Materiały źródłowe

• #1 REM Sleep Behavior Disorder Causes

  https://www.webmd.com/sleep-disorders/rem-sleep-behavior-disorder

  In a person with REM sleep behavior disorder (RBD), the paralysis that normally happens during REM sleep is incomplete or absent, allowing the person to „act out” their dreams. […] The exact cause of RBD is unknown, but it may happen along with degenerative neurological conditions such as Parkinson’s disease, multisystem atrophy (also known as Shy-Drager syndrome), and diffuse Lewy body dementia. […] In 55% of people, the cause is unknown, and in 45%, its linked with alcohol or sedative-hypnotic withdrawal, tricyclic antidepressant (such as imipramine), or serotonin reuptake inhibitor use (such as fluoxetine, sertraline, or paroxetine) or other types of antidepressants (mirtazapine). […] RBD often happens several years before the development of these neurodegenerative diseases. […] The relationship between RBD and Parkinson disease is complex; not everyone with RBD will develop Parkinson’s disease.

• #1 Pathophysiology of REM sleep behavior disorder – VJNeurology

  https://www.vjneurology.com/video/p075w1vbv0m-pathophysiology-of-rem-sleep-behavior-disorder/

  Experts believe that degeneration in the pre-locus coeruleus causes disinhibition of spinal motor neurons during REM sleep, which causes the dream enactment behavior that is seen in patients. […] RBD is a REM parasomnia characterised by dream enactment behavior.

• #1 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  RBD occurs because of the failure to inhibit spinal motor neurons during REM sleep. A strong association between RBD and the future development of a neurodegenerative disorder has been well established. Neurodegenerative disorders linked to alpha-synuclein positive intracellular inclusions, for example, parkinsonism, Lewy body dementia, and multiple system atrophy (MSA) are associated with alpha-synucleinopathies. Nuclei in the pons control REM sleep. Lesions in pons can lead to the development of these synucleinopathies and RBD. A progressive degeneration of these nuclei may explain the RBD as a prodrome before the full onset of the disease spectrum. Neuroimaging studies have shown progressive dopaminergic abnormalities in patients with RBD. Dopaminergic agents like antidepressants may, therefore, worsen RBD. In narcolepsy, about 50% of patients may manifest RBD. Lack of orexin in narcolepsy may fail to stabilize REM sleep and results in a lack of muscle atonia during REM sleep.

• #1 REM Sleep Behavior Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd

  REM sleep behavior disorder (RBD) is a condition in which you physically and/or vocally act out your dreams while in the rapid eye movement (REM) stage of sleep. […] There are two main types of RBD: isolated (idiopathic) and symptomatic (secondary). […] Isolated or idiopathic RBD happens when the condition develops spontaneously without an underlying cause. Most people with idiopathic RBD will eventually develop a neurodegenerative condition specifically, Parkinsons disease, Lewy body dementia or multiple system atrophy (MSA). These conditions are called alpha-synucleinopathies. […] Symptomatic or secondary RBD happens due to an underlying cause, such as Type 1 narcolepsy. […] People who take certain antidepressants can develop RBD. This is called drug-induced RBD. […] One theory for isolated (idiopathic) RBD is that an issue in the part of your brainstem called the pons leads to REM sleep without atonia.

• #1 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  In fact, studies have suggested that RBD may be associated with alpha-synuclein-mediated degeneration of sleep-regulating nuclei in the brainstem, particularly the pontine tegmentum. […] In essence, RBD may be the prodrome of neurodegenerative disease, such as diffuse Lew body (DLB) disease or Parkinson disease. […] Based on findings from sleep studies, most individuals (50%) with initially idiopathic RBD will eventually develop a neurodegenerative disease. RBD is thought to be a prodromal marker of neurodegenerative synucleinopathies and is present in a majority of patients with Parkinson disease (50%), multiple system atrophy (80-90%), dementia with Lewy bodies (80%).

• #1 Sleep Disorder Increases Odds of DLB by Five Times Over Alzheimer’s – Lewy Body Dementia Association

  https://www.lbda.org/sleep-disorder-increases-odds-of-dlb-by-five-times-over-alzheimers/

  REM sleep behavior disorder (RBD) is a condition that causes a person to physically act out their dreams and is a common in Lewy body dementia (LBD). […] RBD is a known risk factor in men for all Lewy body disorders, including LBD, Parkinsons disease and multiple system atrophy; it is not as strongly associated with Lewy body disorders in women. […] This research suggests that RBD may play a more significant role in diagnosing DLB, compared to other DLB symptoms. […] While it is, of course, true that not everyone who has this sleep disorder develops dementia with Lewy bodies, as many as 75 to 80 percent of men with dementia with Lewy bodies in our Mayo database did experience REM sleep behavior disorder. So it is a very powerful marker for the disease, says lead author Melissa Murray, Ph.D., a neuroscientist at the Mayo Clinic in Jacksonville, Florida.

• #1 REM Sleep Behavior Disorder – Neurology Solutions

  https://www.neurologysolutions.com/movement-disorders/rem-sleep-behavior-disorder/

  REM (rapid eye movement) Sleep Behavior Disorder (RBD) is a chronic, non-familial sleep-related movement disorder characterized by dream enactment and the patients loss of inherent muscle atonia (the usual, temporary paralysis of the arms and legs) during REM sleep. […] RBD patients have a high risk of developing other neurodegenerative diseases over 70% of RBD patients will develop parkinsonism or dementia within 12 years of their RBD diagnosis. […] One of the most serious aspects of REM Sleep Behavior Disorder is the fact that RBD patients have a very high risk of developing atypical parkinsonism, dementia, and/or Parkinsons disease. Over 70% of RBD patients will develop either atypical parkinsonism or dementia within 12 years of receiving their RBD diagnosis. […] Atypical parkinsonism and dementia tend to progress more rapidly in patients with RBD.

• #1 REM sleep behavior disorder: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/247730

  REM sleep behavior disorder involves unusual actions or behaviors during the rapid eye movement sleep phase. […] The exact cause of RBD is unclear. […] On occasion, RBD may be an adverse reaction to certain medications and may occur during drug withdrawal. […] Studies suggest that antidepressant medications trigger RBD in up to 6 percent of users. […] Evidence has linked RBD with post-traumatic stress disorder (PTSD), and this sleep issue can occur in people who have recently experienced trauma. […] About 38 percent of people with RBD might develop other neurological diseases such as Parkinsons disease, Lewy body dementia or multiple systems atrophy. Sometimes the RBD can occur 50 years prior to symptoms of other neurological diseases.

• #1 Genome-wide association study of REM sleep behavior disorder identifies polygenic risk and brain expression effects | Nature Communications

  https://www.nature.com/articles/s41467-022-34732-5

  Rapid-eye movement (REM) sleep behavior disorder (RBD), enactment of dreams during REM sleep, is an early clinical symptom of alpha-synucleinopathies and defines a more severe subtype. The genetic background of RBD and its underlying mechanisms are not well understood. Here, we perform a genome-wide association study of RBD, identifying five RBD risk loci near SNCA, GBA, TMEM175, INPP5F, and SCARB2. Expression analyses highlight SNCA-AS1 and potentially SCARB2 differential expression in different brain regions in RBD, with SNCA-AS1 further supported by colocalization analyses. Polygenic risk score, pathway analysis, and genetic correlations provide further insights into RBD genetics, highlighting RBD as a unique alpha-synucleinopathy subpopulation that will allow future early intervention.

• #1 Genome-wide association study of REM sleep behavior disorder identifies polygenic risk and brain expression effects | Nature Communications

  https://www.nature.com/articles/s41467-022-34732-5

  Thus far, the genetics of RBD has only been studied through the candidate gene approach. To better understand RBD and early alpha-synucleinopathy genetics and potential mechanisms, we performed a genome-wide association study (GWAS) on 2843 cases and 139,636 controls. We further examined the biological implications of the nominated risk loci through pathway analysis, investigated variant effects on gene expression, and assessed the cumulative risk using polygenic risk score (PRS). […] The presence of RBD is currently the strongest predictor for the development of dementia in PD and is associated with more rapid progression of non-motor symptoms. RBD is more frequent in DLB, found in ~50-80% of all cases, and is associated with increased severity of DLB symptoms and rapid deterioration. […] Overall, RBD, and specifically iRBD, appears to represent a more malignant subtype of alpha-synucleinopathies.

• #1

  https://www.singhealth.com.sg/news/medical-news/rem-sleep-behaviour-disorder-rbd

  There is increasing debate whether true idiopathic RBD exists with an increasing recognition of the strong association between RBD and the subsequent development of neurodegenerative disease, with 91% developing one of these conditions over 14 years of follow up. […] RBD is now commonly regarded as a prodromal phase of the alpha-synucleinopathies including Parkinsons Disease.

• #1 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Drug-induced RBD is common in individuals who are taking antidepressants. The most likely antidepressants that will incite an RBD episode are serotonin reuptake inhibitors (fluoxetine), tricyclic antidepressants (mirtazapine, protriptyline, amitriptyline, nortriptyline, desipramine, imipramine), and monoamine oxidase inhibitors (phenelzine and selegiline). […] RBD with concomitant narcolepsy may be considered a distinct phenotype of RBD. It is characterized by less violent or complex behavior during REM sleep, earlier age of onset, equal sex distribution, and hypocretin (orexin) deficiency (a lab diagnosis specific for narcolepsy type 1).

• #1 REM Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534239/

  There are also secondary causes of RBD associated with parkinsonism, narcolepsy, or the use of antidepressant medications. Causes of secondary RBD, especially in younger individuals, include parkinsonism, narcolepsy, or the use of antidepressant medications. The prevalence of RBD in narcolepsy has been reported to be as high as 36%. Antidepressant medications can precipitate RBD-type symptoms in up to 6% of cases. Other secondary causes of RBD may include vascular lesions, tumors, demyelinating disease, autoimmune, or inflammatory disorders.

• #1 Raid eye movement disorder | Symptoms & causes

  https://cpdonline.co.uk/knowledge-base/mental-health/rapid-eye-movement-disorder/

  Underlying health conditions RBD is linked with neurological conditions. […] Certain medications antidepressants, beta blockers and some medications taken for Alzheimers can cause REM sleep disorder or make it worse. […] RBD is linked with neurological disorders. […] Many people who suffer from rapid eye movement behaviour disorder will go on to develop a serious neurological disorder such as Parkinsons disease or Lewy body dementia. This can happen years or even decades later, and the RBD occurrences are often the first sign that something is wrong.

• #1 REM Sleep Behavior Disorder: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/sleep-disorders/rem-sleep-behavior-disorder

  Someone can develop REM sleep behavior disorder many years before a diagnosis of a neurodegenerative condition, particularly one associated with Lewy bodies. […] Possible factors that may raise someone’s chances of developing REM sleep behavior disorder include: alcohol withdrawal, antidepressant use, depression, post-traumatic stress disorder (PTSD), being assigned male at birth, smoking, narcolepsy, brain injury. […] Selective serotonin reuptake inhibitors (SSRIs) are the most common medication to cause REM sleep behavior disorder. These antidepressants counteract REM-mediated paralysis, inciting muscle tone instead. […] Other medications that have been shown to cause REM sleep behavior disorder include: tricyclic antidepressants, cholinesterase inhibitors for Alzheimer’s disease, mirtazapine in the treatment of parkinsonism, venlafaxine, monoamine oxidase inhibitors. […] REM sleep behavior disorder is a risk factor for neurodegenerative conditions, such as Parkinson’s disease and Lewy body dementia.

• #1 REM Sleep Behavior Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd

  People with narcolepsy lack orexin (hypocretin), a brain chemical that regulates sleep, wakefulness and appetite. This lack may fail to stabilize REM sleep, leading to RBD. […] Researchers think that certain antidepressants can cause RBD due to imbalances in dopamine and serotonin (neurotransmitters), which are involved in REM sleep.

• #1 REM sleep behavior disorder | MedLink Neurology

  https://www.medlink.com/articles/rapid-eye-movement-sleep-behavior-disorder

  Nearly all patients aged 50 years and older with isolated RBD eventually develop an alpha-synucleinopathy (Parkinson disease, dementia with Lewy bodies, and multiple system atrophy). […] Symptoms of RBD in non-synucleinopathy neurodegenerative disorders suggest concurrent synucleinopathy. […] Structural lesions to the brainstem, specifically the dorsal pons and medulla, can cause RBD that is not associated with a progressive neurodegenerative disease. […] RBD frequently occurs in patients with narcolepsy type 1 and can be seen a variety of autoimmune encephalopathies. […] A variety of medications are known to provoke RBD, most commonly selective serotonin reuptake inhibitors, and are thought to unmask a latent predisposition to develop RBD (and perhaps also synucleinopathy) rather than causing RBD per se.

• #1 REM sleep behavior disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920

  Rapid eye movement (REM) sleep behavior disorder may be associated with other neurological conditions, such as Lewy body dementia (also called dementia with Lewy bodies), Parkinson’s disease or multiple system atrophy. […] Nerve pathways in the brain that prevent muscles from moving are active during normal REM or dreaming sleep, resulting in temporary paralysis of your body. In REM sleep behavior disorder, these pathways no longer work and you may physically act out your dreams. […] Factors associated with the development of REM sleep behavior disorder include: Being male and over 50 years old however, more women are now being diagnosed with the disorder, especially under age 50, and young adults and children can develop the disorder, usually in association with narcolepsy, antidepressant use or brain tumors. […] Recent evidence suggests that there may also be several specific environmental or personal risk factors for REM sleep behavior disorder, including occupational pesticide exposure, farming, smoking or a previous head injury.

• #1 What Is REM Sleep Behavior Disorder? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/sleep/other-disorders/rem-behavior-disorder.aspx

  The Sleep Foundation says that 87 percent of people with RBD are male, and the average onset is about 61 years old. […] It could be that it’s a foreshadowing of developing a very serious disorder, not always but pretty often, particularly if you’re an older male and have isolated episodes of RBD, Cline says. […] Research suggests that REM sleep behavior disorder could be an early sign of neurodegenerative conditions, including Parkinson’s disease and Lewy body dementia.

• #1 REM Sleep Disorders – The Center for Sleep Medicine

  https://www.sleepmedcenter.com/rem-sleep-disorders/

  There may be a link between RBD and degenerative neurological conditions such as Parkinsons disease, diffuse Lewy body dementia, multi-system atrophy, and Shy-Drager syndrome. […] Studies by Drs. Carlos Schneck and Mark Mahowald at the University of Minnesota show that 38% of patients with RBD develop Parkinsons within 12-13 years after the RBD symptoms begin, while 69% of those with multi-system atrophy or Parkinsons disease also have RBD. […] There also appears to be a correlation between sex, age, and RBD; data gathered indicates that 90% of RBD patients are males over 50 years of age, although there are reports of patients less than nine years old.

• #1 Rapid eye movement sleep behavior disorder – Wikipedia

  https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep_behavior_disorder

  Risk factors for developing RBD are a family history of acting out dreams, prior head injury, farming, exposure to pesticides, low education level, depression, and use of antidepressants. […] RBD may be acute and sudden in onset if associated with drug treatment or withdrawal (particularly with alcohol withdrawal). Antidepressant medications can induce or aggravate RBD symptoms.

• #1 REM Sleep Behavior Disorder | Sleep Disorders | Henry Ford Health – Detroit, MI

  https://www.henryford.com/services/sleep-disorders/conditions/rem-disorders

  REM sleep behavior disorder (RBD) is caused by the nerve pathways in the brain that signal temporary muscle paralysis not working, allowing full use of muscles to act out dreams. […] Other potential causes and/or risk factors include having a neurological condition, such as Lewy body dementia, Parkinson’s disease or stroke, having narcolepsy, taking certain antidepressant medications, and sleep apnea which can disrupt sleep, causing brief awakenings and movements that may resemble RBD.

• #1 A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

  https://www.e-jsm.org/journal/view.php?number=382

  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior and REM sleep without atonia and is traumatic for the patient and/or bedpartner. Obstructive sleep apnea (OSA) is a common comorbidity of RBD, and several reports have suggested that severe OSA may aggravate RBD symptoms. […] Although OSA is common in patients with RBD, the influence of comorbid OSA on RBD symptoms remains unclear. […] A previous report showed OSA, especially in highly severe cases, might mask the symptoms of RBD by reducing REM sleep duration and REM sleep fragmentation. […] However, other studies suggest OSA may exacerbate complex motor behavior in patients with RBD by increasing arousal after respiratory events and sleep fragmentation. […] Several studies suggested OSA treatment with continuous positive airway pressure (CPAP) improved RBD symptoms and RWA on night polysomnography (PSG).

• #1 A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

  https://www.e-jsm.org/journal/view.php?number=382

  This patient presented with medically intractable RBD, in which OSA was not initially detected, and was diagnosed with comorbid OSA by a 10-year follow-up PSG. The RBD symptoms improved with nasal CPAP therapy. […] Although not clearly understood, several previous reports suggest sleep-disordered breathing could aggravate RBD symptoms and that CPAP therapy could improve the symptoms. […] One reason is that severe OSA can mimic RBD symptoms, which is called pseudo-RBD. […] In cases of true RBD comorbid with OSA, DEB symptoms could be improved with CPAP therapy by reducing pseudo-RBD behaviors related to respiratory events. […] In addition, severe OSA causes sleep fragmentation and frequent arousal. […] Since OSA causes recurrent cortical microarousal, it may contribute to brainstem activation with increased muscle activity, exacerbating RBD symptoms.

• #1 REM Sleep Behavior Disorder

  https://www.alluremedical.com/rem-sleep-behavior-disorder/

  REM sleep behavior disorder (RBD) is a condition characterized by abnormal behaviors during the rapid eye movement sleep stage due to a lack of muscle paralysis or atonia. This allows individuals to physically act out vivid dreams by talking, shouting, punching, kicking, jumping, and more complex motor behaviors. […] RBD is strongly associated with synucleinopathies like Parkinson’s disease, Lewy body dementia, and multiple system atrophy. Over 50% of RBD patients develop Parkinson’s disease within 10 years of diagnosis, and RBD can be an early marker for Parkinson’s. […] Other neurological conditions related to RBD include mild cognitive impairment, autonomic dysfunction, restless legs syndrome, and overlap parasomnias. Traumatic brain injuries can trigger the onset of RBD in some patients, and factors like medications, alcohol use, and sleep deprivation may precipitate RBD as well. […] RBD has high comorbidity with conditions like major depression, PTSD, obsessive-compulsive disorder, and other mental disorders.

• #1 REM Behavior Disorder Symptoms, Causes, and Treatments

  https://www.verywellhealth.com/what-is-rem-behavior-disorder-3014772

  REM behavior disorder is frequently associated with other neurologic disorders, and many patients will have another disorder like Parkinsons disease, dementia with Lewy bodies, and multiple system atrophy. […] Even when there is not an associated neurologic disorder at presentation, one study showed that up to 90.9% of patients with REM behavior disorder will go on to develop a neurodegenerative disease years or decades later. […] It has been suggested that REM behavior disorder may be a possible useful indicator for early prevention of these disorders. […] There is a less frequent acute form of REM behavior disorder that may result from structural brain lesions such as a stroke, tumor, or in demyelination as may occur in multiple sclerosis. […] Another manifestation may also occur as the result of certain medications (including antidepressants and others that affect the brain), drug intoxication, or withdrawal from alcohol or sedative medications.

• #1 REM sleep behaviour disorder More than just a parasomnia

  https://www.racgp.org.au/afp/2013/november/rem-sleep-behaviour-disorder

  RBD has a transient and a chronic form, the latter being idiopathic or associated with neurodegenerative diseases. As mentioned above, RBD will often predate the onset of the motor symptoms in PD but not all patients report this symptom, or may only develop it later in the course of the neurodegenerative process. […] Secondary RBD has been associated with narcolepsy whilst transient RBD has been reported in several neurological and toxic conditions such as lower brainstem lesions or GuillainBarr syndrome, alcohol withdrawal and antidepressant use. Therefore, careful assessment for such clinical features is needed before the diagnosis of the iRBD is made. […] There is now strong evidence that RBD is linked to the development of neurodegenerative diseases, which are collectively known as the synucleinopathies. These conditions include PD, LBD and multiple system atrophy (MSA), and share common neuropathological and clinical features of Parkinsonism. Longitudinal studies have shown that the risk of the idiopathic form of RBD (iRBD) converting to a Parkinsonian disorder varies from 4080% over a 515 year period.

• #1 REM sleep behavior disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/diagnosis-treatment/drc-20352925

  REM sleep behavior disorder can be the first indication of development of a neurodegenerative disease, such as Parkinson’s disease, multiple system atrophy or dementia with Lewy bodies. So if you develop REM sleep behavior disorder, it’s important to follow up with your doctor. […] Your sleep disturbance is not caused by another sleep disturbance, a mental health disorder, medication or substance abuse.

• #1 Rapid Eye Movement (REM) Sleep Behaviour Disorder | North Bristol NHS Trust

  https://www.nbt.nhs.uk/our-services/a-z-services/neuropsychiatry/rapid-eye-movement-rem-sleep-behaviour-disorder

  People begin acting out their dreams by vocalizing or moving their arms and legs during REM sleep. […] It is caused by a failure of the normal mechanism which keeps people still during dreams. […] REM sleep disorders are usually caused by a problem with the part of the brain that sends information down the spine to the muscles. […] There are some risk factors which may make someone more likely to develop a REM parasomnia, and these include: Being male, Being aged over 50, Having other neurological disorders such as Parkinsons Disease, Having other sleep disorders such as narcolepsy, Taking certain medications such as antidepressants, or the use or withdrawal of alcohol and/or other illicit drugs, Having post traumatic stress disorder. […] However, in a lot of cases, people subsequently go on to develop certain types of neurodegenerative disorders such as Parkinsons and Lewy body dementia. […] This may be several decades later. REM sleep disorders can sometimes be the first symptoms that present in these conditions.

• #1 REM sleep behaviour disorder More than just a parasomnia

  https://www.racgp.org.au/afp/2013/november/rem-sleep-behaviour-disorder

  Several studies attempting to better predict the transition of iRBD to a neurodegenerative synucleinopathy have identified features such as constipation, postural hypotension, cardiac sympathetic denervation, deficiencies in olfaction, colour discrimination and cognition impairments as other potential red flags but, as yet, no reliable biomarkers have offered sufficient predictive value in clinical practice. […] Given the growing burden of neurodegenerative diseases in our ageing population, early identification of RBD in general practice may offer a potential window for the use of future disease-modifying agents.

• #1 REM sleep behaviour disorder | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-018-0016-5

  Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia that is characterized by loss of muscle atonia during REM sleep (known as REM sleep without atonia, or RSWA) and abnormal behaviours occurring during REM sleep, often as dream enactments that can cause injury. […] RBD is categorized as either idiopathic RBD or symptomatic (also known as secondary) RBD; the latter is associated with antidepressant use or with neurological diseases, especially -synucleinopathies (such as Parkinson disease, dementia with Lewy bodies and multiple system atrophy) but also narcolepsy type 1. […] RSWA and RBD are now recognized as manifestations of an -synucleinopathy; most older adults with idiopathic RBD will eventually develop an overt neurodegenerative syndrome. […] In the future, studies will likely evaluate neuroprotective therapies in patients with idiopathic RBD to prevent or delay -synucleinopathy-related motor and cognitive decline.

• #1 Rapid Eye Movement (REM) Sleep Behavior Disorder Quiz: Check Possibility & Treatment with Ubie AI Symptom Checker

  https://ubiehealth.com/diseases/rapid-eye-movement-rem-sleep-behavior-disorder

  Rapid eye movement sleep behavior disorder (RBD) is a condition in which a person abnormally acts out dreams during rapid-eye-movement (REM) sleep, a phase of sleep that is normally characterized by random, rapid movements of the eyes, vivid dreams, and muscle paralysis. The acting out can range from calm limb movements to violent arm and leg thrashing, talking, and/or shouting. Although RBD can be caused by certain medications or sleep conditions such as narcolepsy, RBD is a most commonly a precursor to later onset of Parkinson disease. 75% of RBD patients develop Parkinson disease by 12 years after RBD diagnosis. […] Treatment for REM sleep behavior disorder may include physical safeguards, medications to reduce symptoms, as well as avoiding certain antidepressant medications that can worsen RBD symptoms. Physical safeguards include padding the floor near the bed, removing dangerous objects from the bedroom, or encouraging sleeping alone.

• #1 Identifying and Characterizing Genetic Causes of REM Sleep Behavior Disorder and Parkinson’s Disease | Parkinson’s Disease

  https://www.michaeljfox.org/grant/identifying-and-characterizing-genetic-causes-rem-sleep-behavior-disorder-and-parkinsons

  During the rapid eye movement (REM) phase of sleep, when we dream, our voluntary muscles are paralyzed so that we would not act out our dreams. In REM sleep behavior disorder (RBD), patients lose this ability. In more than 80 percent of the cases, RBD progresses into Parkinsons disease (PD) or a similar disease, and, often, RBD presents many years before the appearance of motor symptoms of PD. […] We hypothesize that there are genetic elements that will allow us to identify individuals who are at risk to develop RBD and later develop PD. […] By doing so, we will be able to identify genetic markers that are associated with the risk to develop RBD and with the risk to further progress to PD. […] The analysis of the 51 genes identified numerous genetic mutations that may lead to PD and RBD or increase the risk to develop them. Furthermore, in the GWAS analysis, we identified potential new genes that may increase the risk to develop RBD and subsequently PD. […] Such genetic variants have the potential to serve as markers to identify individuals in an earlier stage of the disease, before the motor symptoms begin.

• #1 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  The precise etiology and neural structures involved in rapid eye movement sleep behavior disorder (RBD) are unknown. Based on animal (cats, rats), lesional, and neuropathologic studies, sleep-regulating nuclei, particularly the pontine tegmentum, are thought to be involved in the pathogenesis of RBD. Also, a complex interplay of various neurochemical systems, such as the noradrenergic, cholinergic, and serotonergic systems, seems to exist in the pathogenesis of the condition. […] RBD may be idiopathic. However, several studies have suggested that idiopathic RBD is a potential marker for the later development of neurodegenerative disorders characterized by alpha-synuclein deposition. These include Parkinson disease, multiple system atrophy, dementia with Lewy bodies, and pure autonomic failure, with the risk varying among different studies. (RBD is less frequently associated with nonsynucleinopathies.)

• #1 Genome-wide association study of REM sleep behavior disorder identifies polygenic risk and brain expression effects | Nature Communications

  https://www.nature.com/articles/s41467-022-34732-5

  The differential association at the SNCA locus, when comparing PD and RBD, may provide a mechanistic hypothesis for gene expression-dependent regional vulnerability of different brain areas. […] The results of the current study suggest that the genetic background of RBD, PD and DLB only partially overlap, and larger RBD studies will be required to better elucidate the genetic background of RBD. The present study also suggests that the lysosomal pathway, and more specifically the GBA pathway, could be a crucial target for therapeutic development targeting RBD and aimed to prevent neurodegeneration in this population.

• #2 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Rapid eye movement behavior disorder (RBD) is a parasomnia strongly linked to neurodegenerative diseases, and it can also be very disturbing and lead to injury requiring medical attention. RBD can be divided into three categories: idiopathic RBD, drug-induced RBD, and secondary RBD due to a medical condition. […] Predisposing factors that increase RBD diathesis include elderly age, male sex, narcolepsy, antidepressant use, and neurological disorders. RBD can be divided into three categories: Idiopathic RBD, Drug-induced RBD, Secondary RBD due to medical condition. […] The literature suggests that RBD is precipitated by aberrant connections between the brainstem control of muscle tonicity and the cortex. Studies have also suggested associations with traumatic brain injury (TBI), post-traumatic stress syndrome (PTSD), and congenital and neurodevelopmental disorders.

• #2 Rapid eye movement sleep behavior disorder – Wikipedia

  https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep_behavior_disorder

  Rapid eye movement sleep behavior disorder (RBD) occurs when there is a loss of normal voluntary muscle atonia during REM sleep resulting in motor behavior in response to dream content. It can be caused by adverse reactions to certain drugs or during drug withdrawal; however, it is most often associated with the elderly and in those with neurodegenerative disorders such as Parkinson’s disease and other neurodegenerative diseases, for example multiple system atrophy and the Lewy body dementias. […] The underlying cause of RBD is not well understood, but it is likely that RBD is an early symptom of synucleinopathy rather than a separate disorder. Brainstem circuits that control atonia during REM sleep may be damaged, including those in the pontomedullary brainstem. REM sleep circuits are located in caudal brainstem structures—the same structures that are known to lead to be implicated in the synucleinopathies. Motor deficits like those seen in RBD are known to result from lesions in those circuits.

• #2 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  The precise etiology and neural structures involved in rapid eye movement sleep behavior disorder (RBD) are unknown. Based on animal (cats, rats), lesional, and neuropathologic studies, sleep-regulating nuclei, particularly the pontine tegmentum, are thought to be involved in the pathogenesis of RBD. Also, a complex interplay of various neurochemical systems, such as the noradrenergic, cholinergic, and serotonergic systems, seems to exist in the pathogenesis of the condition. […] RBD may be idiopathic. However, several studies have suggested that idiopathic RBD is a potential marker for the later development of neurodegenerative disorders characterized by alpha-synuclein deposition. These include Parkinson disease, multiple system atrophy, dementia with Lewy bodies, and pure autonomic failure, with the risk varying among different studies. (RBD is less frequently associated with nonsynucleinopathies.)

• #2 REM sleep behaviour disorder | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-018-0016-5

  Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia that is characterized by loss of muscle atonia during REM sleep (known as REM sleep without atonia, or RSWA) and abnormal behaviours occurring during REM sleep, often as dream enactments that can cause injury. […] RBD is categorized as either idiopathic RBD or symptomatic (also known as secondary) RBD; the latter is associated with antidepressant use or with neurological diseases, especially -synucleinopathies (such as Parkinson disease, dementia with Lewy bodies and multiple system atrophy) but also narcolepsy type 1. […] RSWA and RBD are now recognized as manifestations of an -synucleinopathy; most older adults with idiopathic RBD will eventually develop an overt neurodegenerative syndrome. […] In the future, studies will likely evaluate neuroprotective therapies in patients with idiopathic RBD to prevent or delay -synucleinopathy-related motor and cognitive decline.

• #2 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  REM (rapid eye movement) sleep behaviour disorder (RBD) is characterised by vivid dreams and dream enactment behaviour such as kicking, shouting, and punching. It can result in injuries to the person with RBD and their bed partner, and is associated with reduced quality of life and severely disrupted sleep. […] It is important to recognise potential RBD because it is also strongly associated with neurodegenerative disease (NDD): RBD affects approximately 50% of people with Parkinsons disease (PD), 80% of people with dementia with Lewy bodies (DLB), and almost 100% of people with multiple system atrophy (MSA). RBD is also an early sign of neurodegenerative disease and can occur in otherwise healthy individuals when it is known as idiopathic or isolated RBD (iRBD). This isolated form is associated with an 80-90% risk of progression to an NDD, such as PD or DLB, within 10 years of first diagnosis.

• #2 REM Sleep Behavior Disorder: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/sleep-disorders/rem-sleep-behavior-disorder

  REM sleep behavior disorder is a condition that causes sleepers to move, shout, and act out their dreams during their REM sleep. […] Certain medications and antidepressants may trigger REM sleep behavior disorder as well as some underlying conditions, such as narcolepsy and other neurodegenerative disorders. […] Doctors do not know the exact cause of REM sleep behavior disorder. So far, it’s believed that anything that affects the regular inhibition of muscle movement during REM sleep can lead to the condition. This includes problems in the nervous system itself as well as substances that might disrupt the pathway. […] Experts categorize REM sleep behavior disorder as: idiopathic: due to an unidentified factor, drug-induced: due to a substance or medication, secondary: due to another neurological condition.

• #2 Rapid Eye Movement Sleep Behavior Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555928/

  Drug-induced RBD is common in individuals who are taking antidepressants. The most likely antidepressants that will incite an RBD episode are serotonin reuptake inhibitors (fluoxetine), tricyclic antidepressants (mirtazapine, protriptyline, amitriptyline, nortriptyline, desipramine, imipramine), and monoamine oxidase inhibitors (phenelzine and selegiline). […] RBD with concomitant narcolepsy may be considered a distinct phenotype of RBD. It is characterized by less violent or complex behavior during REM sleep, earlier age of onset, equal sex distribution, and hypocretin (orexin) deficiency (a lab diagnosis specific for narcolepsy type 1).

• #2 REM Sleep Behavior Disorder: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/sleep-disorders/rem-sleep-behavior-disorder

  Someone can develop REM sleep behavior disorder many years before a diagnosis of a neurodegenerative condition, particularly one associated with Lewy bodies. […] Possible factors that may raise someone’s chances of developing REM sleep behavior disorder include: alcohol withdrawal, antidepressant use, depression, post-traumatic stress disorder (PTSD), being assigned male at birth, smoking, narcolepsy, brain injury. […] Selective serotonin reuptake inhibitors (SSRIs) are the most common medication to cause REM sleep behavior disorder. These antidepressants counteract REM-mediated paralysis, inciting muscle tone instead. […] Other medications that have been shown to cause REM sleep behavior disorder include: tricyclic antidepressants, cholinesterase inhibitors for Alzheimer’s disease, mirtazapine in the treatment of parkinsonism, venlafaxine, monoamine oxidase inhibitors. […] REM sleep behavior disorder is a risk factor for neurodegenerative conditions, such as Parkinson’s disease and Lewy body dementia.

• #2 Rapid eye movement sleep behavior disorder – Wikipedia

  https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep_behavior_disorder

  Risk factors for developing RBD are a family history of acting out dreams, prior head injury, farming, exposure to pesticides, low education level, depression, and use of antidepressants. […] RBD may be acute and sudden in onset if associated with drug treatment or withdrawal (particularly with alcohol withdrawal). Antidepressant medications can induce or aggravate RBD symptoms.

• #2 Rapid Eye Movement (REM) Sleep Behaviour Disorder | North Bristol NHS Trust

  https://www.nbt.nhs.uk/our-services/a-z-services/neuropsychiatry/rapid-eye-movement-rem-sleep-behaviour-disorder

  People begin acting out their dreams by vocalizing or moving their arms and legs during REM sleep. […] It is caused by a failure of the normal mechanism which keeps people still during dreams. […] REM sleep disorders are usually caused by a problem with the part of the brain that sends information down the spine to the muscles. […] There are some risk factors which may make someone more likely to develop a REM parasomnia, and these include: Being male, Being aged over 50, Having other neurological disorders such as Parkinsons Disease, Having other sleep disorders such as narcolepsy, Taking certain medications such as antidepressants, or the use or withdrawal of alcohol and/or other illicit drugs, Having post traumatic stress disorder. […] However, in a lot of cases, people subsequently go on to develop certain types of neurodegenerative disorders such as Parkinsons and Lewy body dementia. […] This may be several decades later. REM sleep disorders can sometimes be the first symptoms that present in these conditions.

• #2 A Case of Intractable REM Sleep Behavior Disorder Improved With Nasal Continuous Positive Airway Pressure Therapy

  https://www.e-jsm.org/journal/view.php?number=382

  This patient presented with medically intractable RBD, in which OSA was not initially detected, and was diagnosed with comorbid OSA by a 10-year follow-up PSG. The RBD symptoms improved with nasal CPAP therapy. […] Although not clearly understood, several previous reports suggest sleep-disordered breathing could aggravate RBD symptoms and that CPAP therapy could improve the symptoms. […] One reason is that severe OSA can mimic RBD symptoms, which is called pseudo-RBD. […] In cases of true RBD comorbid with OSA, DEB symptoms could be improved with CPAP therapy by reducing pseudo-RBD behaviors related to respiratory events. […] In addition, severe OSA causes sleep fragmentation and frequent arousal. […] Since OSA causes recurrent cortical microarousal, it may contribute to brainstem activation with increased muscle activity, exacerbating RBD symptoms.

• #2 REM sleep behavior disorder | MedLink Neurology

  https://www.medlink.com/articles/rapid-eye-movement-sleep-behavior-disorder

  Nearly all patients aged 50 years and older with isolated RBD eventually develop an alpha-synucleinopathy (Parkinson disease, dementia with Lewy bodies, and multiple system atrophy). […] Symptoms of RBD in non-synucleinopathy neurodegenerative disorders suggest concurrent synucleinopathy. […] Structural lesions to the brainstem, specifically the dorsal pons and medulla, can cause RBD that is not associated with a progressive neurodegenerative disease. […] RBD frequently occurs in patients with narcolepsy type 1 and can be seen a variety of autoimmune encephalopathies. […] A variety of medications are known to provoke RBD, most commonly selective serotonin reuptake inhibitors, and are thought to unmask a latent predisposition to develop RBD (and perhaps also synucleinopathy) rather than causing RBD per se.

• #2 REM sleep behaviour disorder More than just a parasomnia

  https://www.racgp.org.au/afp/2013/november/rem-sleep-behaviour-disorder

  Several studies attempting to better predict the transition of iRBD to a neurodegenerative synucleinopathy have identified features such as constipation, postural hypotension, cardiac sympathetic denervation, deficiencies in olfaction, colour discrimination and cognition impairments as other potential red flags but, as yet, no reliable biomarkers have offered sufficient predictive value in clinical practice. […] Given the growing burden of neurodegenerative diseases in our ageing population, early identification of RBD in general practice may offer a potential window for the use of future disease-modifying agents.

• #2 Rapid Eye Movement Sleep Behavior Disorder | Psychology Today

  https://www.psychologytoday.com/us/conditions/rapid-eye-movement-sleep-behavior-disorder

  In many cases of REM sleep behavior disorder, the cause is unknown. In some cases, an individuals reaction to prescription medication, including some anti-depressants and beta-blockers, can trigger the disorder. It is not known, however, whether these medications directly cause symptoms or activate an underlying predisposition to develop the disorder. […] In other cases, the disorder may be associated with damage to parts of the central nervous system as can occur with multiple sclerosis; or with the accumulation of abnormal molecules in the nervous system as can occur in Parkinson’s disease, multiple system atrophy, major or mild neurocognitive disorder with Lewy bodies, or Alzheimer’s disease. […] Research has uncovered a significant association between the onset of REM sleep behavior disorder and the emergence a decade or more later of underlying neurodegenerative disorders such as Parkinson’s disease, multiple system atrophy, or major or mild neurocognitive disorder with Lewy bodies. A patient’s doctor is likely to encourage them to be regularly checked for these serious neurological disorders.

• #2 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  When we sleep, we pass through four distinct stages. During the stage of sleep most associated with dreaming, REM sleep, the eyes move around quickly but all other skeletal muscle tone is lost (atonia) and thus limbs become floppy; this effectively causes paralysis of our bodies during dreaming. However, in RBD the brainstem system that produces atonia is faulty, possibly damaged by early pathology, and people can therefore physically act out their dreams. […] While there remains uncertainty around iRBD and its association with different types of NDD, it is clear that iRBD is a prodrome of neurodegeneration. This means there is an opportunity for dementia risk reduction through managing potentially modifiable dementia risk factors. GPs therefore play a vital role in recognising potential iRBD and applying preventive medicine approaches with the aim of trying to alter iRBD trajectories.

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