Which disorder involves repeated episodes of arousal during sleep with vocalizations/movement during REM and dream enactment?

• A. REM Sleep Behavior Disorder
• B. Nocturnal Seizures
• C. Obstructive Sleep Apnea
• D. Other Specified Dissociative Disorder

Answer: (A)

REM Sleep Behavior Disorder is described by dream-enacting behaviors that occur during REM sleep due to loss of the normal REM-related muscle atonia. Because the usual paralysis during REM is absent, people act out their dreams, which can include talking, yelling, punching, or kicking, and these events are often accompanied by arousal and movement. This pattern stands apart from nocturnal seizures, which are driven by epileptic activity and may occur in various sleep stages with possible postictal confusion; obstructive sleep apnea causes repeated awakenings from airway obstruction with snoring but not dream enactment; and other specified dissociative disorders involve memory or identity disruptions rather than motor enactments during sleep. The described episodes are best explained by REM Sleep Behavior Disorder.