REM Sleep Behavior Disorder

Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) is one of the primary sleep parasomnias. It features loss of the mammalian generalized muscle paralysis of REM sleep (‘REM atonia’) with release of prominent motor-behavioral activity during REM sleep that often represents dream enactment (‘oneirism’). Video polysomnography is essential for diagnosing RBD together with a clinical evaluation. RBD typically comes to medical attention due to disruptive, violent, and injurious sleep behaviors. RBD typically affects middle-aged and older males, many of whom will develop a parkinsonian disorder (Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy) 1–2 decades after the onset of RBD. Narcolepsy--cataplexy, stroke, and other neurological disorders can also be etiologically associated with RBD in adults and children. Various psychotropic medications (selective serotonin reuptake inhibitors, serotonin–Norepisephrise reuptake inhibitors, etc.) can induce RBD in adults of all ages and in both genders. RBD can usually be controlled with bedtime clonazepam and/or melatonin.