The Range of Conditions Associated With REM Sleep Behavior Disorder: Insights From SLEEP 2026 Keynote Speaker Carlos Schenck, MD

CONFERENCE REPORTER

Forty years ago, Carlos H. Schenck, MD, along with his colleagues, discovered REM sleep behavior disorder. Today, he gave his keynote lecture at SLEEP 2026, “REM Sleep Behavior Disorder: 40 Year Perspective.”

In advance of his lecture, Psychiatric Times sat down with Schenck to better understand the relationship between REM sleep behavior disorder and psychiatry.

REM sleep behavior disorder is characterized by REM sleep without atonia (RSWA) with potentially injurious dream enactment. RSWA is due to dysfunction of REM-related circuitry in the pons and medulla, and frequently predates the development of Parkinson disease or other disorders. RBD is a prodromal syndrome of alpha-synuclein degeneration, at least in adults greater than 50 years old.¹

Schenck emphasized the importance of recognizing REM sleep behavior disorder across all age groups, particularly in middle-aged and older adults, and its association with various neurological and medical conditions. He highlighted a study from Hong Kong indicating that up to 7% of middle-aged and older adults with major depressive disorder have comorbid REM sleep behavior disorder, which is a risk factor for neurodegeneration.²

REM sleep behavior disorder can also be associated with certain medications. Schenck stressed that psychiatrists should be aware of the potential for antidepressants to trigger REM sleep behavior disorder, which can lead to severe injuries. He noted that REM sleep behavior disorder is treatable; Management of the condition is focused on decreasing sleep-related injury through changes in the sleeping environment and use of bedtime melatonin or clonazepam, though these drugs do not prevent neurodegeneration.

For his work on REM sleep behavior disorder and other parasomnias, Schenck and colleague Mark W. Mahowald, MD, received the William C. Dement Academic Achievement Award from the American Academy of Sleep Medicine in 2007. They received the Sleep Research Society’s Outstanding Scientific Achievement Award in 2010 and the 2017 Sleep Science Award from the American Academy of Neurology for their discovery of the condition and its strong link with parkinsonism. Additionally, Schenck was the founding president of the International REM Sleep Behavior Disorder Study Group, and a founding member of Sleep Forensics Associates.

Dr Schenck is a senior staff psychiatrist at Hennepin County Medical Center and the Minnesota Regional Sleep Disorders Center and a professor at the University of Minnesota Medical School in Minneapolis.

References

1. Irfan M, Schenck CH. REM sleep behavior disorder. MedLink Neurology. Updated January 14, 2025. Accessed June 14, 2026. https://www.medlink.com/articles/rapid-eye-movement-sleep-behavior-disorder

2. Wang J, Chau SWH, Lam SP, et al. Prevalence and correlates of REM sleep behaviour disorder in patients with major depressive disorder: a two-phase study. J Neurol Neurosurg Psychiatry. 2022;93(9):1010-1017.