RBD (REM sleep behavior disorder) occurs in MSA, LBD, and Parkinson's Disease. This Swiss study is of 14 patients (10 with PD, 3 with MSA, 1 with DLB) who repeatedly laughed during REM sleep. "Nine of the 14 patients were depressed during daytime...suggesting a dissociation between emotional expression during daytime and REM sleep."

"Laughing belongs to the spectrum of behavioral manifestations of RBD." The patients also had other RBD-associated behaviors -- such as smiling, crying, aggressive behavior, screaming, and somniloquia.

Robin



Parkinsonism & Related Disorders. 2011 Feb 28. [Epub ahead of print]

Laughing as a manifestation of rapid eye movement sleep behavior disorder.

Siclari F, Wienecke M, Poryazova R, Bassetti CL, Baumann CR.
Department of Neurology, University Hospital Zürich, Switzerland; Department of Neurology, CHUV University Hospital Lausanne, Switzerland.

Abstract
BACKGROUND: Among the range of sleep-related behavior displayed by patients with rapid eye movement (REM) sleep behavior disorder (RBD), aggressive acts are particularly common, while pleasant behaviors have rarely been reported. We aimed at identifying the frequency and characteristics of patients who displayed laughing as a pleasant, nonviolent manifestation of RBD.

METHODS: We reviewed 67 consecutive polysomnographic recordings of patients with RBD, obtained in our sleep laboratory between July 2004 and July 2009.

RESULTS: We identified 14 patients (21% of our RBD patients with degenerative parkinsonism: 10 males, mean age 63 ± 11 years) who repeatedly laughed during REM sleep. Ten patients had idiopathic Parkinson's disease, 3 suffered from multisystem atrophy and 1 patient was diagnosed with dementia with Lewy bodies. Other RBD-associated behaviors included smiling, crying, aggressive behavior, screaming, and somniloquia. Nine of the 14 patients were depressed during daytime.

CONCLUSION: Laughing belongs to the spectrum of behavioral manifestations of RBD. Many of our patients with RBD-associated laughter were depressed, suggesting a dissociation between emotional expression during daytime and REM sleep.

Copyright © 2011. Published by Elsevier Ltd.

PMID: 21367641

That's pretty interesting Robin, thanks. My Ken (age 65 now) laughs often during rem sleep, for about the first half hour as he is falling asleep at night. He does not seem depressed during the day, although had been before being put on Zoloft. Sher

Fran also laughs in his sleep, at times his laughing is mixed with sounds of fear and anger. Many nights he is having a fight with someone...Bernie

Robinand BerieD. My LO also laughs during REM. She has spoke out load and it unstandable some of the time. She sometimes cries and shows extreme anger and within the same minute laughs. I have heard her ask for a store manager. She has directed her brother and sister as well as children what to do about something. There is never a long conversation or duration of the event. Usually happes within the first 30 minutes of sleep or when waking. She is not violent. She never moves during the incidents

My father is doing this now every night. He often smiles and laughs. He also shakes his limbs like all at once, like he's being electrocuted or something.

I'm glad he's smiling and laughing at least! Lynn

Derek used to do that--almost like a seizure. In fact I sometimes wondered if he was having a seizure but it only occurred in his sleep.

Yes good way to put it " being electrocuted ", when my husband did it , it shook the whole bed and would only last just moments and like Pat's husband this only happened at night !

I have been told….that this skaking occurs as the first outward sign that displays during my RBD episodes…

I sometimes wake up during this time…..and 'I' know….

I believe….that sometimes this 'time' is the same 'time' as the 'freeze' time in really bad RBD episodes….

Let me explain…..during fight or flight…..in the dreams….they are using are saving 'your' life….not mine…..sometimes mine….

but….sometimes in the saving 'my' life…..(going by most vivid memories I recall)….I 'freeze'….

unable to 'fight' or 'flight'…..

I wonder……if…..

this freeze is similar to the freeze I have with vocalization when awake?

ie….the freeze while I am awake is thought to be that neuron channel unavailable at that moment….and the brain 'freezes' unable to perform the demanded request…..
sometimes I recover and am able to complete the action….sometimes I am not able….stuck repeating that freeze over and over……
sometimes after a while I recover and can do what I intended to do…..
sometimes….
when I come out of the 'freeze'….I am lost…..not lost…..I still know where I am…..I know I wanted to get something done….but….that moment….is gone….the intent is gone, because i don't remember what the thought was anymore….

so…..back to RBD…..freezes…..
I wonder…..if the RBD freeze is a similar event….
that neuron channel isn't available…..and likewise to being awake….the brain can't perform the requested demand….and I am stuck…..in the 'freeze' in RBD……

so, during the RBD episode…..a 'normal' RBD episode would be my physical actions during sleep would and 'DO' mimic what I am dreaming….
so…this skaking, is mimicking my 'dream' with accurate physical actions during my sleep…..
my dream…..is froze…..and repeating…..

so…..take one more step…..
the times that it wakes me at this time…..
the 'freeze' is so VIOLENT' …..
that is it is waking me up from sleep…..

some of the memories of this…..
is at the moment of …..attempting……ATTEMPTING….to pull the trigger…..
to kick…..this is a common one….
to plunge the knife into….the bad guy…..
….EDIT: to add: I have distinct memories of this freeze moment that wakes me up….duplicates the awake one….ie….I am attempting to thrust the knife….but it is not moving….or not moving very much….or it is pushing back…..and the exertion to complete the action in my RBD episode then wakes me up…..with ************** A VERY VIOLENT ACTION……OF ONE OF MY LIMBS, MIMICKING THE ACTION I WAS ATTEMPTING IN THE DREAM…..
or the most common one….is attempting to kick….and not being able to….very frustrating... ….since I can't see the effect of it landing…..

……there are some that are missing out….not talking to me…..
time is limited….
there is an urgency….
those around me….don't get it…..

…..the increase dose of donepezil….and the addition (again) of Provilgil…..is making such a different….
…..it also is increasing all the bad effects of my disease….tradeoffs…and the insight to recognize them….

EDIT: Just had another thought….since this is what wife said was first sign of RBD espisode to 'Her'…..
could it be….that the freeze moment in a 'regular' ….REM dream……is the 'TRIGGER' to flip to RBD dream episode…..

so….lets go science fiction for a moment….
if this was the trigger…..for RBD….a 'freeze' moment….
if the neuron channel could be rerouted….like switching a train to a side track…..
…..I am sure someone is working on that…..
just dreaming…..delusions of fixing it….

Isn't aricept type agents….for 'improving' the neuron flow?
so….this pipe dream….is to rechannel it……

so…..I guess the question would be….where to make connections?
then, leave them in place? or make them dynamic?
of course I realise, this could be a physical or a chemical connection….
which I assume aricept type agent to be chemical connection enhancer….

what if we could float…..chemical agent bridge connectors…..sort of standby chemical agents….
would have to pass brain barrier….

so….I can still dream while awake too…

there is so much going on in this mind….and I sit here alone….a shame….

How interesting, Craig. Do you know if you laugh in your sleep? I imagine (just a guess) that those who laugh are doing it outside of an RBD dream, since those are not funny!

I don't recall Coy having any of these "freeze" moments others talk about. But he has not had many RBD episodes for years -- probably less than 5 in the 8 years he has also had LBD, because klopin is so effective for him.

Your theory that the freeze episode in a dream is similar to freeze episodes while awake sounds very plausible.

Do you till have RBD episodes even on medication?

Jeanne,

I don't ever recall waking up laughing violently jerking a limb….no….

When everything lines up….
I take the klonopin, and then go to sleep and get a restful sleep….it seems to lessen them….

if I forget to take the klonopin….one night after multiple nights of taking it….
I usually get a really bad one…

If I nap….ocassionally I get a bad one….

But, it is helping….not eliminate….even on nights when I take it…..but definitely less….

Klonopin totally eliminates the RBD dreams for Coy. If I forget one night he definitely will have the dream. The drug is no cure, but it is marvelously effective for Coy when taken.

Lately he has had many more dreams, although I'm not sure that any of them are the RBD variety. But lately he has been sleeping a LOT more, because of his illness. Long enough, I imagine, for the nighttime pills to wear off. We will be very glad when this illness is over!

Last night he got up and went into the kitchen for juice. He fell. Sigh. I watched it happen but I was a whole room away. No injuries. I got him up, got his walker, got his juice, and after he finished it we both went to bed. Sometime later he got up again and when I shook myself awake I followed him. He was settled into my recliner. So I slept on the couch to be near. Today I asked him how he happened to be sleeping in my chair instead of his own. He said that he'd been dreaming that we were at a friend's house and he couldn't remember where their guest room was so he settled into the first chair he came to. I don't know whether that was a dream or a delusion, but it definitely was not an RBD dream. I was kind of surprised that he had an explanation.

As I say, I am really looking forward to this illness clearing up.