"The groundwork of all happiness is health." - Leigh Hunt

Little-understood sleep problem affects thousands and thousands and has clear links to dementia – 4 questions answered

1. What is REM sleep behavior disorder?

Each night, you undergo 4 to 5 sleep cycles. Each cycle, lasting about 90 to 110 minutes, has 4 phases. That fourth stage is REM sleep.

REM sleep consists only of 20% to 25% of total sleep, but its ratio increases overnight. During REM sleep, your brain rhythms are the identical as once you're awake, your muscles lose tone so that you're unable to maneuver, and your eyes, when closed, move rapidly. This phase is commonly accompanied by muscle twitches and fluctuations in your respiration rate and blood pressure.

But someone with REM sleep behavior disorder will act out their dreams. For reasons that are usually not well understood, the dream content is often violent – ​​patients report that they’re being chased, or that they defend themselves, and while they sleep. They scream, moan, scream, kick, punch and beat.

These incidents often end in injuries. Patients may fall away from bed or by accident hurt a partner. Some 60% of patients and 20% of bed partners suffer from this disorder. Sustaining an injury during sleep.

Due diligence, incl A sleep studyis very important to find out whether a patient has REM sleep behavior disorder, as opposed to a different disorder, e.g. Obstructive sleep apnea. It is a disorder during which respiration is interrupted during sleep.

REM sleep behavior disorder can occur at any age, but symptoms often begin in people of their 40s and 50s. For those under 40, antidepressants are probably the most common reason behind REM sleep behavior disorder. In these younger patients, it affects biological men and women almost equally, but after age 50, it’s more common in biological males.

If you think you might have REM sleep behavior disorder, see a sleep specialist or neurologist.

2. What causes REM sleep behavior disorder?

The mechanism of the disease will not be well understood. In some cases of REM sleep behavior disorder, a transparent cause can’t be identified. In other cases, the error could also be brought on by something specific, e.g Obstructive sleep apnea, NarcolepsyPsychiatric disorders, use of antidepressants, autoimmune disorders and brain injuries, that are parts of the brain tissue which can be damaged.

In each cases, REM sleep behavior disorder May be associated with synucleinopathies, a bunch of neurodegenerative disorders during which aggregates of the protein α-synuclein accumulate in brain cells. The commonest of those neurodegenerative disorders is Parkinson's disease. There are others. Dementia with Lewy bodies, Multiple system atrophy And The Failure of Pure Autonomy. REM sleep behavior disorder may precede these diseases or occur at any time through the disease process.

People with REM sleep behavior disorder may injure themselves and their bed partners.

REM sleep generally is a behavioral disorder. First signs of Parkinson's disease or dementia with Lewy bodies. It occurs in 25% to 58% of patients diagnosed with Parkinson's, 70% to 80% of patients with dementia with Lewy bodies, and 90% to 100% of patients. Multiple system atrophy.

In a long-term study of 1,280 patients with REM sleep behavior disorder that didn’t Parkinsonism — an umbrella term that refers to brain conditions, including Parkinson's disease, that cause slow movements, stiffness and tremors — or dementia, researchers followed participants to see how many individuals had these disorders. will likely be born. After 12 years, 73.5% of individuals with REM sleep behavior disorder a Related neurodegenerative disorders.

Some of the aspects that independently increased the danger of neurodegenerative disorders were the presence of irregular motor symptoms, abnormal dopamine levels, decreased sense of smell, cognitive impairment, abnormal color vision, erectile dysfunction, constipation and old age.

REM sleep behavior disorder can be seen in other neurodegenerative disorders akin to Alzheimer's disease and Huntington's disease, but at much lower rates. The association can be not as strong as that seen in synucleinopathies.

4. Does early diagnosis help?

For most neurodegenerative disorders, there’s a phase that may last many years during which brain changes occur however the patient either stays asymptomatic or develops symptoms without the total manifestation of the disease. RBD, on this scenario, is an early symptom of those disorders. This provides a chance to review how disease develops within the brain and to develop treatments that may either slow the method or prevent it from occurring.

Currently, there aren’t any approved treatments to stop the onset of those neurodegenerative diseases in individuals with REM sleep behavior disorder. However, there are medications akin to melatonin and clonazepam that may improve symptoms. We also recommend measures to stop injury, akin to removing breakables from the room, protecting windows and floors.

Patients affected by REM sleep behavior disorder may decide to take part in research. Proper treatment of the disease may also help prevent injury and improve quality of life.