Gender and Psychiatric Disparities in Rapid-Eye-Movement Sleep Behavior Disorder

Area of Science:

• Neurology
• Sleep Medicine
• Neuroscience

Background:

• REM sleep behavior disorder (RBD) is often under-diagnosed in females and patients with psychiatric disorders.
• Clinical manifestations of RBD can differ between sexes and patient groups.
• A historical male predominance in reported RBD cases may stem from under-diagnosis in women.

Purpose of the Study:

• To highlight under-recognized groups in REM sleep behavior disorder (RBD).
• To discuss factors contributing to the under-diagnosis of RBD in women.
• To emphasize the importance of recognizing RBD in both sexes as an early neurodegeneration marker.

Main Methods:

• Literature review and analysis of existing data on RBD demographics and clinical presentations.
• Examination of factors influencing RBD diagnosis in different populations, particularly women.
• Synthesis of current understanding regarding RBD as a prodromal sign of neurodegenerative diseases.

Main Results:

• Females and individuals with psychiatric disorders represent under-recognized populations with RBD.
• Under-diagnosis in women may be linked to less violent sleep behaviors, hormonal influences, and fewer bed partners.
• RBD is increasingly recognized as an early indicator of neurodegenerative conditions.

Conclusions:

• There is a need for increased awareness and improved diagnostic strategies for RBD in women and psychiatric patients.
• Accurate diagnosis of RBD across all demographics is essential for early identification of potential neurodegeneration.
• Further research is warranted to understand sex-specific differences and improve RBD detection.