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Sleep Medicine pp 391–405Cite as

REM Sleep Behavior Disorder

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Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) was formally identified and named in 1986–1987 and is characterized by loss of REM sleep atonia with the release of complex, aggressive, and violent behaviors that are often simultaneous enactments of abnormal dreams involving confrontation by unfamiliar people and animals, with the dreamer rarely being the instigator. Sports-related and nonviolent dream enactments also occur. Various polysomnographic and clinical aspects of human RBD were described since 1966 by investigators from Europe, Japan, and North America. Since 1965, there have been experimental animal models of RBD in cats and rats produced by specific brainstem lesions, and recently a transgenic mouse model of RBD was developed with impaired glycine and gamma aminobutyric acid (GABA) neurotransmission. Although all age groups and both genders can have RBD, typically RBD affects middle-aged and older men who are at a high risk for developing future parkinsonism/dementia. Most neurologic disorders (particularly neurodegenerative disorders, narcolepsy, cerebrovascular disorder) and antidepressant medications can trigger RBD. Clonazepam and melatonin are highly effective therapies.

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Acknowledgment

Special gratitude goes to my longstanding collaborator, Mark W. Mahowald, M.D. (Fig. 45.5), founding codirector (1978) and director of the Minnesota Regional Sleep Disorders Center from 1986 to 2010, who considered RBD to be a prime example of a dissociated state of sleep that represented important common ground for cross-fertilization among basic researchers and sleep clinicians.

Fig. 45.5
figure 5

Mark W. Mahowald, M.D., director of the Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, Minneapolis, Minnesota, USA, from 1986 to 2010

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Authors and Affiliations

  1. Minnesota Regional Sleep Disorders Center, Minneapolis, USA

    Carlos H. Schenck MD

  2. Department of Psychiatry, Hennepin County Medical Center, Minneapolis, USA

    Carlos H. Schenck MD

  3. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA

    Carlos H. Schenck MD

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  1. Department of Neurology, New Jersey Neuroscience Institute JFK Medical Center, Edison, New Jersey, USA

    Sudhansu Chokroverty

  2. Department of Neurology, Gui de Chauliac Hospital, Montpellier, France

    Michel Billiard

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Schenck, C. (2015). REM Sleep Behavior Disorder. In: Chokroverty, S., Billiard, M. (eds) Sleep Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2089-1_45

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