REM sleep is distinguishable from NREM sleep by changes in physiological states, including its characteristic rapid eye movements. However, polysomnograms show wave patterns in REM to be similar to Stage 1 sleep. In normal sleep (in people without disorders of sleep-wake patterns or REM behavior disorder), heart rate and respiration speed up and become erratic, while the face, fingers, and legs may twitch. Intense dreaming occurs during REM sleep as a result of heightened cerebral activity, but paralysis occurs simultaneously in the major voluntary muscle groups, including the submental muscles (muscles of the chin and neck).

Because REM is a mixture of encephalic (brain) states of excitement and muscular immobility, it is sometimes called paradoxical sleep. It is generally thought that REM-associated muscle paralysis is meant to keep the body from acting out the dreams that occur during this intensely cerebral stage. The first period of REM typically lasts 10 minutes, with each recurring REM stage lengthening, and the final one lasting an hour.