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

This article has now been updated. Please use the final version.

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

Author information

Kazushi Deguchi
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan
Tomokazu Doi
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan
Tadayuki Takata
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan
Yohei Kokudo
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan
Hideki Kobara
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan
Mitsutoshi Yamamoto
Department of Neurology, Takamatsu Neurology Clinic, Japan
Tetsuo Touge
Department of Health Sciences, Kagawa University Faculty of Medicine, Japan
Tsutomu Masaki
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan

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

JOURNAL OPEN ACCESS Advance online publication

Article ID: 6218-20

DOI https://doi.org/10.2169/internalmedicine.6218-20

The final version of this article is now available: Vol. 60 (2021), No. 11 pp. 1775-1778

Details

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.

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