People with a form of sleep disorder, which is REM behavior disorder (RBD), have high probability of developing dementia, Parkinsonism, or multiple system atrophy because all these conditions appear to generate from a similar neurodegenerative origin.
Patients with REM behavior disorder exhibit early signs of an evolving neurodegenerative disease which in most cases appear to be caused by some mishap of the synuclein protein.
Synuclein proteins are associated with synapses in the brain and clumps of abnormal alpha-synuclein protein are present in some forms of dementia. The problem is not present in the synuclein gene itself but it happens to the protein following gene expression.
Researchers examined older males who strike out violently, often yelling, when they entered REM sleep. For many years of research, researchers saw many of them develop symptoms of dementia.
It does not mean someone has this condition when they notice violent movements during sleep. The danger with REM behavior disorder is that patients can hurt themselves or their spouses during the act out behaviors.
The violent behavior occurs sometimes due to untreated sleep apnea and the condition can be cured with regular sleep apnea treatment using CPAP machine. In these cases the cause is sleep apnea.
Due to the violent behavior, safety precautions should be followed. Safety precautions in bedrooms to prevent injury such as removing dangerous objects such as weapons from bedroom, locking all doors and windows, following up regularly with a sleep specialist to monitor for signs of brain degenerating diseases and become familiar with signs of dementia, Parkinson’s or multiple system atrophy.
The REM behavior disorder findings precede dementia by years or decades underscoring the need for patients with suspected REM behavior disorder to undergo a sleep study. Some patients do not exhibit the symptoms of dementia but all patients with RBD do develop the pathology.
Dementia and Parkinson’s disease have no cure but can be treated. Unlike Alzheimer’s, medications can restore cognitive function for many with dementia.
The dilemma of physicians is whether to inform patients that they have an increased risk of developing dementia and Parkinsonism, when symptoms may not appear for years or may never appear at all.
Some physicians say that many patients with REM behavior disorder develop dementia and Parkinsonism, but they can’t expect what will happen in each individual case. Some physicians inform very less of this to their parents.
Some people never show the symptoms and live a normal life. Patients who have REM behavior disorder for years die from stroke, cancer or heart disease and never show any signs of dementia or Parkinson’s.
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