RBD is a parasomnia, characterized by loss of the atonia that normally occurs during rapid eye movement sleep, and is associated with dream enactment
Two concurrent studies in Bangkok using composite nonmotor questionnaire showed that 40-48% of PD had vivid dreams or dream enactment activity [6, 7].
Most (80%) of the dream enactment behaviors were classified as the noninjurious type.
R had reported nightmares with dream enactment behaviors, hypervigilance on awakening and during the daytime, irritability, and anxious and depressed mood with neurovegetative symptoms, and was referred to our clinic for medication management.
R also was referred to the sleep laboratory for a polysomnogram (PSG) because of reported loud snoring and witnessed apneas, especially because sleep apnea can cause nightmares and dream enactment behaviors.
R's frequent dream enactment behaviors, such as kicking, thrashing, and punching during sleep, along with increased EMG activity during REM sleep as recorded on the PSG.
First described in 1986 , rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by repeated episodes of dream enactment behavior and REM sleep without atonia (RWA), evident during polysomnographic recording and manifested as increased phasic or tonic muscle activity on electromyogram channels .
The patient was first referred to our Sleep Research Centre in 2005, when he was 71.5 years old, because he had presented with a 12-year history of repeated nocturnal episodes of violent and automatic complex motor behaviors clearly reflecting dream enactment with frequent dream recall (war scenes or aggression).
In our patient, even if some signs of NC were reported to be present at the time of our first examination, the dream enactment episodes had clearly preceded the onset of excessive daytime somnolence and cataplexy.
The contributors of ten articles plus an able introduction by Stephenson (Jungian analyst and psychodrama practitioner) trace the interaction between the two, including a historical account of theater v therapy, psychodrama in the perspective of analytical psychodrama, Jungian psychodrama, reflections on a Jungian psychodrama group, dream enactment
, emerging rituals, using psychodrama in analysis, psychodrama and the resolution of transference and non-transference, active imagination in performance, and encounters with Jung and Moreno on "the road of bricks and moss."