REM Sleep Behavior Disorder

A disorder characterized by episodes of vigorous and often violent motor activity during REM sleep (SLEEP, REM). The affected individual may inflict self injury or harm others, and is difficult to awaken from this condition. Episodes are usually followed by a vivid recollection of a dream that is consistent with the aggressive behavior. This condition primarily affects adult males. (From Adams et al., Principles of Neurology, 6th ed, p393)

Also Known As:

Networked: 143 relevant articles (2 outcomes, 9 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Lewy Body Disease (Lewy Body Dementia)
2.	Dementia (Dementias)
3.	Neurodegenerative Diseases (Neurodegenerative Disease)
4.	Sleep Apnea Syndromes (Sleep Apnea)
5.	Somnambulism (Sleepwalking)

Experts

1.	Iranzo, Alex: 8 articles (11/2015 - 12/2002)
2.	Inoue, Yuichi: 7 articles (11/2014 - 05/2009)
3.	Postuma, Ronald B: 7 articles (11/2014 - 05/2011)
4.	Högl, Birgit: 5 articles (11/2015 - 12/2010)
5.	Frauscher, Birgit: 4 articles (11/2015 - 11/2014)
6.	Santamaría, Joan: 4 articles (05/2015 - 01/2006)
7.	Montplaisir, Jacques: 4 articles (11/2014 - 07/2011)
8.	Gagnon, Jean-François: 4 articles (02/2013 - 05/2011)
9.	Poewe, Werner: 3 articles (11/2015 - 01/2015)
10.	Tolosa, Eduardo: 3 articles (11/2015 - 02/2015)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to REM Sleep Behavior Disorder:

1.	Levodopa (L Dopa)FDA LinkGeneric 08/01/2010 - "Higher age at onset, higher baseline levodopa-equivalent doses, probable rapid eye movement (REM) sleep behavior disorder at baseline, and follow-up time were independent risk factors of incident PDP. " 03/01/2003 - "Levodopa improved rapid eye movement sleep behavior disorder with diffuse Lewy body disease." 03/01/1996 - "Rapid eye movement sleep behavior disorder preceding Parkinson's disease with therapeutic response to levodopa." 08/01/2010 - "Significant concomitant features of patients with PDP during the 12-year study period were low activities of daily living function (UPDRS II), dementia, high levodopa-equivalent dose, and probable REM sleep behavior disorder. " 09/03/2013 - "Compared to those without cognitive impairment, the PD patients with cognitive impairment had significantly higher score of HAMD (10 ± 7 vs 7 ± 4), increased incidence of hallucinations (40.50% vs 19.60%) and REM behavior disorders (RBD) (63.29% vs 39.21%), significantly higher H-Y stage [2.5(2.0-3.0) vs 2.0 (2.0-2.5)] , United Kingdom Parkinson Disease Society (UPDRS) part III (22 ± 10 vs 19 ± 10) and levodopa-equivalent daily dose (LED) (511 ± 302vs 380 ± 272) (all P < 0.05). "
2.	AcetylcholinesteraseIBA 09/26/2000 - "Three patients with REM behavior disorder whose nocturnal symptoms were markedly improved by treatment with the acetylcholinesterase inhibitor donepezil are reported. " 04/15/2010 - "We report the case of an 88-year-old man with Alzheimer's disease (AD) of 8 years duration (emerging shortly after the de novo onset of sleeptalking) who developed REM sleep behavior disorder (RBD) after increasing the nightly dose of rivastigmine, an acetylcholinesterase inhibitor, from 1.5 mg to 3 mg (total daily dose, 4.5 mg), as therapy for his dementia. "
3.	donepezil (Aricept)FDA LinkGeneric 09/26/2000 - "Donepezil may have a role in the treatment of REM behavior disorder, possibly through its actions on cholinergic pathways in the brainstem." 09/26/2000 - "Treatment of REM sleep behavior disorder with donepezil: a report of three cases." 09/26/2000 - "Three patients with REM behavior disorder whose nocturnal symptoms were markedly improved by treatment with the acetylcholinesterase inhibitor donepezil are reported. "
4.	SynucleinsIBA 11/17/2015 - "Enteric nervous system α-synuclein immunoreactivity in idiopathic REM sleep behavior disorder." 11/01/2014 - "Rapid Eye Movement Sleep Behavior Disorder (RBD) is a sleep disorder that has been strongly linked to synuclein-mediated neurodegeneration. " 02/17/2015 - "The aim of the present study was to determine the predictive value of olfactory dysfunction for the early development of a synuclein-mediated neurodegenerative disease in subjects with idiopathic REM sleep behavior disorder (iRBD) over an observational period of 5 years. " 11/17/2015 - "To investigate the expression of α-synuclein in colonic biopsies of patients with idiopathic REM sleep behavior disorder (iRBD) and address if α-synuclein immunostaining of tissue obtained via colonic biopsies holds promise as a diagnostic biomarker for prodromal Parkinson disease (PD). " 01/01/2015 - "Idiopathic rapid eye movement (REM) sleep behavior disorder (RBD) is a harbinger of synuclein-mediated neurodegenerative diseases. "
5.	AntibodiesIBA 05/01/1997 - "A controlled study of serum anti-locus ceruleus antibodies in REM sleep behavior disorder." 04/01/2011 - "Narcolepsy, REM sleep behavior disorder, and supranuclear gaze palsy associated with Ma1 and Ma2 antibodies and tonsillar carcinoma." 09/01/2014 - "Lack of antibodies to neuropil antigens in idiopathic REM sleep behavior disorder." 01/01/2012 - "α-Synuclein and anti-α-synuclein antibodies in Parkinson's disease, atypical Parkinson syndromes, REM sleep behavior disorder, and healthy controls." 01/01/2006 - "Of six patients registered in our center with nonparaneoplastic limbic encephalitis associated with antibodies to voltage-gated potassium channels, the five men had rapid eye movement sleep behavior disorder (RBD) coincident with voltage-gated potassium channel antibody-associated limbic encephalitis onset. "
6.	Clonazepam (Rivotril)FDA LinkGeneric 01/01/2013 - "An observational clinical and video-polysomnographic study of the effects of clonazepam in REM sleep behavior disorder." 10/01/2015 - "This case concerns an elderly man with a REM sleep behavior disorder, who was initially offered a pharmacological treatment with clonazepam, recommended by other articles, but with poor adherence due to its adverse reactions and persistence of symptoms. " 05/01/2013 - "Effects of long-term use of clonazepam on nonrapid eye movement sleep patterns in rapid eye movement sleep behavior disorder." 04/01/2013 - "The patient was diagnosed with REM Sleep Behavior Disorder and treated with 1 mg clonazepam nightly. " 01/01/2013 - "To analyze the differences in sleep structure and nocturnal motor activity between drug-free REM sleep behavior disorder (RBD) patients and those under therapy with clonazepam, and to evaluate the long-term longitudinal changes under continued therapy with clonazepam. "
7.	Serotonin Uptake Inhibitors (Serotonin Reuptake Inhibitors)IBA 12/02/2013 - "Previous studies have reported that selective serotonin reuptake inhibitors (SSRIs) may induce or exacerbate rapid eye movement (REM) sleep without atonia (RSWA) and increase the risk of developing REM sleep behavior disorder (RBD). " 09/01/2015 - "REM sleep behavior disorder (RBD) can be induced by antidepressants, especially serotonin reuptake inhibitors (SSRI), thus a role of the serotonergic system in the pathogenesis of RBD has been proposed. " 04/01/2014 - "We favor the selective serotonin reuptake inhibitors (SSRIs) in general for both depression and anxiety because of their relative freedom from side effects but will often choose mirtazapine if insomnia or weight loss is a problem, clonazepam for anxiety without depression if an SSRI is insufficient or if REM sleep behavior disorder is a problem, or a tricyclic antidepressant if drooling is troubling and the patient is not demented. "
8.	Carbon MonoxideIBA 04/08/2008 - "This study shows a co-occurrence of impaired cognitive profile and waking EEG slowing in patients with idiopathic REM sleep behavior disorder similar to that observed in early stages of some synucleinopathies." 02/01/2013 - "Co-morbid Parkinson's disease and rapid eye movement sleep behavior disorder were associated with abnormal visual P2 component of event-related potentials. " 12/01/2007 - "REM sleep behavior disorder (RBD) has been documented to precede or to co-occur with Parkinson's disease (PD). "
9.	Blood Proteins (Serum Proteins)IBA 01/01/2012 - "The objectives of this study were to compare the levels of α-synuclein and its antibodies between individuals with typical PD (n=14), atypical Parkinson syndromes (n=11), idiopathic rapid eye movement sleep behavior disorder (n=10), and healthy controls (n=9), to assess the strength of association between these serum proteins, and to determine group sizes needed for a high probability (80% power) of detecting statistical significance for 25% or 50% differences between typical PD and control subjects for these measurements. "
10.	N 30IBA 06/01/1992 - "The PSG reports of four other adult groups were also reviewed: periodic limb movement (PLM) disorder (n = 28); sleep terror/sleepwalking (ST/SW) (n = 54); rapid eye movement (REM) sleep behavior disorder (RBD) (n = 70); patients with clinically unremarkable sleep during two consecutive PSG studies (n = 30). "

Therapies and Procedures

1.	Continuous Positive Airway Pressure 05/01/2008 - "Sleep apnea is treated using continuous positive airway pressure, and REM sleep behavior disorder may improve using pharmacologic interventions, although controlled trials are lacking. "
2.	Activities of Daily Living (ADL) 08/01/2010 - "Significant concomitant features of patients with PDP during the 12-year study period were low activities of daily living function (UPDRS II), dementia, high levodopa-equivalent dose, and probable REM sleep behavior disorder. "
3.	Denervation 07/01/2012 - "Cardiac denervation precedes nigrostriatal damage in idiopathic rapid eye movement sleep behavior disorder." 04/01/2012 - "Symptoms of rapid eye movement sleep behavior disorder are associated with cholinergic denervation in Parkinson disease." 10/30/2010 - "Cardiac denervation in rapid eye movement sleep behavior disorder and Parkinson's disease: getting to the heart of the matter."
4.	Sympathectomy (Sympathectomies) 01/01/2013 - "PD importantly involves nonmotor manifestations, including anosmia, dementia, REM behavior disorder, and orthostatic hypotension, and all of these nonmotor features are associated with neuroimaging evidence for cardiac sympathetic denervation, which seems to occur independently of the movement disorder and striatal dopaminergic lesion. " 11/15/2011 - "Although evidence of cardiac sympathetic denervation is associated with other non-motor manifestations such as anosmia, REM behavior disorder, dementia, baroreflex failure, and orthostatic hypotension (OH), across individual patients the severities of OH and of the cardiac sympathetic lesion (indicated by thoracic 6-[(18)F]fluorodopamine PET scanning) are unrelated to the severity of the putamen dopaminergic lesion (indicated by brain 6-[(18)F]fluorodopa PET scanning). "
5.	Drug Therapy (Chemotherapy) 06/15/2009 - "Drug treatment of REM sleep behavior disorder: the use of drug therapies other than clonazepam." 01/01/2013 - "Several sleep disorders, including obstructive sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder, sleepwalking, REM sleep behavior disorder, and narcolepsy, may be comorbid or possibly mimic numerous psychiatric disorders, and can even occur due to psychiatric pharmacotherapy. "