REM sleep behavior disorder: update on diagnosis and management.

Autor:	Sobreira-Neto MA; Universidade Federal do Ceará, Faculty of Medicine, Division of Neurology, Fortaleza CE, Brazil., Stelzer FG; Univeridade de São Paulo, Ribeirão Preto Medical School, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto SP, Brazil., Gitaí LLG; Universidade Federal de Alagoas, Faculty of Medicine, Division of Neurology, Maceió AL, Brazil., Alves RC; Fleury Medicine Group, Sleep Medicine Center, São Paulo SP, Brazil., Eckeli AL; Univeridade de São Paulo, Ribeirão Preto Medical School, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto SP, Brazil., Schenck CH; Minnesota Regional Sleep Disorders Center; and University of Minnesota, Medical School, Departments of Psychiatry; and Hennepin County Medical Center, Minneapolis MN, United States of America.
Jazyk:	angličtina
Zdroj:	Arquivos de neuro-psiquiatria [Arq Neuropsiquiatr] 2023 Dec; Vol. 81 (12), pp. 1179-1194. Date of Electronic Publication: 2023 Dec 29.
DOI:	10.1055/s-0043-1777111
Abstrakt:	REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. Knowledge of this pathology is important to predict neurodegenerative diseases since there is a strong association of RBD with diseases caused by the deposition of alpha-synuclein in neurons (synucleinopathies), such as Parkinson's disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB). Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. Diagnostic assessment should begin with a detailed clinical history with the patient and bed partner or roommate and the examination of any recorded home videos. Polysomnography (PSG) is necessary to verify the loss of sleep atonia and, when documented, the behaviors during sleep. Technical recommendations for PSG acquisition and analysis are defined in the AASM Manual for the scoring of sleep and associated events, and the PSG report should describe the percentage of REM sleep epochs that meet the criteria for RWA (REM without atonia) to better distinguish patients with and without RBD. Additionally, PSG helps rule out conditions that may mimic RBD, such as obstructive sleep apnea, non-REM sleep parasomnias, nocturnal epileptic seizures, periodic limb movements, and psychiatric disorders. Treatment of RBD involves guidance on protecting the environment and avoiding injuries to the patient and bed partner/roommate. Use of medications are also reviewed in the article. The development of neuroprotective medications will be crucial for future RBD therapy. Competing Interests: The authors have no conflict of interest. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)
Databáze:	MEDLINE
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