REM behavior disorder (RBD) can be one of the first symptoms of childhood narcolepsy

Nevšímalová, Soňa; Příhodová, Iva; Kemlink, David; Li, Gang; Mignot, Emmanuel

doi:10.1016/j.sleep.2006.11.018

Cited by 108 publications

(42 citation statements)

References 9 publications

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“…Orexin, a neuropeptide secreted from the lateral hypothalamus promotes state (wake, NREM, REM) stability and prevents frequent transitioning. When deficient, such as in narcolepsy, REM-wake instability arises with wake-like motor activity in parallel to REM dream mentation [160,161].…”

Section: Orexin Dysfunctionmentioning

confidence: 99%

Parasomnias: An Updated Review

2012

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Parasomnias are abnormal behaviors emanating from or associated with sleep. Sleepwalking and related disorders result from an incomplete dissociation of wakefulness from nonrapid eye movement (NREM) sleep. Conditions that provoke repeated cortical arousals, or promote sleep inertia lead to NREM parasomnias by impairing normal arousal mechanisms. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking disorders. Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after an arousal from sleep. SRED is often associated with the use of sedative-hypnotic medications; in particular, the widely prescribed benzodiazepine receptor agonists. Recently, compelling evidence suggests that nocturnal eating may in some cases be a nonmotor manifestation of Restless Legs Syndrome (RLS). rapid eye movement (REM) Sleep Behavior Disorder (RBD) is characterized by a loss of REM paralysis leading to potentially injurious dream enactment. The loss of atonia in RBD often predates the development of Parkinson's disease and other disorders of synuclein pathology. Parasomnia behaviors are related to an activation (in NREM parasomnias) or a disinhibition (in RBD) of central pattern generators (CPGs). Initial management should focus on decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders. Clonazepam and melatonin appear to be effective therapies in RBD, whereas paroxetine has been reported effective in some cases of sleep terrors. At this point, pharmacotherapy for other parasomnias is less certain, and further investigations are necessary.Keywords Parasomnia . Sleepwalking . Sleep terrors . REM sleep behavior disorder . Restless legs syndrome Classification of ParasomniasParasomnias are typically classified by the sleep state from which they arise: non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM) (see Table 1 NREM parasomnias include: confusional arousals, sleepwalking disorder, and sleep terrors. These behaviors arise when the cortex incompletely arouses from deep NREM sleep, often due to comorbid conditions that provoke repeated arousal or promote sleep inertia. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking and related disorders [3].Sleep-related eating disorder (SRED) is currently classified in the International Classification of Sleep Disorders, 2nd edition (ICSD-2) under "Other Parasomnia" [1]. However the vast majority of SRED cases emanate from NREM [4], and the complex amnestic behaviors with ambulation are striking similar to sleepwalking [5]. Furthermore, both SRED and sleepwalking are frequently triggered by sedating agents in the setting of underlying motor restlessness [6]. Thus, considering these similarities, SRED will be reviewed immediately after NREM parasomnias.REM sleep behavior disorder is the most clinically relevant REM parasomnia. The loss of atoni...

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Section: Orexin Dysfunctionmentioning

confidence: 99%

Parasomnias: An Updated Review

2012

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“…There is no evidence that RBD associated with narcolepsy represents a risk factor for the development of neurodegenerative conditions. [33][34][35][36][37] 4) Eating disorders The prevalence of compulsive eating and restrictive eating behaviors is greater in the population with narcolepsy than in the general population. 38 The symptoms of eating disorders do not correlate with medication use or with affective symptoms.…”

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confidence: 99%

Diretrizes brasileiras para o diagnóstico de narcolepsia

Alóe

Alves

Araújo

et al. 2010

Rev. Bras. Psiquiatr.

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Este artigo relata as conclusões da reunião de consenso com médicos especialistas sobre diagnóstico de narcolepsia baseada na revisão dos artigos sobre narcolepsia listados no Medline entre 1980 e 2010. A narcolepsia é uma doença crônica de início entre a primeira e segunda décadas de vida do indivíduo. Os sintomas essenciais são cataplexia e sonolência excessiva. A cataplexia é definida como episódios súbitos, recorrentes e reversíveis de fraqueza da musculatura esquelética desencadeados por situações de conteúdo emocional. Os sintomas acessórios são alucinações hipnagógicas, paralisia do sono e sono fragmentado. Critérios de diagnóstico clínico de acordo com a Classificação Internacional dos Transtornos do Sono são de sonolência excessiva e cataplexia. Recomenda-se a realização de polissonografia seguida do teste de latência múltipla do sono em um laboratório de sono para confirmação e diagnóstico de comorbidades. Quando não houver cataplexia, deve haver duas ou mais sonecas com sono REM no teste de latência múltipla do sono. Tipagem HLA-DQB1*0602 positiva com níveis de hipocretina-1 abaixo de 110pg/mL devem estar presentes para o diagnóstico de narcolepsia sem cataplexia e sem sonecas com sono REM.

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“…From another standpoint, static neurodevelopmental disabilities such as autism, Moebius syndrome, and Smith Magenis syndrome; structural brainstem lesions such as neoplasms or Chiari type 1 malformation; narcolepsy; juvenile Parkinson disease; and the use of psychotropic medications predominate. [10][11][12][13][14][15][16][17] The common link between RBD of childhood and that of adults is the identical final common pathway leading up to event (ie, sleep state dissociation). 18 This is a process whereby elements of wakefulness such as tonic electromyographic activity, vocalizations, and bodily movement become superimposed on the phenomena of REM sleep.…”

Section: Pathophysiologymentioning

confidence: 99%

“…12 In childhood narcolepsy-cataplexy, RBD may be the initial manifestation. 15 It may be accompanied by hypersomnolence, cataplexy, positive blood test for HLADQB1*0602, and low levels of spinal fluid hypocretin. 15 With regard to medication-induced RBD, such as that related to the use of tricyclic or selective serotonin reuptake inhibitor (SSRI) agents, there may be associated manifestations of the underlying psychiatric disorder.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Rapid Eye Movement Sleep Behavior Disorder During Childhood

Kotagal

2015

Sleep Medicine Clinics

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REM behavior disorder (RBD) can be one of the first symptoms of childhood narcolepsy

Cited by 108 publications

References 9 publications

Parasomnias: An Updated Review

Parasomnias: An Updated Review

Diretrizes brasileiras para o diagnóstico de narcolepsia

Rapid Eye Movement Sleep Behavior Disorder During Childhood

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