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Rapid eye movement sleep behavior disorder

Classification and Characteristics: – RBD is a parasomnia. – Idiopathic RBD is not associated with another neurological condition. – Symptomatic RBD is a symptom of […]

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Classification and Characteristics:
– RBD is a parasomnia.
– Idiopathic RBD is not associated with another neurological condition.
– Symptomatic RBD is a symptom of an underlying disorder.
– Involves complex behaviors during dreams like screaming, kicking, and punching.
– Dreamers may be unaware of their movements, leading to injuries.
– Can be associated with conditions like narcolepsy and Guillain–Barré syndrome.
– Symptoms may precede other neurodegenerative disorders.

Causes and Diagnosis:
– Results from a loss of muscle atonia during REM sleep.
– Can be due to drug reactions, aging, or neurodegenerative diseases.
– Diagnosis through clinical history, polysomnography, and validated questionnaires like RBDSQ.
– Bed partners’ observations and specific criteria from ICSD-3 aid in diagnosis.
– Risk factors include family history, head injury, and certain medications.
– RBD may be an early sign of synucleinopathy.

Differential Diagnosis and Treatment:
– Conditions like non-REM parasomnias and sleep apnea can resemble RBD.
– Polysomnography helps confirm RBD diagnosis.
– Melatonin and clonazepam are common treatments for RBD.
– Melatonin is preferred due to fewer side effects.
– Certain medications can worsen RBD and should be avoided.
– Environmental modifications can prevent injuries during episodes.

Prognosis and Epidemiology:
– Patients with RBD are at risk of sleep-related injuries.
– Most patients with idiopathic RBD may develop a neurodegenerative disorder.
– Early diagnosis and management are crucial for better outcomes.
– Regular follow-ups are essential for monitoring progression.
– RBD prevalence estimated at 0.5–2% overall and 5–13% in those aged 60 to 99.
– More common in males overall, with onset typically in the 50s or 60s.

History, Animal Diagnosis, and Additional Information:
– Michel Jouvet described brain lesions in cats leading to loss of atonia in REM sleep in the 1960s and 1970s.
– Carlos Schenck and Mark Mahowald first described RBD in 1986.
– RBD diagnosed in animals, specifically dogs.
– Almost half of Parkinson’s patients and a high percentage of other neurodegenerative disorder patients have RBD.
– RBD is a strong predictor of progression to synucleinopathies.

Rapid eye movement sleep behavior disorder (Wikipedia)

Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of RBD is loss of muscle atonia (i.e., the loss of paralysis) during otherwise intact REM sleep (during which paralysis is not only normal but necessary). The loss of motor inhibition leads to sleep behaviors ranging from simple limb twitches to more complex integrated movements that can be violent or result in injury to either the individual or their bedmates.

Rapid eye movement sleep behavior disorder
Other namesRBD, REM sleep behavior disorder
Sleep talking in a person with RBD
SpecialtyPsychiatry, Sleep medicine

RBD is a very strong predictor of progression to a synucleinopathy (usually Parkinson's disease or dementia with Lewy bodies). Melatonin is useful in the treatment of RBD. RBD was first described in 1986.

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