Alan Alda has revealed that his Parkinson’s disease first announced itself through a violent dream he acted out in bed.
The 90-year-old actor, best known for “M*A*S*H” and “The West Wing,” said Sunday Morning that his earliest symptom was not the tremors or stiffness most people associate with the condition. Instead, it was REM Sleep Behavior Disorder, or RBD — a condition so poorly understood at the time that he had no idea what was happening to him.
“I had a symptom, which at the time was not that well-known: acting out your dreams,” Alda said in the interview.
The incident that tipped him off occurred while he was asleep beside his wife, Arlene. In the dream, he was under attack.
“I had a dream that somebody was attacking me,” he explained. “And I picked up a sack of potatoes and threw it at ’em. What I was really doing was throwing a pillow at Arlene, my wife.”
RBD strikes during rapid eye movement sleep, the phase when the most vivid dreams occur. Normally, the body paralyzes itself during REM to prevent exactly this kind of physical acting out. In Alda’s case, and in others with Parkinson’s, the neurological switch that controls muscles fails to flip off. The result is involuntary movement — punching, kicking, yelling — that mirrors the dream’s action without the sleeper’s awareness.
The disorder connects to Parkinson’s through the buildup of alpha-synuclein, a protein that damages the brainstem region governing muscle control. Not everyone with RBD develops Parkinson’s, but the sleep disorder frequently serves as an early warning signal, sometimes appearing years before other symptoms emerge.
Alda received his Parkinson’s diagnosis in 2015, a decade ago. Since then, he has spoken openly about living with the disease, including sharing last year that he also experiences prosopagnosia, or face blindness. He now counts among the more than 1.1 million Americans living with Parkinson’s, a number that grows with age.
Medical researchers classify RBD in two categories. Symptomatic, or secondary, RBD stems from an identifiable underlying cause. Isolated, or idiopathic, RBD develops without clear origin — and in most cases, progresses toward a neurodegenerative condition such as Parkinson’s, Lewy body dementia, or multiple system atrophy. Longitudinal studies paint a stark picture of this progression: one study found 33 percent of isolated RBD patients developed a neurodegenerative condition within five years, 76 percent within ten years, and 91 percent within fourteen years.
Beyond neurological disease, risk factors for RBD include being male and over 50, having narcolepsy, and taking certain newer antidepressants. The condition affects roughly 2 percent of Americans over 50, though actual prevalence may be higher given the difficulty of diagnosis.
Diagnosing RBD typically involves a healthcare provider questioning the patient or their sleep partner about nighttime behavior, followed by a polysomnogram — an overnight study tracking heart rate, brain waves, eye movements, and muscle activity. Formal diagnosis requires repeated vocalizations or complex movements during REM sleep, with seizures and other medical or medication-related causes ruled out.
For those managing the condition, safety measures include removing sharp or heavy objects from the bedside, placing pillows between the sleeper and surrounding structures, lowering the mattress to the floor, and using a sleeping bag. No FDA-approved medications specifically target RBD, though studies indicate melatonin, clonazepam, and pramipexole can reduce symptoms.
Alda has continued working and speaking publicly since his diagnosis, and in his CBS Sunday Morning conversation, he addressed the reality of living with a progressive disease.
“I can’t wish it away,” he said of Parkinson’s. “You have to accept it.”