REM sleep absence in patients referred to polysomnography for REM sleep behavior disorder

Bugalho, Paulo; Salavisa, Manuel; Serrazina, Filipa; Fernandes, Marco; Cabral, Gonçalo; Pinho, André Sobral; Ventura, Rita

doi:10.1007/s00702-021-02300-8

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Sleep disruptions and unpleasant dreams due to sleep apnea–related arousals can be very similar to those of RBD 16 . In addition, α-synucleinopathies can also result in a lack of REM sleep 17 …”

Section: Rapid Eye Movement Sleep Behavior Disordermentioning

confidence: 98%

REM Sleep Behavior Disorder and Other REM Parasomnias

Malkani

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE This article reviews rapid eye movement (REM) sleep behavior disorder (RBD) and other REM sleep parasomnias, particularly recurrent isolated sleep paralysis and nightmare disorder. LATEST DEVELOPMENTS People with RBD have dream enactment behaviors that can be distressing and cause injuries to themselves or a bed partner. Diagnosis of RBD still requires video polysomnography but new evaluative techniques are emerging. Automatic scoring of REM sleep without atonia, the polysomnographic RBD feature, has led to clearer diagnostic cutoff values. Isolated RBD is strongly linked with neurodegenerative disorders, particularly α-synucleinopathies, with a median latency to neurodegenerative disease diagnosis of 8 years. Mounting imaging, electrophysiologic, and pathologic evidence supports neurodegenerative changes in patients with isolated RBD. Safety precautions should be reviewed with patients to reduce the risk of injury. Clonazepam and melatonin are first-line agents for RBD symptoms, and rivastigmine appears to be beneficial for RBD in people with mild cognitive impairment. For nightmare disorder, image rehearsal therapy is effective and can be delivered through online platforms. ESSENTIAL POINTS While RBD symptoms can often be managed, patients with isolated RBD should be monitored for signs and symptoms of impending neurodegenerative disease. Individuals who wish to know about the associated risk should be counseled accordingly to allow planning and involvement in research if they choose. Exercise may have some neuroprotective effects, although no treatment has been shown to modify the neurodegenerative risk.

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Section: Rapid Eye Movement Sleep Behavior Disordermentioning

confidence: 98%

REM Sleep Behavior Disorder and Other REM Parasomnias

Malkani

2023

CONTINUUM: Lifelong Learning in Neurology

View full text Add to dashboard Cite

show abstract

“…Not all PD and DLB patients present with RBD, this parasomnia corresponds to a more severe cognitive and motor phenotype. [4][5][6] Although most of the attention has been focused on REM sleep features, there is some suggestion that there are other alterations in sleep functions in alpha-synucleinopathies, including sleep fragmentation in PD 7 and DLB, 8,9 reduction or abolition of REM sleep in PD and DLB, 8,10,11 changes in NREM sleep spindles, K complexes and slow-wave activity in PD, iRBD 12,13 and DLB. 9 The hypothesis that overall sleep architecture could be altered, encompassing sleep functions beyond REM sleep, is in accordance with neuropathological findings in alpha-synucleinopathies 14 showing affection of brainstem structures responsible for maintaining the flip-flop system that controls shifting between states of consciousness, including the reticular activation system and connected mesopontine structures.…”

mentioning

confidence: 99%