Slow‐wave sleep and delta power in rapid eye movement sleep behavior disorder

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by the loss of normal muscle atonia during REM sleep, leading to an increase of phasic muscle activity and complex motor behaviors during the night. There is some evidence that RBD patients have more of slow‐wave sleep (SWS) than healthy elderly subjects. No study has looked at quantitative electroencephalogram analysis during non‐REM sleep in either primary or secondary RBD. The aim of this study was to assess the increase of SWS and to analyze different electroencephalographic frequency ranges during non‐REM sleep in 28 idiopathic RBD patients compared with 28 age‐ and sex‐matched healthy volunteers. Idiopathic RBD patients spent more time in SWS (men: 1.4%; women: 5.9%) than control subjects (men: 0.4%; women: 0.6%; p = 0.004). Spectral analyses demonstrated that idiopathic RBD patients had increased all‐night δ power in comparison with control subjects (p = 002). This study shows an increase of SWS and power in the δ band during non‐REM sleep in idiopathic RBD patients compared with control subjects. Results are discussed about the possible nigrostriatal dopaminergic impairment in RBD patients and the association between RBD and neurodegenerative disorders. Ann Neurol 2005;57:277–282

[1]  N. Quinn,et al.  REM sleep behaviour disorder as the presenting symptom of multiple system atrophy. , 1995, Journal of neurology, neurosurgery, and psychiatry.

[2]  Mark W. Mahowald,et al.  Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder , 1996, Neurology.

[3]  A. Oksenberg,et al.  Rapid Eye Movement (REM) sleep behavior disorder: a sleep disturbance affecting mainly older men. , 2002, The Israel journal of psychiatry and related sciences.

[4]  R. Chervin,et al.  Decreased striatal dopaminergic innervation in REM sleep behavior disorder , 2000, Neurology.

[5]  R. Watts,et al.  Juvenile Parkinson’s disease with REM sleep behavior disorder, sleepiness, and daytime REM onset , 1999, Neurology.

[6]  Amy Lee,et al.  Anatomy of adenosine A2A receptors in brain , 2003, Neurology.

[7]  R. Stafford,et al.  Principles and Practice of Sleep Medicine , 2001 .

[8]  T H Monk,et al.  The effects of age and gender on sleep EEG power spectral density in the middle years of life (ages 20-60 years old). , 2001, Psychophysiology.

[9]  J. Montplaisir,et al.  [Rapid-eye-movement sleep disorders in Parkinson's disease]. , 2002, Revue neurologique.

[10]  Raymond Scott Turner,et al.  The pathology of REM sleep behavior disorder with comorbid Lewy body dementia. , 2000, Neurology.

[11]  G. E. Smith,et al.  REM sleep behavior disorder and degenerative dementia , 1998, Neurology.

[12]  Jacques Montplaisir,et al.  Polysomnographic features of REM sleep behavior disorder , 1992, Neurology.

[13]  M S Mourtazaev,et al.  Age and gender affect different characteristics of slow waves in the sleep EEG. , 1995, Sleep.

[14]  N. Gosselin,et al.  Periodic leg movements in REM sleep behavior disorder and related autonomic and EEG activation , 2002, Neurology.

[15]  C. Bell DSM-IV: Diagnostic and Statistical Manual of Mental Disorders , 1994 .

[16]  B. Boeve,et al.  Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases. , 2000, Brain : a journal of neurology.

[17]  P. Achermann,et al.  Period‐amplitude analysis and power spectral analysis: a comparison based on all‐night sleep EEG recordings , 1993, Journal of sleep research.

[18]  M. Mahowald,et al.  REM sleep behavior disorder: clinical, developmental, and neuroscience perspectives 16 years after its formal identification in SLEEP. , 2002, Sleep.

[19]  D Lehmann,et al.  Sleep deprivation: effect on sleep stages and EEG power density in man. , 1981, Electroencephalography and clinical neurophysiology.

[20]  R. Vasko,et al.  Muscle artifacts in the sleep EEG: Automated detection and effect on all‐night EEG power spectra , 1996, Journal of sleep research.

[21]  M. Mahowald,et al.  REM sleep behaviour disorder: an update on a series of 96 patients and a review of the world literature , 1993 .

[22]  Locatie HoornEnkhuizen EEG , 2001, Clinical Neurophysiology.

[23]  Daniel J Buysse,et al.  Electroencephalographic sleep in the healthy "old old": a comparison with the "young old" in visually scored and automated measures. , 1991, Journal of gerontology.

[24]  B. Boeve,et al.  Association of REM sleep behavior disorder and neurodegenerative disease may reflect an underlying synucleinopathy , 2001, Movement disorders : official journal of the Movement Disorder Society.

[25]  R. S. Miletich,et al.  N6 (L-Phenylisopropyl)adenosine (L-PIA) increases slow-wave sleep (S2) and decreases wakefulness in rats , 1982, Brain Research.

[26]  Julie Carrier,et al.  Slowing of electroencephalogram in rapid eye movement sleep behavior disorder , 2003, Annals of neurology.

[27]  Glenn T. Stebbins,et al.  Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson's disease , 1998, Neurology.

[28]  E. Sforza,et al.  REM sleep behavior disorder: clinical and physiopathological findings. , 1997, Sleep medicine reviews.

[29]  R. McCarley,et al.  Adenosine and behavioral state control: adenosine increases c-Fos protein and AP1 binding in basal forebrain of rats. , 1999, Brain research. Molecular brain research.

[30]  R. McCarley,et al.  Adenosine: a mediator of the sleep-inducing effects of prolonged wakefulness. , 1997, Science.

[31]  Todd Gardner The Slow Wave , 2001 .

[32]  J. Carrier,et al.  REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease , 2002, Neurology.

[33]  S. Noachtar,et al.  Increased muscle activity during rapid eye movement sleep correlates with decrease of striatal presynaptic dopamine transporters. IPT and IBZM SPECT imaging in subclinical and clinically manifest idiopathic REM sleep behavior disorder, Parkinson's disease, and controls. , 2003, Sleep.

[34]  M. Radulovački,et al.  Role of adenosine in sleep and temperature regulation in the preoptic area of rats , 1991, Pharmacology Biochemistry and Behavior.

[35]  H. Heller,et al.  Stimulation of A1 adenosine receptors mimics the electroencephalographic effects of sleep deprivation , 1995, Brain Research.

[36]  D. Dijk,et al.  Sex differences in the sleep EEG of young adults: visual scoring and spectral analysis. , 1989, Sleep.

[37]  G. Plazzi,et al.  REM sleep behavior disorders in multiple system atrophy , 1997, Neurology.

[38]  Stephen R. Morairty,et al.  Adenosinergic modulation of basal forebrain and preoptic/anterior hypothalamic neuronal activity in the control of behavioral state , 2000, Behavioural Brain Research.

[39]  M. W. Mahowald,et al.  REM sleep parasomnias. , 1996, Neurologic clinics.

[40]  E. Wolpert A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .