Abstract REM sleep behavior disorder (RBD) is gaining increasing attention as important prodromal marker for the development of neurodegenerative disorders such as Parkinson's Disease. However, the clinical relevance of this disorder and its association with other prodromal markers is often underestimated in clinical routine. We here report a case of severe clinical complications following extensive nocturnal movements due to RBD, aggravated by occurrence of additional prodromal non‐motor symptoms. This case stresses the importance of recognizing RBD as a multisystem disease by all clinical disciplines.