Brain Health: What’s Sleep Got to Do With It?

A sleep condition in which people act out their dreams—such as punching or kicking while asleep—is linked to brain disease risk.

Good sleep is an important part of keeping your body and brain healthy. But, during times of stress or as you get older, good sleep may be harder to come by. Many have insomnia, or difficulty falling or staying asleep. Others have sleep apnea, or temporary pauses in breathing. Some people like Gary Rafaloff, 70, of Woodbridge, New Jersey, act out their dreams—yelling, kicking, or punching while asleep—as they imagine catching a touchdown pass or fending off a wild animal. This condition is called REM sleep behavior disorder (RBD). Today, scientists are studying RBD and its connection to brain diseases like Parkinson’s disease (PD).

Diagnosed with RBD nearly a decade before his Parkinson’s diagnosis, Gary shared on ABC’s Good Morning America: “It’s a terrible symptom that is really not spoken about a lot. I’m lucky if I average three hours of good sleep at night.”

Not everyone with RBD will go on to develop Parkinson’s. But in some people, like Gary, RBD is one of the earliest symptoms of PD. The sleep condition can occur years or decades before motor symptoms typically associated with Parkinson’s—such as shaking (tremor), slowness and stiffness—appear. RBD is more common in men, people aged 50 or older, and those who live with Post-Traumatic Stress Disorder (PTSD). Certain medications, such as antidepressants, can also contribute to RBD.

Researchers think that some of the same changes in the brain that cause the motor symptoms of Parkinson’s could be behind the sleep disorder. Though there is no cure for RBD, medications like melatonin and clonazepam can help, as well as adjustments like sleeping in a low bed and temporarily sleeping apart from your partner. Further research will help shed light on what causes the condition.

Scientists are working to better understand the link between RBD and PD, in part through studies like The Michael J. Fox Foundation’s landmark Parkinson’s Progression Markers Initiative (PPMI). The study follows people with and without Parkinson’s over time, collecting information on a person’s general health and lifestyle. The de-identified data collected from people with RBD along with other PD risk factors could help researchers better understand why some people with the sleep condition go on to develop Parkinson’s, while others do not.

When learning about this connection, many people, understandably, are concerned about what the future may hold. But many also say it helps them take positive steps to care for themselves and their brains as best they can. Learn more about caring for your brain at every age in The Michael J. Fox Foundation’s recent guide, Better Brain Health.

“I am hopeful that my participation in PPMI can, over time, lead to true scientifically proven cures and prevention strategies,” said Brian Duggan, PPMI volunteer who lives with RBD, age 67, of Mill Valley, California.

People who act out their dreams have a unique opportunity to help researchers understand the sleep condition and speed better treatments and a cure for PD. If you act out dreams or think you might have RBD, talk to your doctor. To learn more about RBD and the study that could change everything about how Parkinson’s is diagnosed treated, and potentially prevented, visit


RBD is a known risk factor for developing Parkinson’s, as it is often one of the earliest symptoms. People with RBD can help scientists understand who develops Parkinson’s, how it comes on from the earliest stages, and why. This information could point to earlier diagnosis, better treatments for symptoms, and therapies to prevent Parkinson’s. If you have RBD or act out your dreams while asleep, you can play a critical role in The Michael J. Fox Foundation’s landmark Parkinson’s Progression Markers Initiative (PPMI) study on a mission to stop PD. Call 877-525-PPMI or email to get started today.

Sponsored by The Michael J. Fox Foundation.