REM sleep behaviour disorder: not just a bad dream
1Brain and Mind Centre, University of Sydney, Sydney, NSW simon.lewis@sydney.edu.au.
The Medical Journal of Australia
|September 14, 2017
Summary
Rapid eye movement sleep behaviour disorder (RBD) involves acting out dreams due to lost muscle paralysis. Idiopathic RBD often precedes Parkinson
Area of Science:
- Neurology
- Sleep Medicine
- Neurodegenerative Diseases
Background:
- Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterized by the loss of normal atonia during REM sleep.
- This leads to motor behaviors enacting dreams, often causing patient concern due to injuries or disturbing dream content.
- Idiopathic RBD affects up to 2% of older adults and is frequently linked to neurodegenerative conditions.
Purpose of the Study:
- To review the diagnosis and management of RBD.
- To highlight the association between idiopathic RBD and future development of Parkinson disease or dementia with Lewy bodies.
- To emphasize the prodromal nature of idiopathic RBD and the need for physician awareness of phenoconversion risks.
Main Methods:
- Diagnosis involves screening questions and polysomnography to rule out mimics.
- Treatment strategies include addressing underlying causes, environmental modifications, and pharmacotherapy (clonazepam or melatonin).
Main Results:
- Idiopathic RBD is recognized as a prodromal phase for Parkinson disease and dementia with Lewy bodies.
- Almost all idiopathic RBD patients are at high risk of developing these neurodegenerative conditions.
Conclusions:
- Physicians must be aware of the phenoconversion risk in idiopathic RBD patients.
- Educating patients on recognizing early symptoms of Parkinson disease or dementia with Lewy bodies is crucial.
- Referral for further testing and enrollment in neuroprotective trials is recommended for idiopathic RBD patients.
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