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REM-Schlaf-Verhaltensstörung (RBD)

Was gibt es Neues zur Diagnosestellung und Therapie?

REM sleep behavior disorder (RBD)

Update on diagnosis and treatment

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Zusammenfassung

Hintergrund

Die REM-Schlaf-Verhaltensstörung (REM Sleep Behavior Disorder, RBD) ist eine Parasomnie, die durch Ausagieren von Träumen gekennzeichnet ist und durch eine Störung der physiologischen Muskelatonie des REM-Schlafs ermöglicht wird. In den letzten Jahren wurden die diagnostischen Kriterien und die Methoden zur Diagnosestellung aktualisiert.

Ziel der Arbeit

In diesem Übersichtsartikel werden die derzeitigen Erkenntnisse zur Diagnose und Therapie vorgestellt.

Methode

Es wurde eine selektive Literaturrecherche durchgeführt.

Ergebnisse und Diskussion

Obwohl mehrere Fragebögen zum Screening für RBD entwickelt wurden, kann eine sichere Diagnose nur anhand einer Polysomnographie gestellt werden. Neue Methoden zur Auswertung der EMG-Aktivität im REM-Schlaf wurden in den letzten Jahren vorgeschlagen und Cut-off-Werte wurden etabliert. In die International Classification of Sleep Disorders sind die neuesten Cut-off-Werte für Scoring von EMG-Aktivität im REM-Schlaf eingegangen. Der von der SINBAR (Sleep INnsbruck BARcelona)-Gruppe vorgeschlagene Cut-off von 27 % Muskelaktivität im REM-Schlaf ist auch in die ICSD-3 übernommen worden. Die am besten untersuchten Therapien bei RBD sind Clonazepam und Melatonin.

Abstract

Background

REM sleep behavior disorder (RBD) is parasomnia that is characterized by the acting out of dreams and is enabled by disruption of physiological muscular atony during REM sleep. Over the last few years, the diagnostic criteria and the methods used to confirm the diagnosis have been updated.

Objective

In this review article the current knowledge on RBD diagnosis and therapy is presented.

Methods

A selective literature search was carried out.

Results and discussion

Although several questionnaires have been developed for the screening of RBD, a diagnosis can only be confirmed on the basis of polysomnography. New methods for scoring electromyography (EMG) activity during REM sleep have been proposed over the past few years and cut-off values have been established. The latest cut-off values for scoring EMG activity during REM sleep are published in the International Classification of Sleep Disorders (ICSD). The cut-off of 27 % muscle activity in REM sleep suggested by the SINBAR (Sleep INnsbruck BARcelona) group has also been included in the third edition of the ICSD. The best treatments for RBD that have been evaluated are clonazepam and melatonin.

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Authors and Affiliations

  1. Schlaflabor, Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich

    Birgit Högl &  Ambra Stefani

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  1. Birgit Högl
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  2. Ambra Stefani
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Correspondence to Birgit Högl.

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Interessenkonflikt

B. Högl hat Beratungskosten von UCB und Mundipharma, Honorar für Vorträge von UCB, Mundipharma, Otsuka, Respironics, Sanofi, Abbvie, Lundbeck und Reisekosten-Förderung von Habel und Vivisol erhalten. A. Stefani hat Reisekosten Förderung von Air Liquide und UCB erhalten.

Dieser Review beinhaltet keine Studien an Menschen oder Tieren.

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Högl, B., Stefani, A. REM-Schlaf-Verhaltensstörung (RBD). Somnologie 19, 241–247 (2015). https://doi.org/10.1007/s11818-015-0025-5

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