Somnambulistic behavior associated with abnormal REM sleep in an elderly woman

Ishigooka, Jun; Westendorp, Floyd; Oguchi, Toru; Takahashi, Akihiko; Sumiyoshi, Akitsugu; Inami, Masaaki

doi:10.1016/0006-3223(85)90198-2

Cited by 21 publications

(5 citation statements)

References 12 publications

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“…The behaviors were described as "delirious," but the state of consciousness upon arousal was not specified (27). Loss of REM atonia and behavioral release also have been reported in two patients with olivo-ponto-cerebellar degeneration (28) and in a neurologically intact elderly woman (29). REM sleep with augmented EMG but without gross motor activity has been reported in patients with parkinsonism and the Shy-Drager syndrome (30,31).…”

Section: Behavioralmentioning

confidence: 90%

Chronic Behavioral Disorders of Human REM Sleep: A New Category of Parasomnia

Schenck

Bundlie

Ettinger

et al. 1986

Sleep

1,049

468

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Four men, aged 67-72 years, had 4-month to 6-year histories of injuring themselves or their spouses with aggressive behaviors during sleep, often during attempted dream enactment. A 60-year-old woman had disruptive though nonviolent sleep and dream behaviors. Polysomnography did not detect seizures but did document REM sleep pathology with variable loss of chin atonia, extraordinarily increased limb-twitch activity, and increased REM ocular activity and density. A broad range of REM sleep behaviors was recorded on videotape, including stereotypical hand motions, reaching and searching gestures, punches, kicks, and verified dream movements. Stage 3-4 slow wave sleep was elevated for age in all patients. NREM sleep was devoid of harmful behaviors, although three men had periodic myoclonus. There was no associated psychiatric disorder, whereas serious neurologic disorder was closely associated in four cases: olivo-ponto-cerebellar degeneration, Guillain-Barre syndrome, subarachnoid hemorrhage, and an atypical dementia. Two patients had immediate and lasting sleep behavioral suppression induced by clonazepam, and another patient had the same response with desipramine. All instances of drug discontinuation prompted immediate relapse. In four cases there was associated dream hyperactivity, which resolved with behavioral control. These REM sleep neurobehavioral disorders constitute another category of parasomnia, replicate findings from 21 years ago in cats receiving pontine tegmental lesions, and offer additional perspectives on human behavior, neurophysiology, pharmacology, and dream phenomenology.

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Section: Behavioralmentioning

confidence: 90%

Chronic Behavioral Disorders of Human REM Sleep: A New Category of Parasomnia

Schenck

Bundlie

Ettinger

et al. 1986

Sleep

1,049

468

View full text Add to dashboard Cite

show abstract

“…In this work, we chose to apply very strict selection criteria to precisely identify and describe late-onset parasomnia behaviors unequivocally emerging from NREM sleep arousals (differently from other previous reports [2,4,8,23–26]) in a highly selected group of patients with alpha-synucleinopathies. We named these events NPBs.…”

Section: Discussionmentioning

confidence: 99%

Distinctive Features of NREM Parasomnia Behaviors in Parkinson’s Disease and Multiple System Atrophy

et al. 2015

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ObjectiveTo characterize parasomnia behaviors on arousal from NREM sleep in Parkinson’s Disease (PD) and Multiple System Atrophy (MSA).MethodsFrom 30 patients with PD, Dementia with Lewy Bodies/Dementia associated with PD, or MSA undergoing nocturnal video-polysomnography for presumed dream enactment behavior, we were able to select 2 PD and 2 MSA patients featuring NREM Parasomnia Behviors (NPBs). We identified episodes during which the subjects seemed to enact dreams or presumed dream-like mentation (NPB arousals) versus episodes with physiological movements (no-NPB arousals). A time-frequency analysis (Morlet Wavelet Transform) of the scalp EEG signals around each NPB and no- NPB arousal onset was performed, and the amplitudes of the spectral frequencies were compared between NPB and no-NPB arousals.Results19 NPBs were identified, 12 of which consisting of ‘elementary’ NPBs while 7 resembling confusional arousals. With quantitative EEG analysis, we found an amplitude reduction in the 5-6 Hz band 40 seconds before NPBs arousal as compared to no-NPB arousals at F4 and C4 derivations (p<0.01).ConclusionsMany PD and MSA patients feature various NREM sleep-related behaviors, with clinical and electrophysiological differences and similarities with arousal parasomnias in the general population.SignificanceThis study help bring to attention an overlooked phenomenon in neurodegenerative diseases.

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“…The periodic appearance of abnormal or delirious behavior during nocturnal sleep was also observed in a patient with brain stem tumor (Ferreira,et ul.,197i?1)~, in a patient with bilateral acoustic neurinoma (Isono, et al, 1979)1°, in elderly patients with nocturnal delirium (Minami and Harada, 197917;Matsuo et al, 198216;Ishigooka et al, 19859) and in 5 patients with miscellaneous conditions including one patient with OPCA (Schenk et al, 1986Iz4. The polygraphic feature during repetitive episodes of abnormal behavior in these patients well resembles that of active stage 1-REM described in this report, and all other previous authors regarded this peculiar sleep state of stage 1-REM as REM sleep without muscle atonia.…”

Section: Discussionmentioning

confidence: 99%

REM Sleep without Muscle Atonia (Stage 1‐REM) and Its Relation to Delirious Behavior during Sleep in Patients with Degenerative Diseases Involving the Brain Stem

Shimizu

Inami

Sugita

et al. 1990

Psychiatry Clin Neurosci

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Nocturnal sleep was examined in 12 patients with degenerative diseases involving the brain stem and in 2 patients with late cerebellar cortical atrophy (LCCA). A peculiar sleep state, characterized by the concomitant appearance of a low‐voltage mixed frequency EEG, rapid eye movements (REMs) and tonic EMG in mental muscles, repeatedly appeared during nocturnal sleep in all of the 12 patients with degenerative diseases involving the brain stem and it was called stage 1‐REM after Tachibana et al.32 In 8 of the 12 patients, delirious or oneiric behavior appeared during, or soon after, the episodes of stage 1‐REM. Inner experiences reported by one of the subjects well corresponded to his behavior during the episode of stage 1‐REM. Stage 1‐REM was not observed during nocturnal sleep of the patients with LCCA. These results indicate that a degenerative lesion in the brain stem induced stage 1‐REM and delirious behavior during nocturnal sleep through abolishing muscle atonia of REM sleep and causing dissociation of the functional components characterizing REM sleep.

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Somnambulistic behavior associated with abnormal REM sleep in an elderly woman

Cited by 21 publications

References 12 publications

Chronic Behavioral Disorders of Human REM Sleep: A New Category of Parasomnia

Chronic Behavioral Disorders of Human REM Sleep: A New Category of Parasomnia

Distinctive Features of NREM Parasomnia Behaviors in Parkinson’s Disease and Multiple System Atrophy

REM Sleep without Muscle Atonia (Stage 1‐REM) and Its Relation to Delirious Behavior during Sleep in Patients with Degenerative Diseases Involving the Brain Stem

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