0737 SLEEP-RELATED RHYTHMIC MOVEMENT DISORDER AND SLEEP APNEA IN FIVE ADULT PATIENTS

Abstract

Sleep-related rhythmic movements (SRRMs) are typical in infancy and childhood, where they usually occur at the wake-sleep transition. However, they have rarely been observed in adults, where they can be idiopathic or associated with other sleep disorders. We report a video case series of 5 adults with sleep-related rhythmic movement disorder (SRRMD), 4 of which had a previous history of SRRMs in childhood. All of them underwent a full-night Video-PSG. A total of 411 RMEs were recorded in our 5 subjects, 78% of them occurred during consolidated sleep, of these, 18% in REM sleep. In the great majority of the cases (81.4%), RMEs were preceded by pathological breathing events. In at least 2 cases, the duration of breathing events associated with RMEs was longer than the one of those unassociated. RMEs retreated after CPAP ventilation in one subject. Four out of five subjects reported a previous history of SRRMD during childhood. We speculate that respiratory-related arousals could drive the occurrence of motor events in predisposed subjects. We strongly recommend to investigate the sleep-related breathing pattern by means of a full video-polysomnography in adults with SRRMD, particularly in those with a new-onset disorder or a recent aggravation, as well as in those whose RMEs tend to occur in consolidated sleep. This may speak against an unsafe treatment with benzodiazepines, which can aggravate sleep apnea. When sleep apnea is confirmed, treatment with CPAP might be beneficial also for RMEs. The SAS-CARE study was supported by grants from the Swiss National Science Foundation (SNF Grant 320030_125069) and SwissHeart.