A little-understood sleep disorder affects millions and has clear links to dementia – 4 questions answered

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The disorder, known as REM sleep behavior disorder, or RBD in the medical field, affects around 1% of the general population worldwide and about 2% of adults over 65.

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The ConversationThe Conversation
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https://theconversation.com/a-little-understood-sleep-disorder-affects-millions-and-has-clear-links-to-dementia-4-questions-answered-201527https://theconversation.com/a-little-understood-sleep-disorder-affects-millions-and-has-clear-links-to-dementia-4-questions-answered-201527
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Saturday, May 27, 2023
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Blood pressure, Smell, Pure autonomic failure, Association, Conversation, Melatonin, Tremor, RBD, Rapid eye movement sleep behavior disorder, Respiratory rate, Sleep, Deficit spending, Narcolepsy, Constipation, Quality of life, Multiple system atrophy, Brain, Research, Disorder, DSM-IV codes, Injury, Dementia, Clonazepam, Parkinsonism, Dream, Patient, Sleep disorder, Risk, Lewy body, Diagnosis, Erectile dysfunction, Obstructive sleep apnea, Color, Synucleinopathy, Disease, REM, Pharmaceutical industry
Summary
Key Points: 
  • The disorder, known as REM sleep behavior disorder, or RBD in the medical field, affects around 1% of the general population worldwide and about 2% of adults over 65.
  • The Conversation talked with Anelyssa D'Abreu, a neurologist who specializes in geriatric neurology, to explain what researchers know about the condition’s links to dementia.

1. What is REM sleep behavior disorder?

    • REM sleep only comprises 20% to 25% of total sleep, but its proportion increases throughout the night.
    • But someone with REM sleep behavior disorder will act out their dreams.
    • Appropriate testing, including a sleep study, are needed to determine if a patient has REM sleep behavior disorder, as opposed to another disorder, such as obstructive sleep apnea.
    • REM sleep behavior disorder can occur at any age, but symptoms usually start with people in their 40s and 50s.

2. What causes REM sleep behavior disorder?

    • In some cases of REM sleep behavior disorder, a clear cause cannot be identified.
    • In both situations, REM sleep behavior disorder may be associated with synucleinopathies, a group of neurodegenerative disorders in which aggregates of the protein α-synuclein accumulate in brain cells.
    • REM sleep behavior disorder may precede these diseases or occur at any time during the disease process.

3. What are the links between the sleep disorder and dementia?

    • REM sleep behavior disorder may be the first symptom of Parkinson’s disease or dementia with Lewy bodies.
    • After 12 years, 73.5% of those with REM sleep behavior disorder had developed a related neurodegenerative disorder.
    • REM sleep behavior disorder may also be observed in other neurodegenerative disorders such as Alzheimer’s disease and Huntington’s disease, but at much lower rates.

4. Does an early diagnosis help?

    • RBD, in that scenario, is an early sign of those disorders.
    • At this time, there are no approved therapies to prevent the onset of these neurodegenerative diseases in those with REM sleep behavior disorder.
    • We also recommend measures to avoid injury, such as removing breakable objects from the room, protecting windows and padding floors.
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