Antidepressants increase REM sleep muscle tone in patients with and without REM sleep behavior disorder

McCarter, Stuart J.; Louis, E. St.; Sandness, David J.; Arndt, Kayla; Erickson, Maia K.; Tabatabai, Grace M.; Boeve, Bradley F.; Silber, Michael H.

doi:10.1016/j.sleep.2015.02.005

Cited by 8 publications

(4 citation statements)

References 38 publications

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“…Although we did not directly investigate the association between VPC and RBD, this result may suggest that the presence of the pineal cysts itself may not affect RBD symptoms. Second, we excluded the subjects who were depressive and/or were taking antidepressants since depression may increase the risk of RBD and antidepressants, selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) in particular, may produce dream-enacting behavior and loss of normal REM sleep atonia [1,28]. However, this study also has several limitations.…”

Section: Discussionmentioning

confidence: 99%

Pineal gland volume is associated with prevalent and incident isolated rapid eye movement sleep behavior disorder

Park

Han

Suh

et al. 2020

Aging

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We aimed to investigate the association of pineal gland volume with the risk of isolated rapid eye movement (REM) sleep behavior disorder (RBD). We enrolled 245 community-dwelling cognitively normal elderly individuals without major psychiatric or neurological disorders at the baseline evaluation, of whom 146 completed the 2-year follow-up evaluation. We assessed RBD symptoms using the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) and defined probable RBD (pRBD) as an RBDSQ score of ≥ 5. We manually segmented the pineal gland on 3T T1-weighted brain magnetic resonance imaging and estimated its volume. The smaller the baseline pineal gland volume, the more severe the RBD symptoms at baseline. The individuals with isolated pRBD showed smaller pineal gland volumes than those without isolated pRBD. The larger the baseline pineal gland volume, the lower the risks of prevalent isolated pRBD at the baseline evaluation and incident isolated pRBD at the 2-year follow-up evaluation. Pineal gland volume showed good diagnostic accuracy for prevalent isolated pRBD and predictive accuracy for incident isolated pRBD in the receiver operator characteristic analysis. Our findings suggest that pineal gland volume may be associated with the severity of RBD symptoms and the risk of isolated RBD in cognitively normal elderly individuals.

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Section: Discussionmentioning

confidence: 99%

Pineal gland volume is associated with prevalent and incident isolated rapid eye movement sleep behavior disorder

Park

Han

Suh

et al. 2020

Aging

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“…[11, 15, 22] This, along with recent data analyzing RSWA in psychiatric RBD patients compared with iRBD and PD-RBD patients,[16] suggests that most adult RBD patients have a common underlying RSWA pathophysiologic mechanism and are likely undergoing a similar synuclein-mediated neurodegenerative process, with most variability explainable by the factor of temporal disease duration and variation in sampling at different time points in the disease process. [16]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic REM sleep muscle activity thresholds in patients with idiopathic REM sleep behavior disorder with and without obstructive sleep apnea

et al. 2017

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Objectives We aimed to determine whether visual and automated REM sleep without atonia (RSWA) methods could accurately diagnose idiopathic REM sleep behavior disorder (iRBD) patients with comorbid obstructive sleep apnea (OSA). Methods We visually analyzed RSWA phasic burst durations; phasic, tonic and “any” muscle activity by 3-second mini-epochs; phasic activity by 30-second (AASM rules) epochs; and automated REM atonia index (RAI) analysis in iRBD patients (n=15) and matched controls (n=30) with and without OSA. Group RSWA metrics were analyzed with regression models. Receiver operating characteristic (ROC) curves were used to determine the best diagnostic cutoff thresholds for REM sleep behavior disorder (RBD). Both split-night and full-night polysomnographic studies were analyzed. Results All mean RSWA phasic burst durations and muscle activities were higher in iRBD patients than in controls (p<0.01). Muscle activity (phasic, “any”) cutoffs for 3-second mini-epoch scorings were: submentalis (SM) (15.8%, 19.5%), anterior tibialis (AT) (29.7%, 29.7%), and combined SM/AT (39.5%, 39.5%). Tonic muscle activity cutoff was 0.70% and RAI (SM) cutoff 0.86. Phasic muscle burst duration cutoffs were SM (0.66) and AT (0.71) seconds. Combining phasic burst durations with RSWA muscle activity improved sensitivity and specificity of iRBD diagnosis. Conclusions This study provides evidence for quantitative RSWA diagnostic thresholds applicable in iRBD patients with OSA. Our findings in this study were quite similar to those seen in Parkinson's disease-REM sleep behavior disorder (PD-RBD) patients, consistent with a common mechanism and presumed underlying etiology of synucleinopathy in both groups.

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“…In the present study, the most frequent clinical history of psychiatric illness was MDD in middle‐aged and older patients exhibiting RWA. Although antidepressants can produce a loss of the normal atonia of REM sleep and dream‐enactment behavior (Winkelman and James, ; McCarter et al ., ), the reason for this connection remains unclear. Recent studies, however, reported that antidepressants might trigger an RBD of a subclinical status.…”

Section: Discussionmentioning

confidence: 99%

REM sleep without atonia in middle‐aged and older psychiatric patients and Lewy body disease: a case series

Fujishiro

Okuda

Iwamoto

et al. 2016

Int J Geriat Psychiatry

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Antidepressants increase REM sleep muscle tone in patients with and without REM sleep behavior disorder

Cited by 8 publications

References 38 publications

Pineal gland volume is associated with prevalent and incident isolated rapid eye movement sleep behavior disorder

Pineal gland volume is associated with prevalent and incident isolated rapid eye movement sleep behavior disorder

Diagnostic REM sleep muscle activity thresholds in patients with idiopathic REM sleep behavior disorder with and without obstructive sleep apnea

REM sleep without atonia in middle‐aged and older psychiatric patients and Lewy body disease: a case series

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