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2 results

  • Rapid Eye Movement (REM) Sleep Behavior Disorder and REM Sleep with Atonia in the Young

  • Garima Shukla, Anupama Gupta, Kamalesh Chakravarty, Angela Ann Joseph, Aathira Ravindranath, Manju Mehta, Sheffali Gulati, Madhulika Kabra, Afsar Mohammed, Shivani Poornima
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 47 / Issue 1 / January 2020
    Published online by Cambridge University Press:
    31 October 2019, pp. 100-108
    • Article
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  • Background:

    Rapid eye movement (REM) sleep behavior disorder (RBD) and REM sleep without atonia (RWA) have assumed much clinical importance with long-term data showing progression into neurodegenerative conditions among older adults. However, much less is known about RBD and RWA in younger populations. This study aims at comparing clinical and polysomnographic (PSG) characteristics of young patients presenting with RBD, young patients with other neurological conditions, and normal age-matched subjects.

    Methods:

    A retrospective chart review was carried out for consecutive young patients (<25 years) presenting with clinical features of RBD; and data were compared to data from patients with epilepsy, attention deficit hyperactivity disorder (ADHD), and autism, as well as normal subjects who underwent PSG during a 2-year-period.

    Results:

    Twelve patients fulfilling RBD diagnostic criteria, 22 autism patients, 10 with ADHD, 30 with epilepsy, and 14 normal subjects were included. Eight patients with autism (30%), three with ADHD (30%), one with epilepsy (3.3%), and six patients who had presented with RBD like symptoms (50%) had abnormal movements and behaviors during REM sleep. Excessive transient muscle activity and/or sustained muscle activity during REM epochs was found in all patients who had presented with RBD, in 16/22 (72%) autistic patients, 6/10 (60%) ADHD patients compared to only 6/30 (20%) patients with epilepsy and in none of the normal subjects.

    Conclusion:

    We observed that a large percentage of young patients with autism and ADHD and some with epilepsy demonstrate loss of REM-associated atonia and some RBD-like behaviors on polysomnography similar to young patients presenting with RBD.

  • Chapter 15 - Recurrent isolated sleep paralysis

  • from Section 3 - Parasomnias usually associated with REM sleep
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 142-152

  • Summary

    The REM sleep behavior disorder (RBD) is the parasomnia most commonly associated with an underlying neurological condition (the so-called symptomatic RBD). RBD usually occurs in setting of neurodegenerative diseases such as Lewy body dementia (LBD), Parkinson's disease (PD), and multiple system atrophy (MSA), and it may precede the development of Parkinsonism by many years. The disorders of arousal are the most frequent of the NREM sleep parasomnias. They may be triggered by prior sleep deprivation, alcohol, emotional stress and febrile illness. Different medications have been associated with RBD or REM sleep without atonia (RSWA), particularly psychotrophic and antihypertensive drugs. In the last two decades, some studies have demonstrated that arousals secondary to apneas, hypopneas and irregular breathing can be the trigger for sleepwalking and related disorders in children and adults. Hallucinations, both diurnal and nocturnal, have been described in PD associated with cognitive decline and RBD.