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[Parasomnia associated with abnormal REM sleep in the aged].
1Department of Psychiatry, Tokyo Metropolitan Tama Geriatric Hospital.
Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica
|January 1, 1990
Summary
Abnormal nocturnal behaviors in older adults are linked to REM sleep without muscle atonia (d-STREM with EMG). Clonazepam effectively reduced these behaviors and improved sleep pathology.
Area of Science:
- Neurology
- Sleep Medicine
- Geriatrics
Background:
- Abnormal nocturnal behaviors can significantly impact the quality of life for aged individuals.
- Understanding the underlying mechanisms of these behaviors is crucial for effective treatment.
Observation:
- Three elderly patients exhibited abnormal sleep behaviors like laughing, weeping, and limb movements.
- These behaviors occurred exclusively during REM sleep episodes characterized by a lack of muscle atonia (d-STREM with EMG).
- NREM sleep architecture and slow-wave sleep percentages remained normal for age.
Findings:
- The observed abnormal behaviors were strongly associated with d-STREM with EMG.
- Patients could be fully awakened and recalled detailed unpleasant dreams.
- Treatment with clonazepam (0.5-1 mg/day) significantly reduced both the abnormal behaviors and the polysomnographic abnormalities (d-STREM with EMG).
Implications:
- Parasomnia in the aged may stem from disruptions in the muscle atonia system during REM sleep.
- Clonazepam shows promise as a therapeutic agent for this condition.
- Further research into REM sleep dysfunctions in the elderly is warranted.