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[Disruptive nocturnal behavior in elderly subjects: could it be a parasomnia?]
Smaranda Leu-Semenescu1, Isabelle Arnulf
1Unité des pathologies du sommeil, Hôpital de la Pitié-Salpêtrière, Paris. smaranda.leu@psl.apha.fr
Psychologie & Neuropsychiatrie Du Vieillissement
|June 8, 2010
Summary
Parasomnias are abnormal sleep behaviors causing disruptive nocturnal events in the elderly. These disorders, including REM sleep behavior disorder (RBD), require accurate diagnosis and management.
Area of Science:
- Neurology
- Sleep Medicine
- Geriatrics
Background:
- Parasomnias are abnormal sleep behaviors frequently impacting the elderly, particularly those with cognitive impairment.
- These conditions can lead to significant nocturnal disruptions, patient injuries, caregiver distress, and institutionalization.
Observation:
- Non-REM sleep disorders of arousal manifest as confusion and complex motor actions during sleep.
- REM sleep behavior disorder (RBD) involves a loss of muscle atonia during REM sleep, leading to physically acted-out dreams.
- RBD is notably associated with neurodegenerative diseases like Parkinson's and dementia with Lewy bodies, often preceding motor symptoms.
Findings:
- Parasomnias, including sleepwalking and RBD, can be triggered or exacerbated by certain medications in older adults.
- Video-polysomnography is crucial for differentiating parasomnias from other sleep disorders like nocturnal frontal lobe epilepsy.
- Clonazepam and melatonin are effective treatments for RBD, with safety measures and medication review important for managing violent parasomnias.
Implications:
- Accurate diagnosis of parasomnias is essential for appropriate patient care and management in the elderly population.
- Understanding the link between RBD and neurodegenerative diseases aids in early detection and intervention.
- Targeted treatments and safety protocols can significantly improve the quality of life for patients and caregivers affected by parasomnias.
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