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Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants
Abstract Background Rapid eye movement (REM) sleep behavior disorder (RBD) has been described predominantly in elderly men and in association with neurodegenerative disease. But an increasing proportion of cases in recent reports and in clinical practice do not fit this description; thus we sought t...
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| Published in: | Sleep medicine 2011-03, Vol.12 (3), p.278-283 |
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| container_end_page | 283 |
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| container_title | Sleep medicine |
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| creator | Ju, Yo-El Larson-Prior, Linda Duntley, Stephen |
| description | Abstract Background Rapid eye movement (REM) sleep behavior disorder (RBD) has been described predominantly in elderly men and in association with neurodegenerative disease. But an increasing proportion of cases in recent reports and in clinical practice do not fit this description; thus we sought to describe a current RBD population and possibly identify new subgroups with RBD. Methods Records of 115 consecutive patients with polysomnogram-confirmed RBD at an academic sleep center were retrospectively reviewed. Results Male to female ratio was 2:1, and 1.25:1 for early-onset (age |
| doi_str_mv | 10.1016/j.sleep.2010.07.022 |
| format | article |
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But an increasing proportion of cases in recent reports and in clinical practice do not fit this description; thus we sought to describe a current RBD population and possibly identify new subgroups with RBD. Methods Records of 115 consecutive patients with polysomnogram-confirmed RBD at an academic sleep center were retrospectively reviewed. Results Male to female ratio was 2:1, and 1.25:1 for early-onset (age <50) cases. Mean age at diagnosis was 53.7 ± 16.4 years. Most (60%) cases were idiopathic, and neurodegenerative disease was coincident primarily in older men. Autoimmune disease was unexpectedly common in women (20%) particularly in the 30–49 age groups (40%). Antidepressant use was frequent (46.1%), especially in early-onset cases (57.8%). Conclusions RBD is diagnosed more equally between men and women and in younger individuals than previously reported. While neurodegenerative disease is frequently co-incident with RBD in older men, most women and early-onset cases have “idiopathic” RBD. High prevalence of autoimmune disease among women with RBD suggests an intriguing link between immune dysfunction and RBD. A high rate of antidepressant use provides support for a potentially causal role for antidepressants in RBD.</description><identifier>ISSN: 1389-9457</identifier><identifier>EISSN: 1878-5506</identifier><identifier>DOI: 10.1016/j.sleep.2010.07.022</identifier><identifier>PMID: 21317035</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Age Distribution ; Age of Onset ; Aged ; Antidepressant ; Antidepressive Agents - adverse effects ; Autoimmune ; Autoimmune Diseases - epidemiology ; Dementia ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Narcolepsy ; Narcolepsy - chemically induced ; Narcolepsy - epidemiology ; Narcolepsy - immunology ; Neurodegenerative Diseases - epidemiology ; Neurology ; Polysomnography ; Prevalence ; RBD ; REM Sleep Behavior Disorder - chemically induced ; REM Sleep Behavior Disorder - epidemiology ; REM Sleep Behavior Disorder - immunology ; Retrospective Studies ; Sex Distribution ; Sleep Medicine ; Synucleinopathy ; Young Adult</subject><ispartof>Sleep medicine, 2011-03, Vol.12 (3), p.278-283</ispartof><rights>Elsevier B.V.</rights><rights>2011 Elsevier B.V.</rights><rights>Copyright © 2011 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-ef4a59ec7aa8ed829c5344c2b1a8c667bec8e0c7cfe58961f532ee9ae7d228f43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21317035$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ju, Yo-El</creatorcontrib><creatorcontrib>Larson-Prior, Linda</creatorcontrib><creatorcontrib>Duntley, Stephen</creatorcontrib><title>Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants</title><title>Sleep medicine</title><addtitle>Sleep Med</addtitle><description>Abstract Background Rapid eye movement (REM) sleep behavior disorder (RBD) has been described predominantly in elderly men and in association with neurodegenerative disease. But an increasing proportion of cases in recent reports and in clinical practice do not fit this description; thus we sought to describe a current RBD population and possibly identify new subgroups with RBD. Methods Records of 115 consecutive patients with polysomnogram-confirmed RBD at an academic sleep center were retrospectively reviewed. Results Male to female ratio was 2:1, and 1.25:1 for early-onset (age <50) cases. Mean age at diagnosis was 53.7 ± 16.4 years. Most (60%) cases were idiopathic, and neurodegenerative disease was coincident primarily in older men. Autoimmune disease was unexpectedly common in women (20%) particularly in the 30–49 age groups (40%). Antidepressant use was frequent (46.1%), especially in early-onset cases (57.8%). Conclusions RBD is diagnosed more equally between men and women and in younger individuals than previously reported. While neurodegenerative disease is frequently co-incident with RBD in older men, most women and early-onset cases have “idiopathic” RBD. High prevalence of autoimmune disease among women with RBD suggests an intriguing link between immune dysfunction and RBD. A high rate of antidepressant use provides support for a potentially causal role for antidepressants in RBD.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Antidepressant</subject><subject>Antidepressive Agents - adverse effects</subject><subject>Autoimmune</subject><subject>Autoimmune Diseases - epidemiology</subject><subject>Dementia</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Narcolepsy</subject><subject>Narcolepsy - chemically induced</subject><subject>Narcolepsy - epidemiology</subject><subject>Narcolepsy - immunology</subject><subject>Neurodegenerative Diseases - epidemiology</subject><subject>Neurology</subject><subject>Polysomnography</subject><subject>Prevalence</subject><subject>RBD</subject><subject>REM Sleep Behavior Disorder - chemically induced</subject><subject>REM Sleep Behavior Disorder - epidemiology</subject><subject>REM Sleep Behavior Disorder - immunology</subject><subject>Retrospective Studies</subject><subject>Sex Distribution</subject><subject>Sleep Medicine</subject><subject>Synucleinopathy</subject><subject>Young Adult</subject><issn>1389-9457</issn><issn>1878-5506</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqFkktv1DAUhS1ERUvhFyAh72CTwY84dpBAQqPykIpAPNaWY1_PeEji1E4qzb-vp1NYsGgXlq-s7_jonnsRekHJihLavNmtcg8wrRgpL0SuCGOP0BlVUlVCkOZxqblqq7YW8hQ9zXlHCJVU1U_QKaOcSsLFGQrrrRk3YdxgB0PcJDNtg804jPjHxVd8a4A72JrrEBN2IcfkIL3F32POoesBg_dgZxw9NsscwzAsY5j32IyunDk4mBLkXMr8DJ1402d4fnefo98fL36tP1eX3z59WX-4rKygbK7A10a0YKUxCpxirRW8ri3rqFG2aWQHVgGx0noQqm2oF5wBtAakY0z5mp-jV8d_pxSvFsizHkK20PdmhLhkrYRoiailLOTre8mSsmwbyRtVUH5EbSqdJ_B6SmEwaV-gA9fonb4NSx-moYnUZRpF9fLOYOkGcP80f-MvwLsjACWQ6wBJZxtgtOBCKrFqF8MDBu__09s-jMGa_g_sIe_iksaStaY6M030z8NCHPaBUkII44zfAK9Vsu0</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Ju, Yo-El</creator><creator>Larson-Prior, Linda</creator><creator>Duntley, Stephen</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants</title><author>Ju, Yo-El ; Larson-Prior, Linda ; Duntley, Stephen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-ef4a59ec7aa8ed829c5344c2b1a8c667bec8e0c7cfe58961f532ee9ae7d228f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Distribution</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Antidepressant</topic><topic>Antidepressive Agents - adverse effects</topic><topic>Autoimmune</topic><topic>Autoimmune Diseases - epidemiology</topic><topic>Dementia</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Narcolepsy</topic><topic>Narcolepsy - chemically induced</topic><topic>Narcolepsy - epidemiology</topic><topic>Narcolepsy - immunology</topic><topic>Neurodegenerative Diseases - epidemiology</topic><topic>Neurology</topic><topic>Polysomnography</topic><topic>Prevalence</topic><topic>RBD</topic><topic>REM Sleep Behavior Disorder - chemically induced</topic><topic>REM Sleep Behavior Disorder - epidemiology</topic><topic>REM Sleep Behavior Disorder - immunology</topic><topic>Retrospective Studies</topic><topic>Sex Distribution</topic><topic>Sleep Medicine</topic><topic>Synucleinopathy</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ju, Yo-El</creatorcontrib><creatorcontrib>Larson-Prior, Linda</creatorcontrib><creatorcontrib>Duntley, Stephen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ju, Yo-El</au><au>Larson-Prior, Linda</au><au>Duntley, Stephen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants</atitle><jtitle>Sleep medicine</jtitle><addtitle>Sleep Med</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>12</volume><issue>3</issue><spage>278</spage><epage>283</epage><pages>278-283</pages><issn>1389-9457</issn><eissn>1878-5506</eissn><abstract>Abstract Background Rapid eye movement (REM) sleep behavior disorder (RBD) has been described predominantly in elderly men and in association with neurodegenerative disease. But an increasing proportion of cases in recent reports and in clinical practice do not fit this description; thus we sought to describe a current RBD population and possibly identify new subgroups with RBD. Methods Records of 115 consecutive patients with polysomnogram-confirmed RBD at an academic sleep center were retrospectively reviewed. Results Male to female ratio was 2:1, and 1.25:1 for early-onset (age <50) cases. Mean age at diagnosis was 53.7 ± 16.4 years. Most (60%) cases were idiopathic, and neurodegenerative disease was coincident primarily in older men. Autoimmune disease was unexpectedly common in women (20%) particularly in the 30–49 age groups (40%). Antidepressant use was frequent (46.1%), especially in early-onset cases (57.8%). Conclusions RBD is diagnosed more equally between men and women and in younger individuals than previously reported. While neurodegenerative disease is frequently co-incident with RBD in older men, most women and early-onset cases have “idiopathic” RBD. High prevalence of autoimmune disease among women with RBD suggests an intriguing link between immune dysfunction and RBD. A high rate of antidepressant use provides support for a potentially causal role for antidepressants in RBD.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>21317035</pmid><doi>10.1016/j.sleep.2010.07.022</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Age Distribution Age of Onset Aged Antidepressant Antidepressive Agents - adverse effects Autoimmune Autoimmune Diseases - epidemiology Dementia Female Humans Incidence Male Middle Aged Narcolepsy Narcolepsy - chemically induced Narcolepsy - epidemiology Narcolepsy - immunology Neurodegenerative Diseases - epidemiology Neurology Polysomnography Prevalence RBD REM Sleep Behavior Disorder - chemically induced REM Sleep Behavior Disorder - epidemiology REM Sleep Behavior Disorder - immunology Retrospective Studies Sex Distribution Sleep Medicine Synucleinopathy Young Adult |
| title | Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants |
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