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A few times a month I have a dream enactment

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Posted on Wed, 20 Feb 2019
Question: A few times a month I have a dream enactment - I act out in real life what I was dreaming was dreaming in my sleep. It usually is a minor movement like a leg kick. However, this morning it was a more extensive movement. My dream was that there was a frog in the house and I jumped up to get away from the frog in the dream and in real life I jumped from my sleeping position to a sitting up position.
I saw a neurologist who specializes in sleep disorders for this about 3 months ago and I had a sleep study done in late November. According to the study, I slept for 5 hours and 13 minutes and my sleep was normal. I have dream enactment episodes that I'm aware of only a few times a month though. Is it possible that the study was just done on a night where I had no dream enactment? Or if I did have REM sleep behavior disorder, would something abnormal definitely have shown up in the 5 hours, 13 min? I'm wondering if I should get a second sleep study done.
I should add that my father and uncle both developed spinocerebellar ataxia at around age 50, although I do not have any symptoms of SCA or any other neurological disorder as far as I know. I believe my father had RBD too.
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Answered by Dr. Erion Spaho (32 minutes later)
Brief Answer:
For now is not necessary to repeat the sleep study.

Detailed Answer:
Hello again and thanks for being part of the "Ask a Doctor " service.

I have read your query and here is my advice.

Since your sleep study (polysomnography) didn't show any problems, in my opinion, it is pointless to repeat it.

RBD is a condition that worsens with time and become more frequent, so, since you don't report any worsening, RBD is not suspected.

In the other hand, increased muscles tone during sleep study, is one of the diagnostic criteria for RBD, so, it's not your case.

Neurological degenerative diseases result in other symptoms, besides RBD, so, I don't think yours is a case of SCA.

Your sleeping and dreams disturbances may be linked to antidepressants use, or increased stress levels.

I think that you should be reevaluated with a sleep study if there will be any worsening or increase in frequency of your symptoms.

Hope you found the answer helpful.

Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Erion Spaho (46 hours later)
Would a sleep study examining RBD definitely have measured "muscle tone" or is it possible they didn't look at that? I remember asking the technician if the results would give a percentage muscle atonia and he said no. I did have a ton of electrodes attached to my body though and I know my doctor told them in the prescription to test for RBD. They didn't mention anything about muscle tone when they called me with the results though. They just said there were no abnormal behaviors.
Your message definitely did help me but I'm still worried I could be beginning to develop RBD.
doctor
Answered by Dr. Erion Spaho (17 hours later)
Brief Answer:
The report of the sleep study is necessary.

Detailed Answer:
Welcome back.

Muscles tone is one of the aspects that a sleep study should evaluate, especially in cases of RDB suspicion.

I don't know what to say if there was such an evaluation or not, but the report should give the necessary information.

If in doubt, then I think, a new sleep study should be considered.

Hope this helps.

Feel free to discuss with me if you have further questions.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 800 Questions

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A few times a month I have a dream enactment

Brief Answer: For now is not necessary to repeat the sleep study. Detailed Answer: Hello again and thanks for being part of the "Ask a Doctor " service. I have read your query and here is my advice. Since your sleep study (polysomnography) didn't show any problems, in my opinion, it is pointless to repeat it. RBD is a condition that worsens with time and become more frequent, so, since you don't report any worsening, RBD is not suspected. In the other hand, increased muscles tone during sleep study, is one of the diagnostic criteria for RBD, so, it's not your case. Neurological degenerative diseases result in other symptoms, besides RBD, so, I don't think yours is a case of SCA. Your sleeping and dreams disturbances may be linked to antidepressants use, or increased stress levels. I think that you should be reevaluated with a sleep study if there will be any worsening or increase in frequency of your symptoms. Hope you found the answer helpful. Let me know if I can assist you further.