REM sleep behaviour disorder: a treatable cause of falls in elderly people

Abstract

Reports of falls occurring exclusively at night have usually been in the context of a hospital setting (attempting to climb out of bed or during sleep) rather than in people living at home [1]. We report a case of recurrent falls in an elderly woman, occurring exclusively at night and caused by rapid eye movement (REM) sleep behaviour disorder. In this condition there is a loss of the normal atonia of postural muscles that usually occurs in REM sleep [2]. It results in complex, vigorous, dream-enacting behaviours during REM sleep [3]. These typical behaviours have the potential to cause serious injury at night, particularly from falls. This disorder appears to have been overlooked in the geriatric literature as a potential source of falls and injury at night.