Rapid eye movement sleep behavior disorder in women: relevance to general and specialty medical practice

J Womens Health (Larchmt). 2009 Dec;18(12):1955-63. doi: 10.1089/jwh.2008.1348.


Rapid eye movement (REM) sleep behavior disorder (RBD) is a treatable parasomnia involving dream-enacting behaviors that is considered to be a male-predominant disorder. However, it is speculated that underrecognition of RBD among female patients in part contributes to the male predominance, probably because women have less aggressive and violent RBD behaviors. We conducted a literature review focused primarily on women with RBD, in which the age of onset of RBD, types of nocturnal behaviors, presence of dream enactment, polysomnographic findings, clinical course, treatment response, male/female ratio, comorbid diagnoses, and medications were tabulated and discussed. RBD was found to primarily affect middle-aged and older women and those with a broad range of neurological disorders. As the link between RBD and neurodegenerative disorders, such as Parkinson's disease, becomes increasingly apparent, including the delayed emergence of parkinsonism in patients initially diagnosed with idiopathic RBD, primary care and specialty physicians should be aware of RBD in women, its potential complications, its excellent response to clonazepam, and its association with neurological disorders and older age groups.

Publication types

  • Review

MeSH terms

  • Clonazepam / therapeutic use
  • Diagnosis, Differential
  • Disease Progression
  • Early Diagnosis
  • Female
  • GABA Modulators / therapeutic use
  • Humans
  • Male
  • Neurodegenerative Diseases / diagnosis
  • Neurodegenerative Diseases / drug therapy
  • Parkinson Disease / drug therapy
  • Parkinson Disease / etiology
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'*
  • Primary Health Care / organization & administration
  • REM Sleep Behavior Disorder / diagnosis*
  • REM Sleep Behavior Disorder / drug therapy*
  • REM Sleep Behavior Disorder / etiology
  • Severity of Illness Index
  • Women's Health*


  • GABA Modulators
  • Clonazepam