REM Sleep Behavior Disorder (cont.)
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REM Sleep Disorder Causes
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The exact cause ofREM sleep behavior disorder(RBD) is unknown, although the disorder may occur in association with various degenerative neurological conditionssuch as Parkinson disease, multisystem atrophy, diffuse Lewy body dementia,and Shy-Drager syndrome. In 55% of persons the cause is unknown, and in 45%, the cause is associated with alcohol or sedative-hypnotic withdrawal, tricyclic antidepressant (such as imipramine), or
serotonin reuptake inhibitor use (such as fluoxetine,sertraline, orparoxetine)or other types of antidepressants (mirtazapine).
RBD often precedes the development ofthese neurodegenerative diseases by several years. In one study, 38% of patients diagnosed withRBDsubsequently developed Parkinson disease within an average time of 12-13 years from the onset ofRBDsymptoms. The prevalence of RBD is increased in persons with Parkinson disease and in multisystem atrophy where it is observed in 69% of these patients. The relationship betweenRBDand Parkinson disease is complex; however, not all persons with RBD develop Parkinson disease.
ABM Salah Uddin, MD
Erasmo A Passaro, MD
Francisco Talavera, PharmD, PhD
Stephen Berman, MD, PhD
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