A case of marital discord and secondary depression with attempted suicide resulting from REM sleep behavior disorder in a 35-year-old woman

A 35-year-old woman with childhood-onset parasomnia, marked by arm waving with talking and shouting, developed marital discord solely because her parasomnia disrupted her husband's sleep. She became progressively depressed after her husband began to sleep in a separate bedroom, eventually becoming acutely suicidal. There had been no psychiatric history prior to her marriage. An evaluation with a sleep specialist-neurologist and polysomnographic monitoring confirmed the diagnosis of idiopathic REM sleep behavior disorder (RBD). Treatment with clonazepam, 1.0-1.5 mg at bedtime controlled her RBD and she again slept with her husband, which fully resolved their marital discord and her secondary depression.