Skip to main content
SpringerLink
Log in

Rapid Eye Movement Sleep Behavior Disorder

  • Chapter
Parkinson’s Disease and Nonmotor Dysfunction

Part of the book series: Current Clinical Neurology ((CCNEU))

  • 947 Accesses

Abstract

Rapid eye movement sleep behavior disorder (RBD) is a rapid eye movement (REM) parasomnia in which the normal muscle atonia of REM sleep is absent. The lack of muscle atonia may lead to motor activation and the appearance of dream-related behaviors. Dream content during RBD is vivid and often has aggressive themes, such as being threatened, chased, or attacked. During an episode, both the patient with RBD and their bed partner are at risk for serious injuries (e.g., bruises, lacerations, and bone fractures). Diagnosis of RBD currently requires the presence of established clinical criteria, but polysomnography is recommended to confirm the diagnosis and differentiate it from other sleep disorders, including sleep apnea. Controlled trials are lacking; yet, clonazepam has been effective in treating symptoms in up to 90% of patients with RBD. Other treatment approaches are dopaminergic agonists, antiepileptic agents, α-adrenergic agonists, acetylcholinesterase inhibitors, and melatonin. RBD is frequently associated with synucleinopathies, such as multiple system atrophy, dementia with Lewy bodies, and Parkinson’s disease. In these patients, RBD symptoms may precede motor symptoms by months to years. Abnormalities in central dopaminergic mechanisms have been postulated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Schenck CH, Bundlie SR, Ettinger MG, Mahowald MW. Chronic behavioral disorders of human REM sleep: a new category of parasomnia. Sleep 1986;9:293–308.

    PubMed  CAS  Google Scholar 

  2. Boeve BF, Silber MH, Parisi JE, et al. Synucleinopathy pathology and REM sleep behavior disorder plus dementia or Parkinsonism. Neurology 2003;61:40–45.

    PubMed  CAS  Google Scholar 

  3. Olson EJ, Boeve BF, Silber MH. Rapid eye movement sleep behavior disorder: demographic, clinical and laboratory findings in 93 cases. Brain 2000;123:331–339.

    Article  PubMed  Google Scholar 

  4. Schenck CH, Hurwitz TD, Mahowald MS. REM sleep behavior disorder: an update on a series of 96 patients and a review of the world literature. J Sleep Res 1993;2:224–231.

    Article  PubMed  Google Scholar 

  5. Sforza E, Krieger J, Petiau C. REM sleep behavior disorder: clinical and physiopathological findings. Sleep Med Rev 1997;1:57–69.

    Article  PubMed  CAS  Google Scholar 

  6. Boeve BF, Silber MH, Ferman TJ, et al. Association of REM sleep behavior disorder and neurodegenerative disease may reflect an underlying synuclienopathy. Mov Disord 2001;16:622–630.

    Article  PubMed  CAS  Google Scholar 

  7. Pajera J, Caminero A, Masa J, Dobato J. A first case of progressive supranuclear palsy and pre-clinical REM sleep behavior disorder presenting as inhibition of speech during wakefulness and somniloquy with phasic muscle twitching during REM sleep. Neurologia 1996;11:304–306.

    Google Scholar 

  8. Kimura K, Tachibana N, Toshihiko A, et al. Subclinical REM sleep behavior disorder in a patient with corticobasal degeneration. Sleep 1997;20:891.

    PubMed  CAS  Google Scholar 

  9. Comella CL, Nardine TM, Diederich NJ. Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson’s disease. Neurology 1998;51:526–529.

    PubMed  CAS  Google Scholar 

  10. Gagnon JF, Bedard MA, Fantini ML, et al. REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease. Neurology 2002;59:585–589.

    PubMed  CAS  Google Scholar 

  11. Wetter TC, Trenkwalder C, Gershanik O, Hogl B. Polysomnographic measures in Parkinson’s disease: a comparison between patients with and without REM sleep disturbances. Wien Klin Wochenschr 2001;113: 249–253.

    PubMed  CAS  Google Scholar 

  12. Plazzi G, Corsini R, Provini F, et al. REM sleep behavior disorders in multiple system atrophy. Neurology 1997;48:1094–1097.

    PubMed  CAS  Google Scholar 

  13. Boeve BF, Silber MH, Ferman TJ, et al. REM sleep behavior disorder and degenerative dementia: an association likely reflecting Lewy Body disease. Neurology 1998;51:363–370.

    PubMed  CAS  Google Scholar 

  14. Schenck CH, Bundlie SR, Mahowald MW. Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder. Neurology 1996;46: 388–393.

    PubMed  CAS  Google Scholar 

  15. Tan A, Salgado M, Fahn S. Rapid eye movement sleep behavior disorder preceding Parkinson’s disease with therapeutic response to levodopa. Mov Disord 1996;11:214–216.

    Article  PubMed  CAS  Google Scholar 

  16. Lai YY, Siegel JM. Physiological and anatomical link between Parkinson-like disease and REM sleep behavior disorder. Mol Neurobiol 2003;27:137–152.

    Article  PubMed  CAS  Google Scholar 

  17. Jouvet M. Paradoxical sleep—A study of its nature and mechanisms. Prog Brain Research 1965; 18:867–870.

    Google Scholar 

  18. Jouvet M. Paradoxical sleep mechanisms. Sleep 1994;17:S77–S83.

    PubMed  CAS  Google Scholar 

  19. Scarnati E, Florio T. The pedunculopontine nucleus and related structures. Adv Neurol 1997;74: 97–110.

    PubMed  CAS  Google Scholar 

  20. Pahapill PA, Lozano AM. The pedunculopontine nucleus and Parkinson’s disease. Brain 2000; 123:1767–1783.

    Article  PubMed  Google Scholar 

  21. Hirsch EC, Graybiel AM, Duyckaerts C, Javoy-Agid F. Neuronal loss in the pedunculopontine tegmental nucleus in Parkinson disease and in progressive supranuclear palsy. Proc Natl Acad Sci USA 1987;84:5976–5980.

    Article  PubMed  CAS  Google Scholar 

  22. Gai WP, Halliday GM, Blumbergs PC, et al. Substance P-containing neurons in the mesopontine tegmentum are severely affected in Parkinson’s disease. Brain 1991;114:2253–2267.

    Article  PubMed  Google Scholar 

  23. Turner RS, D’Amato CJ, Chervin RD, Blaivas M. The pathology of REM sleep behavior disorder with comorbid Lewy body dementia. Neurology 2000;55:1730–1732.

    PubMed  CAS  Google Scholar 

  24. Uchiyama M, Isse K, Tanaka K, et al. Incidental Lewy body disease in a patient with REM sleep behavior disorder. Neurology 1995;45:709–712.

    PubMed  CAS  Google Scholar 

  25. Factor SA, McAlarney T, Sanchez-Ramos JR, Weiner WJ. Sleep disorders and sleep effect in Parkinson’s disease. Mov Disord 1990;5:280–285.

    Article  PubMed  CAS  Google Scholar 

  26. Culebras A, Moore JT. Magnetic resonance findings in REM sleep behavior disorder. Neurology 1989; 39:1519–1523.

    PubMed  CAS  Google Scholar 

  27. Irazano A, Santamaria J, Pujol J, et al. Brainstem proton magnetic resonance spectroscopy in idiopathic REM sleep behavior disorder. Sleep 2002;25:867–870.

    Google Scholar 

  28. Albin RL, Koeppe A, Chervin RD, et al. Decreased striatal dopaminergic innervation in REM sleep behavior disorder. Neurology 2000;55:1410–1412.

    PubMed  CAS  Google Scholar 

  29. Gilman S, Koeppe A, Chervin RD, et al. REM sleep behavior disorder is related to striatal monoaminergic deficit in MSA. Neurology 2003;61:29–34.

    PubMed  CAS  Google Scholar 

  30. Eisensehr I, Linke R, Noachtar S, et al. Reduced striatal dopamine transporters in idiopathic rapid eye movement sleep behavior disorder: comparison with Parkinson’s disease and controls. Brain 2000;123: 1155–1160.

    Article  PubMed  Google Scholar 

  31. Eisensehr I, Linke R, Tatsch K, et al. Increased muscle activity during rapid eye movement sleep correlates with decrease of striatal presynaptic dopamine transporters. IPT and IBZM SPECT imaging in subclinical and clinically manifest idiopathic REM sleep behavior disorder, Parkinson’s disease, and controls. Sleep 2003;26: 507–512.

    PubMed  Google Scholar 

  32. Comella CL, Tanner CM, Ristanovic RK. Polysomnographic sleep measures in Parkinson’s disease patients with treatmentinduced hallucinations. Ann Neurol 1993;34:710–714.

    Article  PubMed  CAS  Google Scholar 

  33. Arnulf I, Bonnet AM, Damier P, et al. Hallucinations, REM sleep and Parkinson’s disease. Neurology 2000;55:281–288.

    PubMed  CAS  Google Scholar 

  34. Nomura T, Inoue Y, Mitani H, et al. Visual hallucinations as REM sleep behavior disorder in patients with Parkinson’s disease. Mov Disord 2003;18:812–817.

    Article  PubMed  Google Scholar 

  35. Onofrj M, Thomas A, D’Andreamatteo G, et al. Incidence of RBD and hallucination in patients affected by Parkinson’s disease: 8-year follow-up. Neurol Sci 2002;23(Suppl 2):S91–S94.

    Article  PubMed  Google Scholar 

  36. American Sleep Disorders Association. The International Classification of Sleep Disorders. Diagnostic and Coding Manual (Revised). American Sleep Disorders Association, Rochester, MN, 1997.

    Google Scholar 

  37. Lapierre O, Montplaisir J. Polysomnographic features of REM sleep behavior disorder: development of a scoring method. Neurology 1992;42(Suppl 6):44–51.

    Google Scholar 

  38. Bliwise DL, Williams ML, Irbe D, et al. Inter-rater reliability for identification of REM sleep in Parkinson’s disease. Sleep 2000;23:671–676.

    PubMed  CAS  Google Scholar 

  39. Eisensehr I, v Lindeiner H, Jager M, Noachtar S. REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson’s disease: is there a need for polysomnography? J Neurol Sci 2001;186: 7–11.

    Article  PubMed  CAS  Google Scholar 

  40. Woods JH, Winger G. Current benzodiazepine issues. Psychopharmacology 1995;118:107–115.

    Article  PubMed  CAS  Google Scholar 

  41. Ringman JM, Simmons JH. Treatment of REM sleep behavior disorder with donepezil: a report of three cases. Neurology 2000;55:870–871.

    PubMed  CAS  Google Scholar 

  42. Boeve BF, Silber MH, Ferman TJ. Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med 2003;4:281–284.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Rush University Medical Center, Chicago, IL

    Suzanne Stevens MD

  2. Department of Psychology, Rush University Medical Center, Chicago, IL

    Suzanne Stevens MD

  3. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL

    Cynthia Comella MD

Authors
  1. Suzanne Stevens MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cynthia Comella MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN

    Ronald F. Pfeiffer MD

  2. Department of Neurology, State University of New York, Downstate Medical Center, Brooklyn, NY

    Ivan Bodis-Wollner MD, DSc

  3. Department of Ophthalmology, State University of New York, Downstate Medical Center, Brooklyn, NY

    Ivan Bodis-Wollner MD, DSc

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Stevens, S., Comella, C. (2005). Rapid Eye Movement Sleep Behavior Disorder. In: Pfeiffer, R.F., Bodis-Wollner, I. (eds) Parkinson’s Disease and Nonmotor Dysfunction. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-859-5:191

Download citation

  • DOI: https://doi.org/10.1385/1-59259-859-5:191

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-316-9

  • Online ISBN: 978-1-59259-859-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation