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REM sleep behavioral disorders
E Sforza1, M Zucconi, R Petronelli
1Institutes of Neurology, University of Bari, Italy.
Abstract:
REM sleep behaviors were recently described as wild, dream-enacting behaviors during REM sleep with loss of usual atonia on submental muscles. We examined 6 patients (5 M, 1F) with characteristic episodes of behavioral manifestations during REM sleep. Polysomnographic data indicate a decrease in first REM latency, an absence of stage 4 NREM, altered phasic motor activity and behavioral episodes during REM sleep even with normal chin muscle atonia. Three patients had Shy-Drager syndrome, 1 olivopontocerebellar atrophy and 2 patients had no neurological disease. The crucial importance of a disinhibited locomotor system during sleep appears to be responsible for this REM parasomnia.
Insights
This study investigates REM sleep behavior disorder, characterized by dream-enacting behaviors during REM sleep. Findings suggest a disinhibited motor system may cause this REM parasomnia.
Area of Science:
- Neurology
- Sleep Medicine
- Neuroscience
Background:
- Rapid eye movement (REM) sleep behavior disorder involves dream enactment due to loss of muscle atonia.
- This study examines patients exhibiting behavioral episodes during REM sleep.
Purpose of the Study:
- To characterize REM sleep behavior disorder in patients with and without neurological disease.
- To explore the underlying mechanisms of REM sleep parasomnias.
Main Methods:
- Polysomnography was used to record sleep patterns in 6 patients.
- Clinical neurological examinations were performed.
Main Results:
- Patients displayed reduced REM latency, absent stage 4 NREM, and motor activity during REM sleep.
- Three patients had Shy-Drager syndrome, one had olivopontocerebellar atrophy, and two had no neurological disease.
- Chin muscle atonia was normal in some cases despite behavioral episodes.
Conclusions:
- A disinhibited locomotor system during sleep is implicated in REM sleep behavior disorder.
- REM sleep parasomnias can occur even with normal chin muscle atonia.
- Further research into the motor control of sleep is warranted.