REM sleep behaviour disorder in Parkinson's disease (Review)

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by simple or complex abnormal movements occurring in REM state, instead of the physiological muscular atonia. RBD may be idiopathic, or secondary as in the case of Parkinson's disease (PD). Several studies have confirmed that idiopathic RBD may precede with several years the onset of the specific motor characteristics of PD. The high prevalence of RBD in PD (19-70%) may be explained by several common pathophysiological pathways, mainly related to the dopaminergic cell loss. RBD is also associated with several comorbidities, including cognitive impairment, hallucinations, dysautonomia, or daytime sleepiness. The gold standard investigation for the diagnosis and assessment of RBD is video polysomnography, but in clinical practice, the use of clinical scales and questionnaires is reasonable for the screening of this complex parasomnia. Management options include ensuring a safe environment for the patient and pharmacological treatment, incuding clonazepam, melatonin or certain antiparkinsonian drugs.

Automated summary

Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder characterized by abnormal movements during REM state, which can be idiopathic or secondary. RBD is associated with Parkinson's disease and may precede the specific motor symptoms of PD by several years. In addition to video polysomnography, clinical scales and questionnaires can also be used for screening RBD in clinical practice. Management options include ensuring patient safety and pharmacological treatment with medications such as clonazepam, melatonin, or certain antiparkinsonian drugs.