Is it normal to talk in your sleep while on Carbidopa?

A fellow caregiver asked...

My husband has complete conversations in his sleep. He's in his 8th year and takes Carbidopa every three hours. Is this normal?

Expert Answer

Graham A. Glass, MD, is the co-founder of PEAK Neurology and Sleep Medicine, LLC with multiple locations across Alaska. Previously, he was deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center PADRECC and assistant clinical professor of neurology at the University of California, San Francisco (UCSF). Glass received his medical degree from the University of Texas Health Sciences Center at the San Antonio School of Medicine and completed his neurology residency at Tufts-New England Medical Center. He subsequently completed a fellowship in movement disorders at the Mayo Clinic.

More than half of patients with Parkinson's disease will at some point have what we call "REM sleep behavior disorder" or RBD. This means that they act out or vocalize their dreams. Behaviors range from simple conversations to kicking, punching and even falling out of bed. This disorder is not caused by the medications, but rather by the Parkinson's disease itself. The disease affects the part of the brainstem that turns of the motor system during dreams so that it is "leaky" and varying amounts of movement gets through. If necessary, and we usually decide to treat if the patient is in danger of falling out of bed or hurting the bed partner, we start by reccomending some small modifications to the sleeping environment like moving the night stand away etc. If the symptoms are bothersome, there are medications that are used and can be very effective at helping this. Most commonly, very low doses of clonazepam are used, but this decision varies on the patient significantly.