Skip to content REM-SLEEP BEHAVIOUR DISORDER
(RBD)
To understand RBD it is important to first understand what a normal REM-sleep is.
REM-SLEEP
REM is the stage of sleep associated with dreaming. The acronym stands for ‘Rapid Eye Movement’ because the eyes move around rapidly in different directions during REM-sleep. In this phase, while the brain is highly active, muscle tone is reduced (atonia), meaning that muscles are paralyzed. This is important to avoid acting out dreams.
RBD
RBD is characterized by dream-enactment behaviors that are associated with loss of atonia (muscles paralysis) during REM-sleep. Because in RBD the paralysis is incomplete or absent, the person acts out their dreams in a vivid, intense and violent way, imposing harm to themselves and also to their sleeping partners.
WHAT IT MEANS TO HAVE RBD?
RBD can be a side effect of specific medications, but it can also occur without a known cause. For those isolated (or idiophatic) RBD cases, the term ‘iRBD’ is used. iRBD is acknowledged as a prodromal phase of neurodegenerative diseases, in particular Parkinson’s disease, dementia with Lewy bodies or multiple system atrophy. Studies have shown people with iRBD have a very high risk of converting to one of these neurodegenerative diseases within 10-15 years.
HOW TO DIAGNOSE RBD?
A documented history of dream enactment is the first strong indication. For a definitive diagnosis, it is required to do a video polysomnography (vPSG) to capture REM sleep without paralysis of muscles (atonia) and/or dream enactment behaviour. A vPSG consists on the application of several sensors to the head and body to collect data during a night of sleep. The polysomnography measures many parameters, among them: EEG (electrical activity of the brain) that should be active during sleep, and EMG (muscle activity), which should provide a non-active (flat) signal, as muscles are expected to be paralysed. RBD diagnosis is confirmed when EMG shows activity.
SO I GOT AN iRBD DIAGNOSIS, NOW WHAT?
It can be quite overwhelming, given the known high conversion rate from iRBD to neurodegenerative diseases in a decade or so after the iRBD diagnosis. So it is important to take one step at a time. First, the diagnosis needs to be confirmed. In case of confirmation, one thing to consider is joining an iRBD cohort. A cohort is a group of people that shares the same characteristics. Cohorts can be part of observational studies and clinical trials, and joining a cohort is mutually beneficial for the person diagnosed with iRBD, and the team of specialists. While neurologists and neuroscientists benefit from getting valuable information and advacing their knowledge about iRBD, the same valuable information increase the chances of early intervention, management of symptoms, and potential treatment options in the future. Besides, being part of an iRBD cohort, provides the opportunity for these individuals to be followed up by a knowledgeable team of specialists on the disorder, including neurologists, nurses specialized in neurodegenerative diseases, neuroscientists and sleep-experts.
CONTACT US ABOUT iRBD
Our team is highly trained and well equipped to diagnose iRBD.
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