What are the safe sleeping practices and treatment options for patients with REM (Rapid Eye Movement) behavior disorder, particularly those with a history of neurological disorders such as Parkinson's disease or dementia?

Safe Sleeping Instructions for REM Behavior Disorder

Creating a safe bedroom environment is absolutely critical and must be implemented immediately for all REM behavior disorder patients to prevent potentially serious injuries to you or your bed partner. 1

Essential Bedroom Safety Measures (Required for All Patients)

Remove all weapons immediately:

• Remove all firearms from the bedroom and lock them away outside the bedroom with keys held by another person 1
• Remove any objects that could be used as weapons, including bedside lamps, sharp objects, or anything that could inflict injury if thrown or wielded 1

Modify your sleeping surface:

• Place your mattress directly on the floor, or use a very low bed to prevent fall injuries 1
• Place a soft carpet, rug, or mat next to the bed to cushion any falls 1

Protect against furniture and windows:

• Move sharp furniture like nightstands away from the bed 1
• Pad the corners and edges of any remaining furniture and the headboard 1
• Install window protection or heavy curtains to prevent falls through windows 1

Consider sleeping arrangements:

• If you have severe, uncontrolled symptoms, sleep in a separate room from your partner 1
• At minimum, place a pillow barrier between you and your bed partner 1

Why These Measures Matter

Up to 60% of REM behavior disorder patients experience injuries before treatment, and bed partners are also at significant risk of being punched, kicked, or assaulted during dream enactment episodes. 1, 2 These safety measures are mandatory regardless of whether you're taking medication, as no medication completely eliminates all dream enactment behaviors. 3, 2