Presumed REM sleep behavior disorder arising from cataplexy and wakeful dreaming

REM sleep behavior disorder (RBD) is an injurious parasomnia occasionally associated with narcolepsy. RBD usually occurs within REM sleep. We report a case of RBD in a narcoleptic patient arising from cataplexy and wakeful dreaming. The problem of state boundary control inherent in narcolepsy together with the pharmacological effects of tricyclic antidepressants used to treat cataplexy are usually the reason of RBD in narcoleptics. By similar mechanism our patient has presumed RBD out of REM intrusions into wakefulness.