Rapid Eye Movement Sleep Behavior Disorder During Childhood

Kotagal, Suresh

doi:10.1016/j.jsmc.2015.02.004

Cited by 25 publications

(7 citation statements)

References 20 publications

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“…3 Recent reports suggest that clinical and subclinical forms of RBD occur in children and adolescents. 4 Although pediatric RBD is considered to be a rare occurrence, its prevalence may be underestimated due to limited awareness, overlap with other parasomnias, and the requirement of nocturnal PSG for diagnosis. 4,5 Additionally, it is unclear whether or not the adult clinical definitions should pertain to pediatric presentations due to a current lack of neuropathologic studies of childhood RBD.…”

Section: Introductionmentioning

confidence: 99%

“…4 Although pediatric RBD is considered to be a rare occurrence, its prevalence may be underestimated due to limited awareness, overlap with other parasomnias, and the requirement of nocturnal PSG for diagnosis. 4,5 Additionally, it is unclear whether or not the adult clinical definitions should pertain to pediatric presentations due to a current lack of neuropathologic studies of childhood RBD. 4 Differentiating RBD from other parasomnias in the younger population is significant clinically because of the potential to inform on neuropsychiatric state and therefore guide treatment choices, as evidenced in conditions such as narcolepsy where 60% of patients will have RBD.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Additionally, it is unclear whether or not the adult clinical definitions should pertain to pediatric presentations due to a current lack of neuropathologic studies of childhood RBD. 4 Differentiating RBD from other parasomnias in the younger population is significant clinically because of the potential to inform on neuropsychiatric state and therefore guide treatment choices, as evidenced in conditions such as narcolepsy where 60% of patients will have RBD. In adult psychiatric populations, RBD has been associated with the use of psychotropic medications and particularly with serotonin reuptake-blocking antidepressants.…”

Section: Introductionmentioning

confidence: 99%

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Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Gaughan

Buckley

Hommer

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Polysomnographic investigation of sleep architecture in children presenting with pediatric acute-onset neuropsychiatric syndrome (PANS). Methods: Fifteen consecutive subjects meeting criteria for PANS (mean age = 7.2 y; range 3-10 y) underwent single-night full polysomnography (PSG) read by a pediatric neurologist. Results: Thirteen of 15 subjects (87%) had abnormalities detected with PSG. Twelve of 15 had evidence of rapid eye movement (REM) sleep motor disinhibition, as characterized by excessive movement, laughing, hand stereotypies, moaning, or the continuation of periodic limb movements during sleep (PLMS) into REM sleep. Conclusions: This study shows various forms of REM sleep motor disinhibition present in a population of children with PANS. Keywords: obsessive compulsive disorder, PANS, polysomnography, REM sleep behavior disorder Citation: Gaughan T, Buckley A, Hommer R, Grant P; Williams K, Leckman JF, Swedo SE. Rapid eye movement sleep abnormalities in children with pediatric acute-onset neuropsychiatric syndrome (PANS). J Clin Sleep Med 2016;12(7):1027-1032. I NTRO DUCTI O N Schenck et al.1 were the first to suggest that rapid eye movement (REM) sleep neurobehavioral disorders were a separate category of parasomnia in a 1986 case series of four males aged 67-72 y. Polysomnography (PSG) of these four subjects showed a loss of chin atonia and high limb-twitch activity among other REM sleep pathology, whereas videography showed various REM sleep behaviors including punching, kicking, and dream enactment.1 Since then, REM sleep behavior disorder (RBD) has been recognized across a wide range of ages, sometimes decades prior to the onset of other neurobehavioral changes and often heralding serious neurodegenerative conditions affecting synuclein.2 A recent retrospective study of patients showing REM sleep without atonia on PSG found a majority (73%) of patients had idiopathic RBD, defined as RBD in the absence of known neurological or sleep disorders.3 Recent reports suggest that clinical and subclinical forms of RBD occur in children and adolescents.4 Although pediatric RBD is considered to be a rare occurrence, its prevalence may be underestimated due to limited awareness, overlap with other parasomnias, and the requirement of nocturnal PSG for diagnosis.4,5 Additionally, it is unclear whether or not the adult clinical definitions should pertain to pediatric presentations due to a current lack of neuropathologic studies of childhood RBD.4 Differentiating RBD from other parasomnias in the younger population is significant clinically because of the potential to inform on neuropsychiatric state and therefore guide treatment choices, as evidenced in conditions such as narcolepsy where 60% of patients will have RBD. In adult psychiatric populations, RBD has been associated with the use of psychotropic medications and particularly with serotonin reuptake-blocking antidepressants.3,7 However, a recent study suggests that antidepressants cannot fully explain RBD symptomatology in their psychiat...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Gaughan

Buckley

Hommer

et al. 2016

Journal of Clinical Sleep Medicine

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“…Unlike in the older population, males and females are represented equally in this group suggesting confounding gender associations with these factors 27 . Similarly, RBD in the paediatric population is a distinct entity and usually occurs in the setting of narcolepsy or comorbid malignant or neurodevelopmental abnormalities 28 …”

Section: Epidemiologymentioning

confidence: 99%

REM sleep behaviour disorder: not just a bad dream

Matar

Lewis

2017

Medical Journal of Australia

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Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterised by the loss of the normal atonia during the REM stage of sleep, resulting in overt motor behaviours that usually represent the enactment of dreams. Patients will seek medical attention due to sleep-related injuries or unpleasant dream content. Idiopathic RBD which occurs independently of any other disease occurs in up to 2% of the older population. Meanwhile, secondary RBD is very common in association with certain neurodegenerative conditions. RBD can also occur in the context of antidepressant use, obstructive sleep apnoea and narcolepsy. RBD can be diagnosed with a simple screening question followed by confirmation with polysomnography to exclude potential mimics. Treatment for RBD is effective and involves treatment of underlying causes, modification of the sleep environment, and pharmacotherapy with either clonazepam or melatonin. An important finding in the past decade is the recognition that almost all patients with idiopathic RBD will ultimately go on to develop Parkinson disease or dementia with Lewy bodies. This suggests that idiopathic RBD represents a prodromal phase of these conditions. Physicians should be aware of the risk of phenoconversion. They should educate idiopathic RBD patients to recognise the symptoms of these conditions and refer as appropriate for further testing and enrolment into research trials focused on neuroprotective measures.

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“…REM without atonia reflects excessive amount of sustained or intermittent elevation of tonic submental tone or excessive phasic activity (which clinically may look like twitching in REM sleep) [53]. In children, REM behavior disorder (RBD) may present with symptoms of yelling, flailing limbs, pantomimic behaviors, gestures as well as more violent actions such a punching and kicking commonly reported among adults with RBD [54]. In children, findings of PLMS with indexes of >5/h are not uncommon on PSG with rates of 7.7 % among community recruited participants [55], but RBD and REM without atonia are relatively rare in this population [56].…”

Section: Periodic Limb Movements Of Sleep and Rem Behavior Disordermentioning

confidence: 99%

Beyond Daytime Sleepiness: Medical, Behavioral, Psychiatric, and Sleep Co-morbid Conditions Associated with Pediatric Narcolepsy

Maski

Heroux

2016

Curr Sleep Medicine Rep

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Pediatric narcolepsy can be challenging to diagnose and manage given a broad range of co-morbidities only recently described in the literature. These co-morbidities are broad in scope and span medical, psychiatric, and sleep disorders. Such associated conditions highlight potential novel effects of hypocretin deficiency on metabolic and neural functioning. Clinically, medication treatments for narcolepsy have the potential to alter co-morbid symptoms for better or worse and may guide individual treatment plans. Furthermore, sleep physicians may need to ally with other health care providers in endocrinology and psychiatry to optimize the care of pediatric patients with narcolepsy.

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Rapid Eye Movement Sleep Behavior Disorder During Childhood

Cited by 25 publications

References 20 publications

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

REM sleep behaviour disorder: not just a bad dream

Beyond Daytime Sleepiness: Medical, Behavioral, Psychiatric, and Sleep Co-morbid Conditions Associated with Pediatric Narcolepsy

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