Is REM sleep behavior disorder a friend or foe of obstructive sleep apnea? Clinical and etiological implications for neurodegeneration

Jung, Yu Jin; Oh, Eungseok

doi:10.5664/jcsm.9144

Cited by 7 publications

(11 citation statements)

References 80 publications

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“…Although not clearly understood, several previous reports suggest sleep-disordered breathing could aggravate RBD symptoms and that CPAP therapy could improve the symptoms. [4][5][6]8 One reason is that severe OSA can mimic RBD symptoms, which is called "pseudo-RBD. " 6,8 Patients with severe OSA can present abnormal behavior upon arousal after respiratory events, which may appear similar to DEB in RBD.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,5 Although OSA is common in patients with RBD, the influence of comorbid OSA on RBD symptoms remains unclear. [4][5][6] A previous report showed OSA, especially in highly severe cases, might mask the symptoms of RBD by reducing REM sleep duration and REM sleep fragmentation. 7 However, other studies suggest OSA may exacerbate complex motor behav-ior in patients with RBD by increasing arousal after respiratory events and sleep fragmentation.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

Shin

2023

J Sleep Med

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Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior and REM sleep without atonia and is traumatic for the patient and/or bedpartner. Obstructive sleep apnea (OSA) is a common comorbidity of RBD, and several reports have suggested that severe OSA may aggravate RBD symptoms. This case report discusses a patient with medically intractable RBD combined with OSA, confirmed by 10-year follow-up polysomnography (PSG) data, which improved with nasal continuous positive airway pressure (CPAP) therapy. The clinical symptoms of RBD markedly improved after CPAP treatment. Clinicians should raise the clinical suspicion of OSA in patients with intractable RBD and consider follow-up PSG and OSA treatments.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

Shin

2023

J Sleep Med

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“…Attention has been drawn to the possibility that RBD may protect against REM OSA because UA muscle tone is usually preserved in RBD. On the other hand, sleep apnoea-induced movement arousals accompanied with vocal sounds may mimic features of RBD [ 67 ]. In a case–control study, 109 patients with idiopathic RBD and OSA (RBD-OSA) were consecutively enrolled and compared with matched OSA controls without RBD.…”

Section: Epidemiologymentioning

confidence: 99%

REM sleep obstructive sleep apnoea

Bonsignore,

Mazzuca,

Baiamonte

et al. 2024

Eur Respir Rev

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Obstructive sleep apnoea (OSA) can occur in both rapid eye movement (REM) and non-REM sleep or be limited to REM sleep, when the upper airway is most prone to collapse due to REM sleep atonia. Respiratory events are usually longer and more desaturating in REM than in NREM sleep. The prevalence of REM OSA is higher in women than in men and REM OSA usually occurs in the context of mild–moderate OSA based on the apnoea–hypopnoea index calculated for the entire sleep study. Studies have highlighted some detrimental consequences of REM OSA; for example, its frequent association with systemic hypertension and a degree of excessive daytime sleepiness similar to that found in nonsleep-stage-dependent OSA. Moreover, REM OSA could increase cardiometabolic risk. Continuous positive airway pressure (CPAP) treatment aimed at preventing REM OSA should be longer than the 4 h usually considered as good compliance, since REM sleep occurs mostly during the second half of the night. Unfortunately, patients with REM OSA show poor adherence to CPAP. Alternative non-CPAP treatments might be a good choice for REM OSA, but data are lacking. This review summarises the available data on REM OSA and critically examines the weaknesses and strengths of existing literature.

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“…Rapid eye movement sleep behavior disorder (RBD) is characterized by incomplete or absent muscle paralysis during REM sleep, thus leading to forceful movements, vocalization, and dream enactment (Huang et al, 2018;Zhang et al, 2022). It is a rare diagnosis, with prevalence around 0.5%, with risk factors including prior pesticide exposure or head injury, 10.3389/fnins.2022.951147 lower educational level, male gender, increased age and prior psychiatric diagnosis (Gabryelska et al, 2018;Jung and Oh, 2021;Zhang et al, 2022). RBD can be secondary to medications or isolated RBD, and the latter is thought to be a precursor of alpha-synucleinopathies, such as Parksinson's disease, pure autonomic failure, dementia with Lewy bodies (DLB), and multiple system atrophy.…”

Section: Autonomic Dysfunction In Rapid Eye Movement Sleep Behavior D...mentioning

confidence: 99%

“…Other studies have shown that patients can develop autonomic dysfunction and neurodegenerative disease symptoms in parallel ( Barone and Henchcliffe, 2018 ). Another cohort found that change in color vision, olfactory and motor function, and not using antidepressants was also a risk factor for phenoconversion to a synucleinopathy ( Jung and Oh, 2021 ). Gender also appears to play a role in patients with DLB, with men being more likely to develop RBD prior to cognitive dysfunction and women being more likely to develop RBD and cognitive dysfunction simultaneously ( de Vivo et al, 2017 ).…”

Section: Autonomic Dysfunction In Rapid Eye Movement Sleep Behavior D...mentioning

confidence: 99%

Sleep apnea and autonomic dysfunction in patients with dementia

Herberts

Kolla²,

Paul³

et al. 2022

Front. Neurosci.

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Sleep apnea is common sleep disorder that is associated with an is an increase in risk of many health conditions, including systemic hypertension, stroke, atrial fibrillation, and heart failure. The predominant underlying pathophysiological mechanism for elevated risk of these conditions in patients with sleep apnea is thought to involve autonomic dysfunction in the form of sympathetic overactivity. Autonomic dysfunction is also associated with several neurodegenerative disorders and sleep apnea, in turn, has been shown to be associated with an increased risk of development of mild cognitive impairment and various types of dementia. Rapid eye movement sleep behavior disorder, which is also associated with an increased risk of alpha synucleiopathy-related dementia, is also linked with autonomic dysfunction. In this article we explore the relationship between sleep apnea, autonomic dysfunction, rapid eye movement sleep behavior disorder and dementia. This article describes the various autonomic dysfunction that are thought to occur in the context of sleep apnea. And illustrate the mechanisms by which sleep apnea, through its impact on autonomic dysfunction could potentially result in dementia. We also review the evidence examining the impact of treatment of sleep apnea on autonomic dysfunction and cognitive outcomes.

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Is REM sleep behavior disorder a friend or foe of obstructive sleep apnea? Clinical and etiological implications for neurodegeneration

Cited by 7 publications

References 80 publications

A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

REM sleep obstructive sleep apnoea

Sleep apnea and autonomic dysfunction in patients with dementia

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