Rapid Eye Movement Sleep Behavior Disorder-like Symptoms Due to Arousal Responses Associated with Severe Obstructive Sleep Apnea-hypopnea

Kazushi Deguchi; Tomokazu Doi; Tadayuki Takata; Yohei Kokudo; Hideki Kobara; Mitsutoshi Yamamoto; Tetsuo Touge; Tsutomu Masaki

doi:10.2169/internalmedicine.6218-20

Rapid Eye Movement Sleep Behavior Disorder-like Symptoms Due to Arousal Responses Associated with Severe Obstructive Sleep Apnea-hypopnea

Intern Med. 2021 Jun 1;60(11):1775-1778. doi: 10.2169/internalmedicine.6218-20. Epub 2021 Jan 8.

Authors

Kazushi Deguchi¹, Tomokazu Doi¹, Tadayuki Takata¹, Yohei Kokudo¹, Hideki Kobara¹, Mitsutoshi Yamamoto², Tetsuo Touge³, Tsutomu Masaki¹

Affiliations

¹ Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan.
² Department of Neurology, Takamatsu Neurology Clinic, Japan.
³ Department of Health Sciences, Faculty of Medicine, Kagawa University, Japan.

Abstract

A 78-year-old man suspected of having α-synucleinopathies received a high score on a validated questionnaire for rapid eye movement (REM) sleep behavior disorder (RBD). Although he did in fact have unpleasant dreams and vigorous behaviors, polysomnography (PSG) found only obstructive sleep apnea-hypopnea (OSAH). The RBD-like symptoms corresponded with arousal responses, namely augmented inspiratory effort and leg movements, to his frequent apnea-hypopnea events during REM sleep. Thus, severe OSAH might cause RBD-like symptoms. PSG can discriminate real RBD from RBD-like symptoms associated with severe OSAH and therefore may be essential for determining an appropriate course of treatment in certain patients.

Keywords: REM sleep behavior disorder (RBD); REM sleep without atonia (RWA); brainstem; obstructive sleep apnea; polysomnography; questionnaire.

Publication types

Case Reports

MeSH terms

Aged
Arousal
Humans
Male
Polysomnography
REM Sleep Behavior Disorder* / diagnosis
Sleep Apnea, Obstructive* / diagnosis
Sleep, REM