• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.3-12
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• 1995

In the International Classification of Sleep Disorders(ICSD), REM sleep behavior disorder(RBD) and nightmares are classified as 'parasomnias usually associated with REM sleep'. RBD can be defined as the intermittent absence of REM sleep EMG atonia and the appearance of the elaborate motor activity associated with dream mentation. Bilateral pontine tegmental lesions in cats induce RBD-like behavior, but in human cases, more than 60% are idiopathic. Polysomnograpy shows characteristic findings in REM sleep and treatment with clonazepam is highly effective. With nightmares as long, frightening dream decreasing with age, their persistence or apperance in adults is related with certain drugs, trauma, personality and psychotic episode. Psychotherapy, behavior techniques or medication is used for treatment, but all of nightmares do not require treatment.

• Sleep Medicine and Psychophysiology
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• v.29 no.2
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• pp.35-39
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• 2022

REM sleep behavior disorder is parasomnia characterized by unpleasant dreams and dream-enactment behaviors associated with excessive electromyography activity in REM sleep. This may appear idiopathic or secondary to other neurological or medical conditions. REM sleep behavior disorder, which appears to be idiopathic, most often implies the possibility of later neurodegenerative diseases due to synucleinopathy, so accurate diagnosis is important in predicting prognosis. For the diagnosis of REM sleep behavioral disorder, REM sleep without atonia, which appears in the polysomnography, is essential. Obstructive sleep apnea, trauma-related sleep disorders, and vigorous periodic leg movements during sleep are known as diseases that show dream enactment behavior in elderly patients. Considering that it may be accompanied by other sleep disorders that can mimic REM sleep behavioral disorders, it is important to differentiate sleep

• Sleep Medicine and Psychophysiology
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• v.1 no.1
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• pp.99-106
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• 1994

The authors report a case of REM sleep behavior disorder which occurred in a 69-year-old business man. He began experiencing episodic "acting out" behavior of his dream at the age of 66. The episodes tended to be associated with dream contents, mainly being chased or threatened. Before that, his sleep was relatively quiet despite occasional nightmares, midsleep arousal, and shallowness. Injuries resulted from leaping out of bed, jumping onto furnitures, and grabbing and biting the spouse's arm. Most recent dream-incurred laceration of chin required 5 sutures. Medical and psychiatric history revealed no significant findings except that he had been overanxious all his life within himself with others' reputation of himself as pleasant and easy-going. A nocturnal polysomnogram showed repeatedly intermittent increase of chin and/or leg muscle tones during otherwise characteristic REM sleep period. The overnight video recording revealed head lifting and limb movements during REM sleep periods. Brain MRI and EEG were normal. Job-related stress was presumed to be an etiological possibility. Clonazepam 0.25-0.5mg nightly almost completely relieved the symptoms.

• Sleep Medicine and Psychophysiology
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• v.18 no.1
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• pp.23-28
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• 2011

Objectives: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. Methods: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. Results: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. Conclusions: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.18-21
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• 2001

The change of sleep pattern is one of the most often altered normal physiological functions in elderly people. Besides normal change of sleep, insomnia and sleep apnea syndrome (SAS) are (one of) the main complaints. In addition, parasomnia is also frequent in this age group. Several parasomnias frequently found in the elderly are reviewed. Periodic limb movements in sleep (PLMS), restless legs syndrome (RLS), and REM sleep behavior disorder are the most frequent parasomnias in old age. Most parasomnias could be diagnosed by polysomnography, and be treated easily. Therefore, early and precise diagnosis and management for parasomnia in aging people are needed.

• Sleep Medicine and Psychophysiology
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• v.15 no.1
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• pp.33-38
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• 2008

Introduction: It has been proposed that narcolepsy and REM sleep behavior disorder (RBD) have overlapped symptom profile and pathophysiology. This study was aimed at measuring and comparing changes in EEG frequency band of REM sleep in narcolepsy and RBD, applying EEG spectral analysis method. Methods: Nine patients diagnosed as narcolepsy and the same number of RBD patients were studied. Spectral analysis of the REM sleep EEG was performed in each patient on 9 epochs selected evenly from the first, second, and third REM periods. Then, we compared frequency band percentages of REM sleep EEG in narcolepsy and RBD. Results: Narcolepsy patients had significantly higher delta frequency ratio than RBD ones (p=0.00). In alpha and beta2 frequency bands, RBD patients showed higher percentage than narcolepsy ones. Slow wave sleep was more prevalent in narcolepsy patients. But, no difference of REM sleep percentage was found between the two groups (p=0.93). Conclusion: Higher delta frequency ratio in REM sleep of narcolepsy patients than RBD ones reflects that sleep-promoting mechanism is more dominant in narcolepsy than in RBD.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.7-11
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• 2012

Polysomnography is used to diagnose many types of sleep disorders including sleep apnea, periodic limb movement disorder, REM sleep behavior disorder, parasomnias, and narcolepsy. It is a comprehensive recording of the biophysiological changes that occur during sleep. The polysomnography monitors many body functions parameters including EEG, EOG, EMG, ECG, respiratory airflow, respiratory effort, and pulse oximetry during sleep. Multiple Sleep Latency Test (MSLT) is performed for diagnosing narcolepsy and excessive daytime sleepiness. It is usually to be done after an overnight polysomnography. The test consists of four or five 20-minute nap opportunities that are scheduled two hours apart.

• Journal of Oriental Neuropsychiatry
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• v.24 no.4
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• pp.343-352
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• 2013

Objectives: This study was performed to review the research trends in treatment for REM sleep behavior disorder (RBD) in Traditional Chinese Medicine (TCM) and Kampo in Japan. Methods: We searched articles in CNKI (China National Knowledge Infrastructure) under the key words, "RBD", and Chinese words related with it in Traditional Chinese Medicine, Traditional Chinese Medicinal Herbs and Combination of Traditional Chinese Medicine With Western Medicine' field, and also in CiNii (Citation Information by NII); we also searched articles in Kampo Square in Japan under the key words, "RBD" and Japanese words related with it. We found 10 papers, and then selected 6 of them except the non-clinical and unrelated studies. We then analyzed their way of diagnosis, treatments, study type and etc.. Results: 6 studies were divided into 4 case reports, one control study, and one literature review study. All of the studies reported that Herbal medicine for RBD was effective as much as Western medicine like clonazepam and paroxetine. However, the quality and the quantity of these clinical studies were not enough. Conclusions: It seems that the researches for RBD have gradually been performed in TCM and Kampo. We hope that our study can activate/push forward clinical research for this disorder in Korean traditional medicine.

• Sleep Medicine and Psychophysiology
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• v.30 no.1
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• pp.9-12
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• 2023

Periodic limb movements during sleep (PLMS) are prevalent in various sleep disorders, such as restless legs syndrome (RLS), periodic limb movements disorder, obstructive sleep apnea (OSA), REM sleep behavior disorder (RBD), and narcolepsy. PLMS has been hypothesized to be related to the decline of dopaminergic transmission. In RLS, PLMS is suggested to be related to iron deficiency and symptom severity. PLMD is a rare sleep disorder, and the role of PLMS in PLMD has not been clearly investigated yet. PLMS in OSA, which remain after proper PAP therapy, may need further management. The clinical relevance of PLMS in RBD and narcolepsy have not been investigated thoroughly and need further studies. Whether PLMS are to be considered as a mere symptom of individual sleep disorders or not can be elucidated through studies investigating the efficacy of therapeutic approaches to reduce PLMS in various sleep disorders.

• Sleep Medicine and Psychophysiology
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• v.14 no.1
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• pp.5-12
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• 2007

Sleep changes substantially with age. There is a phase advance in the circadian sleep cycle and increased waking after sleep onset. The elderly people wake more frequently during the night and experience fragmented sleep and excessive daytime sleepiness. The prevalence of sleep disorders increases with age, and the composition of sleep disorders in the elderly differs from that in the young. The most frequently encountered sleep disorders are psychophysiologic insomnia, sleep disturbance due to dementia, sleeprelated respiratory disorder, restless legs syndrome and periodic limb movement disorder, and REM sleep behavior disorder. To treat the elderly sleep problem appropriately, it is important to know how sleep pattern changes as we age and to understand the cause of sleep-related symptoms. This article will review the sleep physiology and common sleep disorders in the elderly.