Sleep related rhythmic movement disorder treated with positive airway pressure

Sleep-related rhythmic movement disorder (SRMD) in adults is rare, posing a distinctive challenge for healthcare practitioners. These movements can lead to significant disruption in sleep and can be a potential indicator of underlying severe Obstructive Sleep Apnea (OSA). The aim of the study was to evaluate OSA patients presenting with SRMD and their management with positive airway pressure therapy (PAP). Data of patients (aged between 18 and 80 years) with OSA and video documentation of abnormal movements during sleep study were taken from the sleep registry for this study. SRMD was defined as per Polysomnographic scoring rules in the AASM Manual for the Scoring of Sleep and Associated Events. All these patients were treated with PAP therapy. Seven patients were diagnosed as rhythmic movement disorders while being evaluated as cases of obstructive sleep apnea (OSA) during level I polysomnography (PSG). These movements significantly decreased during titration with positive airway pressure. The most frequently seen movements were rhythmic repetitive cyclic leg movements, leg kicking and rolling seen in three patients, followed by head banging in two patients. Combination of more than two movements was present in one patient. These movements significantly decreased with PAP therapy usage during follow-up. OSA is one of the important causes of SRMD in adults. CPAP is effective in treating SRMD associated with sleep apnea, emphasizing the importance of an accurate diagnosis through Level 1 PSG.

The online version contains supplementary material available at 10.1007/s41105-025-00609-5.