RBD, Rapid Eye Movement Sleep Behavior Disoder
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Clinic
- RBD is a parasomnia, A sleep disorder in which people act out their dreams. It involves abnormal behavior during REM sleep.
- The major feature of RBD is loss of muscle atonia during otherwise intact REM sleep.
- Loss of motor inhibition leads to sleep behaviors ranging from simple limb twitches to more complex integrated movements
- RBD is a very strong predictor of progression to Parkinson's disease or dementia with Lewy bodies
Main symptoms
- RBD is characterized by the dreamer acting out their dreams, with complex behaviors.
- Dreams often involve Violent / Aggressive actions, Screaming, Shouting, Laughing, Crying, Arm flailing, Kicking, Punching, Choking, and Jumping
- The sleeping person may be unaware of these movements.
Other symptoms
- Reduced motor abilities
- Posture and gait changes
- Mild cognitive impairment
- Alterations in the sense of smell
- Impairments in color vision
- Autonomic dysfunction (Orthostatic hypotension, Constipation, Urinary problems and Sexual dysfunction)
- Depression
Related disease
Causes
- Loss of normal voluntary muscle atonia during REM sleep results in motor behavior in response to dream content
- Brainstem circuits (Pontomedullary brainstem) that control atonia during REM sleep may be damaged.
- REM sleep circuits are located in caudal brainstem structures are the same structures that are implicated in the synucleinopathies.
- Motor deficits like those seen in RBD are known to result from lesions in those circuits.
Differential Diagnosis
- Non-REM parasomnias (Sleepwalking, sleep terrors)
- Periodic limb movement disorder
- Severe obstructive sleep apnea
- Dissociative disorders