Predisposing factors that increase RBD diathesis include elderly age, male sex, narcolepsy, antidepressant use, and neurological disorders. Counseling and management of RBD focus on injury prevention and the treatment of underlying precipitating disorders in addition to pharmacological treatment of severe cases using oral medications such as melatonin or Clonazepam. This topic will review the etiology, epidemiology, pathogenesis, clinical features, evaluation, management, and prognosis of RBD in adults. The diagnosis requires confirmation by an in-laboratory sleep study (polysomnography) with video recording, which helps assert abnormal behaviors during REM sleep and excludes other sleep disorders. Symptoms of RBD may precede neurodegenerative disorders by decades therefore, a careful history is significant in assessing these patients. The strongest correlation exists between RBD and comorbid neurodegenerative alpha-synucleinopathies (i.e., Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy). RBD has been associated with antidepressant use as well as narcolepsy. These symptoms may bring serious harm to the individual themselves and their sleeping partners. Rapid eye movement behavior disorder (RBD) is a parasomnia involving dream enactment behavior associated with loss of atonia during rapid eye movement (REM) sleep. Describe the importance of interprofessional team strategies for improving care coordination and communication to advance management of rapid eye movement behavior disorder and improve outcomes.Review the treatment and management options available for rapid eye movement behavior disorder.Outline the appropriate evaluation of rapid eye movement behavior disorder.Identify the etiology of rapid eye movement behavior disorder.This activity describes the evaluation and management of RBD and highlights the role of the healthcare team in improving care for patients with this condition. All rights reserved.Rapid eye movement behavior disorder (RBD) is parasomnia strongly linked to neurodegenerative diseases, and it can also be very disturbing and lead to injury requiring medical attention. These findings carry important clinical and research implications in the convergent fields of sleep medicine, neurology, and neuroscience, and identify an optimal clinical group for conducting prospective research studies utilizing putative neuroprotective agents to delay the emergence of, or halt the progression to, parkinsonism and/or cognitive impairment as manifestations of either PD, DLB or MSA.ĭementia with Lewy bodies Multiple system atrophy Neuroprotection PD Parkinson’s disease RBD REM sleep behavior disorder Video-polysomnography.Ĭopyright © 2012 Elsevier B.V. Also, the specificity of iRBD converting to parkinsonism/dementia is striking. The vast majority of men > or =50 years old initially diagnosed with iRBD in this study eventually developed a parkinsonian disorder/dementia, often after a prolonged interval from onset of iRBD, with the mean interval being 14 years while the range extended to 29 years. Among the 21 iRBD "converters," the mean age (±SD) of iRBD onset was 57.7☗.7 years mean age (±SD) of parkinsonism/dementia onset was 71.9☖.6 years and mean interval (±SD) from iRBD onset to parkinsonism/dementia onset was 14.2☖.2 years (range: 5-29 years).
RBD SLEEP STUDY CENTER WEST VIRGINIA PLUS
The distribution of diagnoses was as follows: n=13, Parkinson's disease (PD) n=3, dementia with Lewy bodies (DLB) n=1, dementia (unspecified profound) n=2, multiple system atrophy (MSA) n=2, clinically diagnosed Alzheimer's Disease (AD) with autopsy-confirmed combined AD plus Lewy body disease pathology. All patients had video-polysomnography (vPSG) confirmed RBD.Ĩ0.8% (21/26) of patients who were initially diagnosed with iRBD eventually developed parkinsonism/dementia (three of the original 29 patients were lost to follow-up). The methods of evaluation, diagnosis and follow-up were previously described in the 1996 report.
RBD SLEEP STUDY CENTER WEST VIRGINIA UPDATE
To provide a 16-year update from the authors' 1996 report documenting a 38% conversion from idiopathic rapid eye movement sleep behavior disorder (iRBD) to a parkinsonian disorder at a mean interval of nearly 13 years after the onset of iRBD in a series of 29 males > or =50 years old.
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