Associated factors of REM sleep without atonia in younger (≤ 50 years) hospitalized psychiatric patients

BMC Psychiatry. 2020 Oct 1;20(1):482. doi: 10.1186/s12888-020-02879-4.

Abstract

Background: Isolated REM sleep without atonia (RSWA) as a main polysomnograhic feature of REM sleep behaviour disorder (RBD) is thought to be a prodromal or subclinical state of the disease. RSWA/RBD occurence in psychiatric population is much more frequent than in general population but its associated factors are still not known.

Methods: We invited 88 psychiatry in-patients to undervent video-polysomnography. The visual scoring was focused on RSWA in submentales and flexores digitales superficiales muscles. This parametr was subsequently correlated mainly with age/gender, their medication and mental status.

Results: The RWSA was mostly still in normal range despite the fact, that selected psychiatry patients (≤ 50 years) were taking several classes of psychoactive medication. 3,6% had convincingly RBD, although 35.7% reported rare lifetime occurence of dream-enacting behaviour and 62.8% sporadic nightmares. We found correlation between RSWA and SNRI medication class (p = 0.015), specifically venlafaxine (p = 0.029) as well as quetiapine (p = 0.030). Another significant associated factors were current anxiety (p < 0.001) and depressive symptoms (p = 0.05), but we found no relation between RSWA and given diagnosis.

Conlucions: Isolated RSWA in younger psychiatry patients might be a result of multiple factors, including medication and current mental status but these factors are in most cases not sufficient to manifest RBD.

Keywords: Antidepressants; Antipsychotics; Anxiety; Depression; Psychiatric patients; REM sleep behaviour disorder; REM sleep without atonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Muscle Hypotonia
  • Polysomnography
  • REM Sleep Behavior Disorder*
  • Sleep, REM*