A: Not only isn't it funny or weird, but there's actually a name for it: REM sleep behavior disorder, or RSBD. Here's where I put on my neuropsychologist's hat, so pay attention.

Although many people regard sleep as just the absence of wakefulness, sleep is actually a very active and complex brain state. There are several depths and stages of sleep that occur in regular patterns throughout the night: light sleep, medium sleep, deep sleep, and dreaming sleep, also known as REM sleep. The latter stands for "Rapid Eye Movement" sleep, named for the observation of the sleeper's eyes flitting back and forth under his or her lids, as if the dreamer were scanning a visual scene. Most of the vivid action dreams that we recall take place during REM sleep, and the electrophysiological state of the brain during REM sleep resembles that of high conscious alertness - except we're asleep.

The reason that we all don't act out our dreams every night is due to specific brain systems that inhibit the voluntary musculature of the body during REM sleep. In effect, our brains keep us paralyzed during REM precisely so we won't jump around and act out our dreams. Neuroscientists know where these brain systems are, and destroying these structures in experimental animals results in disinhibition of action during REM sleep: cats pounce, dogs chase, and rats run around - all in their sleep.

In humans, disinhibition of action during sleep can occur for a number of reasons. Occasionally, under states of acute stress, otherwise healthy persons can show some degree of REM disinhibition. For some elderly patients with specific types of dementia, REM disinhibition can result from degeneration of certain brain structures as the disease progresses. In other cases, the symptoms may represent the acting out of a psychodynamically unconscious wish or conflict. But for many RSBD sufferers, the syndrome is a chronic and sometimes progressive condition.

Actually, the true "sufferers" are probably the spouses or other bedmates of these individuals, who may be punched, kicked, pushed, strangled, or otherwise assaulted by their partners, who - as in any other kind of dreaming - are unaware of what they're doing until they awaken. They may then remember the dream in greater or lesser detail, but the only clue to their behavioral act-out may be their bruised bed partner or sometimes their own bloody limbs from wounds sustained in their nocturnal "battles" with furniture or other objects.

Some RSBD have resorted to tying themselves up before they go to bed. Most mates soon learn to sleep somewhere else, and there are even a few isolated reports in the forensic psychology literature of homicides being committed during a RSBD state, with at least one case found not guilty by reason of mental disease or defect.

Fortunately, there are treatments available. Several medications have proven useful in controlling the disorder. In the present case, if your husband's dream attacks represent more than an isolated incident, the first step is an evaluation by a neurologist who specializes in sleep disorders. If a medical solution is indicated, this may solve the problem. If a psychological approach is required, try to identify a competent mental health clinician with knowledge and experience in treating neuropsychological disorders.

Now, get some sleep.

Laurence Miller, PhD is a clinical, forensic, and consulting psychologist in Boca Raton, Florida, and police psychologist for the West Palm Beach Police Department. Dr. Miller can be reached at (561) 392-8881, or online at:
www.practicalpsych.com