REM sleep behavior disorder: update on diagnosis and management
| Autor: | Manoel Alves Sobreira-Neto, Fernando Gustavo Stelzer, Lívia Leite Góes Gitaí, Rosana Cardoso Alves, Alan Luiz Eckeli, Carlos H. Schenck |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
REM Sleep Behavior Disorder
Sleep REM Parasomnias Synucleinopathies Sleep Wake Disorders Polysomnography Drug Therapy Transtorno do Comportamento do Sono REM Sono REM Parassonias Sinucleinopatias Transtornos do Sono-Vigília Polissonografia Tratamento Farmacológico Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 |
| Zdroj: | Arquivos de Neuro-Psiquiatria, Vol 81, Iss 12, Pp 1179-1194 (2023) |
| Druh dokumentu: | article |
| ISSN: | 0004-282X 1678-4227 |
| DOI: | 10.1055/s-0043-1777111 |
| Popis: | 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. |
| Databáze: | Directory of Open Access Journals |
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