However, clonazepam needs to be manipulated carefully because of its significant side effects, i.e., morning confusion or memory impairment, mainly in patients with neurodegenerative disorders with dementia.Demographically, 90% of RBD patients are males, and most are older than 50 years of age. However, this prevalence in males could be biased due to the fact that women tends to have a less violent type of RBD, which leads to lower reports at sleep centres and different clinical characteristics. While men might have more aggressive behaviour during dreaming, women have presented more disturbance in their sleep. RBD may be also influenced by a genetic compound, since primary relatives seem to have significantly more chance to develop RBD compared with non-relatives control group.Typical clinical features of REM sleep behavior disorder are:

Male gender predilection
Mean age of onset 50–65 years (range 20–80 years)
Vocalisation, screaming, swearing that may be associated with dreams
Motor activity, simple or complex, that may result in injury to patient or bed-partner
Occurrence usually in latter half of sleep period (REM sleep)
May be associated with neurodegenerative disease Acute RBD occurs mostly as a result of a side-effect in prescribed medication—usually antidepressants. Furthermore, substance abuse or withdrawal can result in RBD.Chronic RBD is idiopathic, meaning of unknown origin, or associated with neurological disorders. There is a growing association of chronic RBD with neurodegenerative disorders—Parkinsons disease, multiple system atrophy (MSA), or dementia—as an early indicator of these conditions by as much as 10 years.
Do you move while dreaming, as if you are simultaneously attempting to carry out the dream? l Have you ever hurt yourself or your bed partner during sleep? Do you sleepwalk or have sleep terrors with loud screaming? Do your legs feel restless or begin to twitch a lot or jump around when you are drowsy or sleepy, either at bedtime or during the day? Do you eat food or drink fluids without full awareness during the night? Do you wake up in the morning feeling bloated and with no desire to eat breakfast?In potentially harmful or disturbing cases a specialist in sleep disorders should be approached. Video polysomnographic documentation is necessary only in REM sleep behavior disorder (RBD), since it is an essential diagnostic criteria in the ICSD to demonstrate the absence of muscle atonia and to exclude comorbid sleep disorders. For most of the other parasomnias, polysomnographic monitoring is a costly, but still supportive tool in the clinical diagnosis.The use of actigraphy can be promising in the diagnostical assessment of NREM-related parasomnias, for example to rule out sleep deprivation or other sleep disorders, like circadian sleep-wake rhythm disorder which often develops among shift workers. However, there is currently no generally accepted standardized technique available of identifying and quantifying periodic limb movements in sleep (PLMS) that distinguishes movements resulting from parasomnias, nocturnal seizures, and other dyskinesias. Eventually, using actigraphy for parasomnias in general is disputed.