A 32-year-old man tells the nurse at the sleep disorders clinic that he awakens almost nightly in the
midst of acting out a violent dream in which he is defending himself against multiple attackers.
When he awakens, he finds he has been hitting and kicking his wife to the point of bruising her face,
arms, body, and legs. His wife insists that he must get help if she is to sleep in the same bed with
him. The nurse assesses this disorder as being most consistent with criteria for
a. sleep paralysis.
b. sleep-related bruxism.
c. night terror disorder.
d. REM sleep behavior disorder.
D
The scenario describes REM sleep behavior disorder in which the client engages in violent and
complex behaviors during REM sleep as though acting out his dreams. Option A: Sleep paralysis
refers to the sudden inability to perform voluntary movement either at sleep onset or awakening
from sleep. Option B: Bruxism refers to grinding teeth during stage 2 sleep. Option C: Night terror
disorder occurs as arousal in the first third of the night during non-REM sleep and is accompanied
by feelings of panic.
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