Rapid Eye Movement Sleep Behavior Disorder
Rapid Eye Movement Sleep Behavior Disorder
Prevalence
The prevalence of REM sleep behavior disorder is approximately 0.38%-0.5% in the general population.
Prevalence in patients with psychiatric disorders may be greater, possibly related to medications prescribed for the psychiatric disorder.
Risk factors
Genetic and physiological
Many widely prescribed medications, including tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and beta-blockers, may result in REM sleep behavior disorder.
N.B: It is not known whether the medications per se result in REM sleep behavior disorder or they unmask an underlying predisposition.
Symptoms
Repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors.
These behaviors arise during rapid eye movement (REM) sleep and therefore usually occur more than 90 minutes after sleep onset, are more frequent during the later portions of the sleep period, and uncommonly occur during daytime naps.
Upon awakening from these episodes, the individual is completely awake, alert, and not confused or disoriented.
Either of the following:
REM sleep without atonia on polysomnographic recording.
A history suggestive of REM sleep behavior disorder and an established synuclein-opathy diagnosis (e.g., Parkinson’s disease, multiple system atrophy).
The behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (which may include injury to self or the bed partner).
The disturbance is not attributable to the physiological effects of a substance or another medical condition.
Coexisting mental and medical disorders do not explain the episodes.