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In the award-winning movie Sleepwalk with Me, based on the one-man show of the same name,
在获奖电影《伴我入眠》中，喜剧演员迈克·比格利亚根据同名单人秀节目，
comedian Mike Birbiglia describes the hilarious and often startling things his body does when he's sleeping.
描述了他睡觉时身体所做的滑稽，又经常令人吃惊的事情。
Birbiglia has REM sleep behavior disorder, or RBD, a sleep disorder that causes people to physically act out their dreams.
比格利亚患有快速眼动睡眠行为障碍（RBD），这是一种睡眠障碍，使人们在身体上表现出他们在睡眠中的行为。
And while that might sound goofy at first, think about the last dream you had,
虽然这一开始听起来很傻，但想想你最近做的一个梦，
where you were running from homework monsters or throwing punches at Voldemort.
你是在逃避作业怪物，或是与伏地魔拳打脚踢。
Maybe… maybe you wouldn't want to act those out in real life.
也许你不想在现实生活中这样表现出来。
Thankfully, RBD can be treated. But in some cases, it can also tell a deeper story about what's happening in someone's brain.
谢天谢地，RBD可以治愈，但在某些情况下，它还会反映出一个人大脑中正在发生的更深层次的故事。
RBD affects roughly 1% of the population — although that number is slightly higher in older people.
RBD影响了大约1%的人口，尽管这个数字在老年人中偏高。
And it's often associated with a huge range of things.
这种疾病通常与很多事情联系在一起。
We're talking everything from pre-existing, neurodegenerative diseases like Parkinson's to narcolepsy to tumors to certain antidepressants.
我们讨论的范围很广，从帕金森氏症、嗜睡症、肿瘤到某些抗抑郁药等神经退行性疾病。
But ultimately, it happens because something interferes with the brain during sleep.
但归根结底，这是因为睡眠中有东西干扰了大脑。
Typically, about 90 minutes after you fall asleep, you begin the REM sleep stage.
一般来说，在你入睡90分钟后，就会进入快速眼动睡眠阶段。
REM stands for "rapid eye movement," because it's when your eyes move back and forth under your closed eyelids.
REM代表“快速眼动”，因为这时你的眼睛在闭着的眼皮下来回移动。
But it's also the stage where you experience most of your dreams.
但是，这也是你体验大部分梦境的舞台。
During this time, your brain activity rises to near-waking levels, and your breathing and heart rate speed up.
在这段时间里，你的大脑活动上升到接近清醒的水平，呼吸和心率加快。
But typically, your body isn't able to move.
但通常情况下，身体无法移动。
That's because, during REM, structures in the brainstem prevent the body from acting out dreams by relaxing muscles and suppressing motor activity.
这是因为，在快速眼动期间，脑干的结构通过放松肌肉和抑制运动活动来阻止身体按照梦境行事。
Specifically, clusters of neurons from a structure called the pons activate neurons in another structure called the medulla.
具体来说，一种叫做脑桥的结构中神经元簇，激活另一种叫做髓质结构中的神经元。
Then, the medulla sends signals to motor neurons in the spinal column to keep the muscles relaxed and put motor activity on pause.
然后，髓质向脊柱中的运动神经元发送信号，保持肌肉放松，暂停运动活动。
In RBD, that's where the trouble lies. An issue in the pons results in a failure to turn off those motor neurons, so someone can move as much as they want during a dream.
对于RBD患者来说，这就是问题所在。脑桥上的问题导致无法关闭这些运动神经元，因此人们能在梦中随心所欲地移动。
Now, to be clear, a little movement during sleep is totally normal.
现在，说清楚点，睡觉时稍微动一下完全正常。
What these brainstem areas do is stop big movements like kicking and arm-swinging.
这些脑干区域所做的事，就是制止像踢腿和手臂摆动这样的大动作。
Without this kind of inhibition, a person might just knock a lamp off their nightstand or bruise themselves by kicking their footboard.
如果没有这种抑制，一个人可能会把床头柜上的灯敲下来，或是踢到床上的竖板而擦伤自己。
But for those who share a bed, this disorder can have more serious consequences.
但对于那些同床共枕的人来说，这种紊乱会带来更严重的后果。
Like, in 1986 when RBD was formally identified, researchers described men who would dream they were defending their wives from an attacker,
比如，1986年，当RBD这种疾病被正式确认时，研究人员描述了那些梦见自己在保护妻子免受攻击的男人，
only to wake up and find they were actually attacking their wives.
结果他们醒来后发现，他们实际是在攻击自己的妻子。
Which, understandably, would be pretty alarming. It's kind of thing that you do want to treat.
这样的场面是相当惊人的，这是你确实想要治疗的病症。
And the very good news is, RBD is treatable, and there are two medications research has shown to be effective.
好消息是，RBD可以治疗。研究显示，有两种药物已经证明有效。
The first choice for many doctors is clonazepam, a medication traditionally prescribed for seizures.
许多医生的首选药物是氯硝西泮，这是传统上用于癫痫发作的一种药物。
It does come with a number of side effects, including drowsiness, dizziness, and incontinence.
它确实有很多副作用，包括困倦、头晕和尿失禁。
But for some, that's better than the alternative.
但对某些人来说，这比另一种药更好。
The other medication is melatonin, the same hormone our brains secrete to make us sleepy at night.
另一种药物是褪黑激素，也就是大脑分泌的使我们晚上昏昏欲睡的激素。
It has minimal side effects, but it only seems to work for some patients.
其副作用很小，但似乎只对某些病人有效。
Unfortunately, it's not clear right now why these medications work. But, they do seem to.
很遗憾，现在还不清楚为什么这些药物有效。但是，它们似确实管用。
This being said, even though RBD is treatable, it's still something doctors tend to keep a close eye on.
尽管RBD能够治疗，但医生们还是会密切关注。
Because sometimes, this condition can signal that something bigger is changing in the brain.
因为有时候，这种疾病可能预示着大脑中正在发生更大的变化。
Earlier in this episode, I mentioned that RBD is often associated with pre-existing neurodegenerative diseases, like Parkinson's. And that's true.
在本期的早些时候，我提到RBD常与先前存在的神经退行性疾病（如帕金森氏症）有关，情况确实如此。
But researchers have also noticed another connection here.
但研究人员也注意到另一种联系。
They've found that many otherwise-healthy people with RBD actually go on to develop neurodegenerative diseases later in life.
他们发现，许多原本健康的RBD患者，在晚年实际上会发展成神经退行性疾病。
For example, a 2009 study followed 93 patients who had been diagnosed with RBD at a hospital's sleep lab.
例如，2009年的一项研究中，跟踪了93名被医院睡眠实验室确诊为RBD的患者。
People who had no other signs of neurodegenerative disease.
这些患者没有其他神经退行性疾病的迹象。
Researchers followed the health of these patients for several years, and monitored who got diagnosed with what and when.
研究人员对这些病人的健康状况进行了为期数年的跟踪调查，并监测出患者在何时患上了何种疾病。
Then, based on those results, they estimated the risk of developing a neurodegenerative disease within 12 years after an RBD diagnosis.
然后，根据这些结果，他们估计在RBD诊断后12年内，这些人存在发展为神经退行性疾病的风险。
And that risk was a whopping 52% — basically, a one in two chance. And other studies have found similar results.
这个风险高达52%，这基本上是二分之一的几率，其他研究也发现了类似的结果。
Additionally, papers have identified RBD in an average of 24% of existing Parkinson's cases,
此外，研究发现，RBD患者中，平均24%患有帕金森氏症、
88% of cases of multiple systems atrophy, and 76% of Lewy body dementia cases.
88%患有多系统萎缩患者、76%患有路易体痴呆。
As for why? Well, these conditions are all types of alpha-synucleinopathies.
为什么呢？恩，这些病症都是α-同核细胞病。
Those are diseases caused by buildup of the protein alpha-synuclein in — where else? — the brainstem.
这些都是由蛋白质α-突触核蛋白在其他地方的积聚引起的疾病？——脑干。
The same region of the brain that causes RBD symptoms.
大脑中引起红细胞疾病症状的同一区域。
Researchers aren't sure exactly how all of this is connected, and it's something they're still looking into.
研究者还不确定所有这些因素如何联系在一起，他们还在研究该问题。
But there does seem to be a link here between alpha-synuclein in the brainstem and RBD.
但脑干中的α-突触核蛋白和RBD之间似乎确实存在联系。
Hopefully, as we figure it out, we'll learn more about how these diseases develop and progress.
希望我们弄清楚时，就能更多地了解这些疾病的发展和进程了。
For now, though, RBD can at least be the canary in the coal mine,
不过，就目前而言，RBD至少可以成为煤矿里的金丝雀，
letting people know something could be up a decade or more before they show symptoms of full neurodegenerative disease.
让人们在出现完全神经退行性疾病症状之前的10年甚至更长的时间里，就能知道。
Again, not everyone with RBD will go on to develop these conditions.
同样，并不是所有患有RBD的人都会继续发展这些病症。
But for those who do, treatments for these diseases are more effective when they're administered early.
但对于那些患病的人来说，这些疾病的治疗在早期时应用会更有效。
And that counts for a lot.
这很重要。
REM sleep behavior disorder is a reminder that our brains are big, connected systems.
快速眼动睡眠行为障碍提醒我们，大脑是相互连接的庞大系统。
So, the more we learn about specific conditions, the better-equipped we are to understand all kinds of other things.
所以，我们对具体病症了解得越多，就越有能力了解其他各种情况。
After all, research into this rare sleep disorder could have a lot to teach us about some of the most common brain diseases.
毕竟，对这种罕见睡眠障碍的研究，可能教给我们一些有关最常见的脑部疾病的许多知识。
Thanks for watching this episode of SciShow Psych. If the symptoms we just described are ringing a bell for you, consider reaching out to your doctor.
感谢收看本期《心理科学秀》。如果我们刚才描述的症状给你敲响了警钟，你可以考虑联系自己的医生。
Because we can tell you a lot about what RBD is, but we're definitely not medical professionals and this is not a diagnostic tool.
因为我们可以告诉你很多关于它的很多知识，但我们肯定不是医学专业人士，这不是一个诊断工具。
