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REM sleep behavior disorder

L Ferini-Strambi1, M Zucconi

  • 1Sleep Disorders Center, Istituto Scientifico H San Raffaele, Via Prinetti 27, 20127, Milano, Italy. ferinistrambi.luigi@hsr.it

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|September 21, 2000
PubMed

Insights

REM sleep behavior disorder (RBD) involves loss of muscle paralysis during REM sleep, leading to acting out dreams. While specific causes are unclear, it

Area of Science:

  • Neurology
  • Sleep Medicine
  • Neuroscience

Background:

  • Rapid eye movement (REM) sleep is characterized by vivid dreams, desynchronized EEG, and muscle atonia.
  • REM sleep behavior disorder (RBD) presents as intermittent loss of REM atonia, enabling complex motor activity during dreams.

Purpose of the Study:

  • To review the pathophysiology, clinical presentation, and associations of REM sleep behavior disorder (RBD).
  • To highlight the diagnostic and therapeutic aspects of RBD.

Main Methods:

  • Review of existing literature on REM sleep behavior disorder (RBD).
  • Analysis of neurological evaluations in human patients with idiopathic and symptomatic RBD.
  • Examination of animal models for REM sleep without atonia.

Main Results:

  • Animal models suggest lesions in the perilocus coeruleus disrupt motor control pathways.
  • Human studies show potential links to diffuse hemispheric, thalamic, or brain-stem lesions.
  • Symptomatic RBD is associated with neurodegenerative diseases like Parkinson's and dementia.

Conclusions:

  • RBD is a treatable condition, often preceding or co-occurring with neurodegenerative disorders.
  • Early diagnosis and treatment with medications like clonazepam can significantly improve motor behavior during sleep.

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