Rapid eye movement sleep behavior disorder in adults younger than 50 years of age

Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) occurring prior to age 50 is termed early-onset RBD. Early-onset RBD comprises a substantial minority of cases, and demonstrates the differences in demographics, comorbidities, and clinical considerations from previously described typical RBD with onset >50 years. The world literature on RBD is reviewed with specific focus on features that distinguish early-onset RBD, including more gender parity, increased proportion of idiopathic cases, increased proportion of cases associated with narcolepsy, parasomnia overlap disorder, antidepressants, and possibly autoimmune disorders, and clinical presentation.

Sleep disorders in the elderly: Diagnosis and management

“…RBD is more common in males and usually occurs after 50 years of age. Early‐onset RBD (onset before 50 years of age) has been associated with increased gender parity, an increased proportion of idiopathic RBD and an increased occurrence of narcolepsy and antidepressant use …”

“…Earlyonset RBD (onset before 50 years of age) has been associated with increased gender parity, an increased proportion of idiopathic RBD and an increased occurrence of narcolepsy and antidepressant use. 57 It is becoming increasingly clear that 50% of idiopathic patients with RBD convert to a parkinsonian disorder within a decade and that 81%-90% patients with RBD eventually develop a neurodegenerative disorder. 58 Older patients with RBD should be regularly evaluated for the presence of subtle parkinsonism and cognitive and olfactory impairment.…”

Trauma-Associated Sleep Disturbances: a Distinct Sleep Disorder?

“…20,21 RBD co-occurs more commonly in narcolepsy with cataplexy than narcolepsy without cataplexy. 24 There can be clinical confusion amongst the disorders; researchers recently described a new variant of periodic limb movement disorder that mimicked RBD and responded well to ropinirole. 25 Patients with RBD may have a milder severity of sleep apnea, possibly owing to increased muscle tone during REM sleep.…”

Sleep‐related motor and behavioral disorders: Recent advances and new entities

“…In younger patients reporting vigorous dream‐enactment behaviors, alternative diagnoses such as NREM parasomnias, periodic limb movements, obstructive sleep apnea, or nocturnal seizures are more likely . Although RBD does exist in younger individuals, it tends to be secondary to causes such as narcolepsy or certain medications (see below) …”

“…9 Although RBD does exist in younger individuals, it tends to be secondary to causes such as narcolepsy or certain medications (see below). 10 Various questionnaires have been developed as screening tools for probable RBD (Mayo Sleep Questionnaire, 11 RBD Single-Question Screen, 12 RBD Screening Questionniaire, 13 RBD Questionnaire-Hong Kong, 14 and Innsbruck RBD Inventory 15 ), but it is recognized that they may lead to false-positive and falsenegative results. RBD is the only parasomnia in which video polysomnography is mandatory to confirm the diagnosis (by demonstrating the presence of REM sleep without atonia).…”