Rapid Eye Movement (REM) Sleep Behavior Disorder Quiz

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Benjamin Kummer, MD

Benjamin Kummer, MD (Neurology)

Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.

Shohei Harase, MD

Shohei Harase, MD (Neurology)

Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.

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What is 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.

Typical Symptoms of Rapid Eye Movement (REM) Sleep Behavior Disorder

  • Abnormal sleep behaviors happen just before waking up in the morning

  • Abnormal sleep behaviors that happen together with nightmares

  • Usually able to recall the events in my dreams

  • Uncontrollable movements that usually happen at night

  • Light sleeper or easily awoken

  • Have performed violent actions while asleep

  • Sleep-talking loudly

  • Eyes shut during a seizure

Doctor's Diagnostic Questionson Rapid Eye Movement (REM) Sleep Behavior Disorder

Your doctor may ask these questions to check for this disease:

  • Do your sleep abnormalities occur just before waking up?

  • Do your abnormal sleep behaviors occur with nightmares?

  • Are you usually able to recall your dreams?

  • Do your uncontrollable movements happen at night?

  • Do you wake up easily?

Treatmentof Rapid Eye Movement (REM) Sleep Behavior Disorder

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.

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References

  • Postuma RB, Iranzo A, Hu M, Högl B, Boeve BF, Manni R, Oertel WH, Arnulf I, Ferini-Strambi L, Puligheddu M, Antelmi E, Cochen De Cock V, Arnaldi D, Mollenhauer B, Videnovic A, Sonka K, Jung KY, Kunz D, Dauvilliers Y, Provini F, Lewis SJ, Buskova J, Pavlova M, Heidbreder A, Montplaisir JY, Santamaria J, Barber TR, Stefani A, St Louis EK, Terzaghi M, Janzen A, Leu-Semenescu S, Plazzi G, Nobili F, Sixel-Doering F, Dusek P, Bes F, Cortelli P, Ehgoetz Martens K, Gagnon JF, Gaig C, Zucconi M, Trenkwalder C, Gan-Or Z, Lo C, Rolinski M, Mahlknecht P, Holzknecht E, Boeve AR, Teigen LN, Toscano G, Mayer G, Morbelli S, Dawson B, Pelletier A. Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain. 2019 Mar 1;142(3):744-759. doi: 10.1093/brain/awz030. PMID: 30789229; PMCID: PMC6391615.

    https://academic.oup.com/brain/article/142/3/744/5353011?login=false

  • Fernández-Arcos A, Iranzo A, Serradell M, Gaig C, Santamaria J. The Clinical Phenotype of Idiopathic Rapid Eye Movement Sleep Behavior Disorder at Presentation: A Study in 203 Consecutive Patients. Sleep. 2016 Jan 1;39(1):121-32. doi: 10.5665/sleep.5332. PMID: 26940460; PMCID: PMC4678361.

    https://academic.oup.com/sleep/article/39/1/121/2726045?login=false

  • Fasiello E, Scarpelli S, Gorgoni M, Alfonsi V, Galbiati A, De Gennaro L. A systematic review of dreams and nightmares recall in patients with rapid eye movement sleep behaviour disorder. J Sleep Res. 2023 Jun;32(3):e13768. doi: 10.1111/jsr.13768. Epub 2022 Oct 31. PMID: 36316953.

    https://onlinelibrary.wiley.com/doi/10.1111/jsr.13768

  • Miglis MG, Adler CH, Antelmi E, Arnaldi D, Baldelli L, Boeve BF, Cesari M, Dall'Antonia I, Diederich NJ, Doppler K, Dušek P, Ferri R, Gagnon JF, Gan-Or Z, Hermann W, Högl B, Hu MT, Iranzo A, Janzen A, Kuzkina A, Lee JY, Leenders KL, Lewis SJG, Liguori C, Liu J, Lo C, Ehgoetz Martens KA, Nepozitek J, Plazzi G, Provini F, Puligheddu M, Rolinski M, Rusz J, Stefani A, Summers RLS, Yoo D, Zitser J, Oertel WH. Biomarkers of conversion to α-synucleinopathy in isolated rapid-eye-movement sleep behaviour disorder. Lancet Neurol. 2021 Aug;20(8):671-684. doi: 10.1016/S1474-4422(21)00176-9. PMID: 34302789; PMCID: PMC8600613.

    https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(21)00176-9/fulltext

  • Schenck CH, Mahowald MW. Rapid eye movement sleep parasomnias. Neurol Clin. 2005 Nov;23(4):1107-26. doi: 10.1016/j.ncl.2005.06.002. PMID: 16243618.

    https://www.sciencedirect.com/science/article/abs/pii/S0733861905000435?via%3Dihub

User Testimonials

Reviewed By:

Benjamin Kummer, MD

Benjamin Kummer, MD (Neurology)

Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.

Shohei Harase, MD

Shohei Harase, MD (Neurology)

Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.

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