Parasomnias

2018 ◽  
Author(s):  
KyoungBin Im
Keyword(s):  
Mental Disorders ◽  
Rem Sleep ◽  
Slow Wave Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
Normal Subjects ◽  
Related Phenomenon ◽  
Sleep Behavior ◽  
Diagnostic And Statistical Manual

Parasomnias have long been recognized as part of sleep-related disorders or diseases in the mental disorders classification system such as Diagnostic and Statistical Manual of Mental Disorders. Nevertheless, many parasomnia symptoms are considered as a transient deviation from the norm in otherwise normal subjects due to disrupted status of consciousness. Sleep states are classified as rapid eye movement (REM) sleep and non-REM (NREM) sleep; similarly, parasomnias are classified as NREM-related parasomnias and REM-related parasomnias. NREM-related parasomnias share common pathophysiology of arousal-related phenomenon out of slow-wave sleep. Although listed as REM parasomnia disorders, nightmares and sleep paralysis are still considered comorbid symptoms or signs of other sleep disorders or mental disorders. Only REM sleep behavior disorder (RBD) is considered a relatively homogenous disease entity among all parasomnia diagnoses. Although RBD is the most newly added disorder entity in parasomnias, it is the most rigorously studied parasomnia such as RBD is strongly and clearly associated with concomitant or future developing neurodegenerative disease. This review contains 1 figure, 4 tables, and 18 references. Key Words: confusional arousals, dream enactment, pseudo-RBD, REM sleep behavior disorder, sleep-related eating, sleep terror, sleepwalking

scholarly journals Nonrapid eye movement sleep electroencephalographic oscillations in idiopathic rapid eye movement sleep behavior disorder: a study of sleep spindles and slow oscillations

SLEEP ◽  
2020 ◽  
Author(s):  
Jun-Sang Sunwoo ◽  
Kwang Su Cha ◽  
Jung-Ick Byun ◽  
Jin-Sun Jun ◽  
Tae-Joon Kim ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
Sleep Spindles ◽  
Rapid Eye Movement ◽  
Sleep Behavior ◽  
Slow Oscillations ◽  
Lower Amplitude

Abstract Study Objectives We investigated electroencephalographic (EEG) slow oscillations (SOs), sleep spindles (SSs), and their temporal coordination during nonrapid eye movement (NREM) sleep in patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD). Methods We analyzed 16 patients with video-polysomnography-confirmed iRBD (age, 65.4 ± 6.6 years; male, 87.5%) and 10 controls (age, 62.3 ± 7.5 years; male, 70%). SSs and SOs were automatically detected during stage N2 and N3. We analyzed their characteristics, including density, frequency, duration, and amplitude. We additionally identified SO-locked spindles and examined their phase distribution and phase locking with the corresponding SO. For inter-group comparisons, we used the independent samples t-test or Wilcoxon rank-sum test, as appropriate. Results The SOs of iRBD patients had significantly lower amplitude, longer duration (p = 0.005 for both), and shallower slope (p < 0.001) than those of controls. The SS power of iRBD patients was significantly lower than that of controls (p = 0.002), although spindle density did not differ significantly. Furthermore, SO-locked spindles of iRBD patients prematurely occurred during the down-to-up-state transition of SOs, whereas those of controls occurred at the up-state peak of SOs (p = 0.009). The phase of SO-locked spindles showed a positive correlation with delayed recall subscores (p = 0.005) but not with tonic or phasic electromyography activity during REM sleep. Conclusions In this study, we found abnormal EEG oscillations during NREM sleep in patients with iRBD. The impaired temporal coupling between SOs and SSs may reflect early neurodegenerative changes in iRBD.

scholarly journals 0789 Decreased Sigma Band Power During NREM Sleep in REM Sleep Behavior Disorder

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A300-A300
Author(s):  
Y Lee ◽  
B Lee
Keyword(s):  
Rem Sleep ◽  
Spectral Power ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
Control Group ◽  
Sleep Behavior ◽  
Band Power ◽  
Potential Biomarker ◽  
Obstructive Sleep

Abstract Introduction REM sleep Behavior Disorder (RBD) is characterized by dream enacting behaviors and a loss of atonia during REM sleep. Early detection of RBD is important because it is considered premonitory symptoms neurodegenerative disorders. In this study, we investigated the slow and fast sigma band power of patients with RBD using frequency analysis. Methods Twenty patients who were diagnosed as RBD according to the ICSD-3 criteria and 20 age-matched controls who underwent polysomnography (PSG) for other sleep disorders (insomnia, snoring) and showed normal to mild obstructive sleep apnea (OSA). NREM sleep EEG data was extracted and N1 sleep data was excluded to minimize arousal artifact. Fast Fourier transform-based spectral power analysis was used to compute the power spectral densities of the EEG in the MATLAB environment. The sigma bands were divided into 2 discrete bands: slow sigma (11 to 13 Hz) and- fast sigma (13 to 15 Hz). Mann-Whitney U test by SPSS was used. Results RBD patients (61.9 ± 7.1 years old; 12 men) had a significantly lower sigma band power than the control group (61.5 ± 1.1 years old; 11 men) in central region (p = 0.028). Particularly, the slow sigma band power showed a bigger difference in all regions except O1 (F3 = 0.017, F4 = 0.027, C3 = 0.004, C4 = 0.009, O2 = 0.017). Conclusion Sigma power was lower in the RBD patients than in the control. It suggests that RBD has impaired cortical activity. Thus, decreased spindle activity during NREM sleep may be a potential biomarker of RBD. Support  

scholarly journals A high-density electroencephalography study reveals abnormal sleep homeostasis in patients with rapid eye movement sleep behavior disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amandine Valomon ◽  
Brady A. Riedner ◽  
Stephanie G. Jones ◽  
Keith P. Nakamura ◽  
Giulio Tononi ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
High Density ◽  
Rapid Eye Movement ◽  
Sleep Behavior ◽  
Eeg Abnormalities ◽  
Beta Power

AbstractRapid eye movement (REM) sleep behavior disorder (RBD) is characterized by disrupting motor enactments during REM sleep, but also cognitive impairments across several domains. In addition to REM sleep abnormalities, we hypothesized that RBD patients may also display EEG abnormalities during NREM sleep. We collected all-night recordings with 256-channel high-density EEG in nine RBD patients, predominantly early-onset medicated individuals, nine sex- and age- matched healthy controls, and nine additional controls with matched medications and comorbidities. Power spectra in delta to gamma frequency bands were compared during both REM and NREM sleep, between phasic and tonic REM sleep, and between the first versus last cycle of NREM sleep. Controls, but not RBD patients, displayed a decrease in beta power during phasic compared to tonic REM sleep. Compared to controls, RBD patients displayed a reduced decline in SWA from early to late NREM sleep. Overnight changes in the distribution of the amplitude of slow waves were also reduced in RBD patients. Without suppression of beta rhythms during phasic REM sleep, RBD patients might demonstrate heightened cortical arousal, favoring the emergence of behavioral episodes. A blunted difference between REM sleep sub-stages may constitute a sensitive biomarker for RBD. Moreover, reduced overnight decline in SWA suggests a reduced capacity for synaptic plasticity in RBD patients, which may favor progression towards neurodegenerative diseases.

Parasomnias

2020 ◽  
pp. 158-171
Author(s):  
Jessica Jung ◽  
Erik K. St. Louis
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
Sleep Behavior ◽  
Medical Disorders ◽  
Abnormal Movements ◽  
Psychological Comorbidities

Parasomnias are undesirable and abnormal movements, behaviors, emotions, perceptions, and dreams that occur during or immediately surrounding sleep. The parasomnias are categorized as nonrapid eye movement (NREM) sleep parasomnias, rapid eye movement (REM) sleep parasomnias, and other parasomnias. This chapter provides an overview to the epidemiology, clinical characteristics, differential diagnoses, diagnostic approach, and treatment of common parasomnias encountered in clinical practice. These common parasomnias include NREM parasomnias, considered to be disorders of arousal from NREM sleep and which include a heterogeneous spectrum of sleep behaviors encountered following arousal from NREM sleep exemplified by the phenotypes of sleep terrors, sleep walking, confusional arousals, sleep-related eating disorder, and sexsomnias; the REM parasomnias, including nightmare disorder, recurrent isolated sleep paralysis, and REM sleep behavior disorder, which is strongly associated with prodromal or overt alpha-synucleinopathy neurodegenerative disorders such as Parkinson disease and dementia with Lewy bodies; and other parasomnias, including a spectrum of “leftovers” that do not map well to NREM or REM sleep specifically such as exploding head syndrome, sleep-related hallucinations, sleep enuresis, and parasomnias ascribed to medical disorders, medication or substance use, or unspecified etiologies. It is important for a psychiatrist to be conversant with the complete range of parasomnias given the importance of effective management of frequent psychiatric and psychological comorbidities, which serve as drivers of the frequency and severity of nocturnal events, and to ensure timely referral for polysomnography or other necessary sleep diagnostics where appropriate.

scholarly journals Rapid Eye Movement (REM) Sleep Behavior Disorder and REM Sleep with Atonia in the Young

2019 ◽  
Vol 47 (1) ◽  
pp. 100-108 ◽  
Author(s):  
Garima Shukla ◽  
Anupama Gupta ◽  
Kamalesh Chakravarty ◽  
Angela Ann Joseph ◽  
Aathira Ravindranath ◽  
...  
Keyword(s):  
Eye Movement ◽  
Rem Sleep ◽  
Muscle Activity ◽  
Young Patients ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Normal Subjects ◽  
Rapid Eye Movement ◽  
Sleep Behavior ◽  
Patients With Epilepsy

ABSTRACT:Background:Rapid eye movement (REM) sleep behavior disorder (RBD) and REM sleep without atonia (RWA) have assumed much clinical importance with long-term data showing progression into neurodegenerative conditions among older adults. However, much less is known about RBD and RWA in younger populations. This study aims at comparing clinical and polysomnographic (PSG) characteristics of young patients presenting with RBD, young patients with other neurological conditions, and normal age-matched subjects.Methods:A retrospective chart review was carried out for consecutive young patients (<25 years) presenting with clinical features of RBD; and data were compared to data from patients with epilepsy, attention deficit hyperactivity disorder (ADHD), and autism, as well as normal subjects who underwent PSG during a 2-year-period.Results:Twelve patients fulfilling RBD diagnostic criteria, 22 autism patients, 10 with ADHD, 30 with epilepsy, and 14 normal subjects were included. Eight patients with autism (30%), three with ADHD (30%), one with epilepsy (3.3%), and six patients who had presented with RBD like symptoms (50%) had abnormal movements and behaviors during REM sleep. Excessive transient muscle activity and/or sustained muscle activity during REM epochs was found in all patients who had presented with RBD, in 16/22 (72%) autistic patients, 6/10 (60%) ADHD patients compared to only 6/30 (20%) patients with epilepsy and in none of the normal subjects.Conclusion:We observed that a large percentage of young patients with autism and ADHD and some with epilepsy demonstrate loss of REM-associated atonia and some RBD-like behaviors on polysomnography similar to young patients presenting with RBD.

scholarly journals Qualitative Scoring of the Pentagon Test: A Tool for the Identification of Subtle Cognitive Deficits in Isolated REM Sleep Behavior Disorder Patients

2019 ◽  
Vol 34 (7) ◽  
pp. 1113-1120
Author(s):  
Andrea Galbiati ◽  
Giulia Carli ◽  
Alessandra Dodich ◽  
Sara Marelli ◽  
Pagnini Caterina ◽  
...  
Keyword(s):  
Executive Functions ◽  
Rem Sleep ◽  
Slow Wave Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Verbal Comprehension ◽  
Impaired Performance ◽  
Visuospatial Abilities ◽  
Positive Correlations

Abstract Objective Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) frequently represents the prodromal stage of alpha-synucleinopathies, and similar to these pathologies, iRBD patients show neuropsychological deficits, particularly in the domain of visuospatial abilities and executive functions. We hypothesized that the qualitative scoring of the Mini-Mental State Examination pentagon test (QSPT) may detect subtle visuospatial deficits in these subjects, and we evaluated its relationship with indexes of sleep quality, as measured by polysomnography. Methods A total of 80 polysomnography-confirmed iRBD patients and 40 healthy controls (HCs) were retrospectively recruited. Global and specific qualitative performances were evaluated according to QSPT procedure. Comparisons between iRBD and HC regarding all QSPT parameters, neuropsychological tests, and polysomnographic recordings were performed. Results Patients displayed significantly lower scores in both “closing-in” and total score parameters in comparison to HC. The QSPT total score exhibited significant positive correlations with verbal comprehension, fluency, visuospatial abilities, and executive functions. Notably, iRBD patients with impaired performance at QSPT showed decreased neuropsychological performances and higher percentages of slow wave sleep (SWS). In addition, SWS percentages negatively correlated with verbal comprehension, fluency, visuospatial abilities, executive functions, and QSPT total score. Conclusion QSPT may represent a brief and easy to administer tool for the detection of subtle visuospatial changes in iRBD patients. Furthermore, polysomnographic findings suggest a possible slowdown of electroencephalographic pattern during non-REM sleep in iRBD patients in line with the presence of cognitive decline.

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