severe OSA may present as if they have RBD.-- http://www.aasmnet.org/Resources/bestpr ... PP_RBD.pdf

Always be impressed with a doc that ain't pushing drugs atcha right away, I say, since drug treatment is mostly what they hear about in school and what patients often want and what most of the doc's junk mail and party invitations are all about, I reckon.

It may turn out that the drug is needed if PAP therapy does not solve the problem.

Thanks for that link, JNK! This is of particular interest to me because my father (RIP) would have had a very different life if he had been born in this era. At first glance, he would be classic for RBD. However, knowing what I know now, his OSA was off the charts severe. I feel bad for all the expectations I placed upon him not understanding how he was suffering just trying to get through every day. It makes sense to me... OSA is often at its worst during REM, when dreaming is at its peak. For me, OSA triggered horrific dreams. Since apnea events can cause arousals but not always to the point of becoming fully awake, being jolted out of the REM stage would turn off the safety feature of paralysis during REM, right in the midst of a bad dream experience. My understanding of RBD is there's movement during REM, but I think the activity my father had was what I described as related to OSA. Also, how can the brain function as expected when oxygen deprived?

pamjs53, you say you are certain your boyfriend has RBD. What did his 2 sleep studies say? They monitor the brain waves and would have shown if he had movements during REM. Of course there's the possibility that his activity is sporadic and he didn't exhibit it during the studies.

I understand your concerns and even your fear for your own safety. I told my mother she had to have nerves of steel to sleep with my dad all those years. Her well being was at risk every night. Dad had caused bodily harm and property damage from acting out his dreams. Sometimes when he would be forced awake he would remember what he was dreaming. Once when he punched a window out by the bed, he was dreaming he was fighting. When he picked my brother up by the head and flung him over his shoulder he was dreaming he was throwing a sack over his shoulder at work. You have to make your own choices about what to do, but do take it seriously. My dad was a gentle harmless man when awake, but not when he was asleep. It would be tragic to medicate a person when their misbehavior may actually be their survival mechanism. Taking a medication that relaxes the muscles would likely worsen OSA. Your boyfriend can count his blessings that he has a doctor who is telling him like it is. Don't know how important your relationship is to him, but just maybe your safety and your presence will be important enough for him to be convinced to wear a mask every night. You won't know if that totally resolves his nighttime activity until he is consistently on therapeutic treatment for his OSA then see if there are residual symptoms. Good luck.