[Clinical and polysomnographic features of rapid eye movement sleep behavior disorder]

Abstract

Objective: To evaluate the clinical and polysomnographic features of rapid eye movement sleep behavior disorder (RBD) in Chinese patients.

Methods: Six parasomnic patients, 4 males and 2 females, with the mean onset age of 58 years (range 50 approximately 66 years) and 6 age and sex matched controls, were video-monitored for successive two nights, to record the electroencephalography, electrooculography, electromyography, electrocardiography and nasal airflow.

Results: Polysomnographic recordings disclosed an augmented muscle tone, which appeared intermittently or continuously in REM sleep, accompanied by complex behaviors correlated to dream contents observed by video-monitoring, and without seizure activity. All the 6 patients presented with a long history of parasomnia. The average total-sleep time of the patients was 353 +/- 42 minutes, the stage II sleep time was 139 +/- 76 minutes, and sleep efficiency was 74.3% +/- 12.3% lower compared with that of the controls. Pakinsonism occurred in 1 patient 9 years after parasomnia and dementia in 2 patients 8 and 18 years respectively after symptom of RBD. Clonazepam was administered for parasomnia in 3 cases with a favorable response.

Conclusion: REM sleep without atonia is demonstrated in association with violent movements by video-monitored polysomnography in 6 Chinese patients.