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RBD: Gender Implications

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Rapid-Eye-Movement Sleep Behavior Disorder

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Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) has a reported male predominance. This gender difference may partially relate to underdiagnosis of RBD in women. Less violent behaviors, decreased numbers of behaviors on sleep studies, genetics, risk of neurodegenerative disorders, age, hormones, and lack of bed partner may contribute to this gender difference. As more evidence accumulates supporting idiopathic RBD as an early manifestation of a neurodegenerative disorder such as Parkinson’s disease, it is imperative to fully recognize RBD in both genders.

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References

  1. Schenck CH, Bundlie SR, Ettinger MG, Mahowald MW. Chronic behavioral disorders of human REM sleep: a new category of parasomnia. Sleep. 1986;9:293–308.

    Article  CAS  Google Scholar 

  2. Postuma RB, Gagnon JF, Vendette M, Fantini ML, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology. 2009;72:1296–300.

    Article  CAS  Google Scholar 

  3. Iranzo A, Santamaria J, Rye DB, Valldeoriola F, Marti MJ, Munoz E, Vilaseca I, Tolosa E. Characteristics of idiopathic REM sleep behavior disorder and that associated with MSA and PD. Neurology. 2005;65:247–52.

    Article  CAS  Google Scholar 

  4. Wong JC, Li J, Pavlova M, Chen S, Wu A, Wu S, Gao X. Risk factors for probable REM sleep behavior disorder: a community-based study. Neurology. 2016;86:1306–12.

    Article  Google Scholar 

  5. Frauscher B, Gschliesser V, Brandauer E, Marti I, Furtner MT, Ulmer H, Poewe W, Hogl B. REM sleep behavior disorder in 703 sleep-disorder patients: the importance of eliciting a comprehensive sleep history. Sleep Med. 2010;11:167–71.

    Article  Google Scholar 

  6. Ju YE, Larson-Prior L, Duntley S. Changing demographics in REM sleep behavior disorder: possible effect of autoimmunity and antidepressants. Sleep Med. 2011;12:278–83.

    Article  Google Scholar 

  7. Bonakis A, Howard RS, Ebrahim IO, Merritt S, Williams A. REM sleep behaviour disorder (RBD) and its associations in young patients. Sleep Med. 2009;10:641–5.

    Article  Google Scholar 

  8. Schenck CH, Hurwitz TD, Mahowald MW. Symposium: normal and abnormal REM sleep regulation: REM sleep behaviour disorder: an update on a series of 96 patients and a review of the world literature. J Sleep Res. 1993;2:224–31.

    Article  CAS  Google Scholar 

  9. Sforza E, Krieger J, Petiau C. REM sleep behavior disorder: clinical and physiopathological findings. Sleep Med Rev. 1997;1:57–69.

    Article  CAS  Google Scholar 

  10. Olson EJ, Boeve BF, Silber MH. Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases. Brain. 2000;123(Pt 2):331–9.

    Article  Google Scholar 

  11. Iranzo A, Molinuevo JL, Santamaria J, Serradell M, Marti MJ, Valldeoriola F, Tolosa E. Rapid-eye-movement sleep behaviour disorder as an early marker for a neurodegenerative disorder: a descriptive study. Lancet Neurol. 2006;5:572–7.

    Article  Google Scholar 

  12. Wing YK, Lam SP, Li SX, Yu MW, Fong SY, Tsoh JM, Ho CK, Lam VK. REM sleep behaviour disorder in Hong Kong Chinese: clinical outcome and gender comparison. J Neurol Neurosurg Psychiatry. 2008;79:1415–6.

    Article  CAS  Google Scholar 

  13. Okura M, Taniguchi M, Sugita H, Ohi M, Tachibana N. [Demographic characteristics of RBD patients at a sleep center—with special emphasis on neurodegenerative diseases as the background condition]. Brain Nerve. 2007;59:1265–71.

    Google Scholar 

  14. Taylor KS, Cook JA, Counsell CE. Heterogeneity in male to female risk for Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2007;78:905–6.

    Article  CAS  Google Scholar 

  15. Bjornara KA, Dietrichs E, Toft M. REM sleep behavior disorder in Parkinson’s disease—is there a gender difference? Parkinsonism Relat Disord. 2013;19:120–2.

    Article  Google Scholar 

  16. Szewczyk-Krolikowski K, Tomlinson P, Nithi K, Wade-Martins R, Talbot K, Ben-Shlomo Y, Hu MT. The influence of age and gender on motor and non-motor features of early Parkinson’s disease: initial findings from the Oxford Parkinson Disease Center (OPDC) discovery cohort. Parkinsonism Relat Disord. 2014;20:99–105.

    Article  Google Scholar 

  17. Bjornara KA, Dietrichs E, Toft M. Clinical features associated with sleep disturbances in Parkinson’s disease. Clin Neurol Neurosurg. 2014;124:37–43.

    Article  Google Scholar 

  18. Bliwise DL, Trotti LM, Greer SA, Juncos JJ, Rye DB. Phasic muscle activity in sleep and clinical features of Parkinson disease. Ann Neurol. 2010;68:353–9.

    Article  Google Scholar 

  19. Zhou J, Zhang J, Li Y, Du L, Li Z, Lei F, Wing YK, Kushida CA, Zhou D, Tang X. Gender differences in REM sleep behavior disorder: a clinical and polysomnographic study in China. Sleep Med. 2015;16:414–8.

    Article  Google Scholar 

  20. Mahale RR, Yadav R, Pal PK. Rapid eye movement sleep behaviour disorder in women with Parkinson’s disease is an underdiagnosed entity. J Clin Neurosci. 2016;28:43–6.

    Article  Google Scholar 

  21. Bodkin CL, Schenck CH. Rapid eye movement sleep behavior disorder in women: relevance to general and specialty medical practice. J Womens Health (Larchmt). 2009;18:1955–63.

    Article  Google Scholar 

  22. Tribl GG, Trindade MC, Bittencourt T, Lorenzi-Filho G, Cardoso Alves R, Ciampi de Andrade D, Fonoff ET, Bor-Seng-Shu E, Machado AA, Schenck CH, et al. Wilson’s disease with and without rapid eye movement sleep behavior disorder compared to healthy matched controls. Sleep Med. 2016;17:179–85.

    Article  Google Scholar 

  23. Litwin T, Gromadzka G, Czlonkowska A. Gender differences in Wilson’s disease. J Neurol Sci. 2012;312:31–5.

    Article  CAS  Google Scholar 

  24. Vale TC, Fernandes do Prado LB, do Prado GF, Povoas Barsottini OG, Pedroso JL. Rapid eye movement sleep behavior disorder in paraneoplastic cerebellar degeneration: improvement with immunotherapy. Sleep. 2016;39:117–20.

    Article  Google Scholar 

  25. Iranzo A, Graus F, Clover L, Morera J, Bruna J, Vilar C, Martinez-Rodriguez JE, Vincent A, Santamaria J. Rapid eye movement sleep behavior disorder and potassium channel antibody-associated limbic encephalitis. Ann Neurol. 2006;59:178–81.

    Article  Google Scholar 

  26. Teman PT, Tippmann-Peikert M, Silber MH, Slocumb NL, Auger RR. Idiopathic rapid-eye-movement sleep disorder: associations with antidepressants, psychiatric diagnoses, and other factors, in relation to age of onset. Sleep Med. 2009;10:60–5.

    Article  Google Scholar 

  27. Borek LL, Kohn R, Friedman JH. Phenomenology of dreams in Parkinson’s disease. Mov Disord. 2007;22:198–202.

    Article  Google Scholar 

  28. Valli K, Frauscher B, Peltomaa T, Gschliesser V, Revonsuo A, Hogl B. Dreaming furiously? A sleep laboratory study on the dream content of people with Parkinson’s disease and with or without rapid eye movement sleep behavior disorder. Sleep Med. 2015;16:419–27.

    Article  Google Scholar 

  29. Tatman JE, Sind JM. REM behavior disorder manifests differently in women and men. Sleep Res. 1996;25:380.

    Google Scholar 

  30. Comella CL, Nardine TM, Diederich NJ, Stebbins GT. Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson’s disease. Neurology. 1998;51:526–9.

    Article  CAS  Google Scholar 

  31. Fernandez-Arcos A, Iranzo A, Serradell M, Gaig C, Santamaria J. The clinical phenotype of idiopathic rapid eye movement sleep behavior disorder at presentation: a study in 203 consecutive patients. Sleep. 2016;39:121–32.

    Article  Google Scholar 

  32. Mattarozzi K, Bellucci C, Campi C, Cipolli C, Ferri R, Franceschini C, Mazzetti M, Russo PM, Vandi S, Vignatelli L, et al. Clinical, behavioural and polysomnographic correlates of cataplexy in patients with narcolepsy/cataplexy. Sleep Med. 2008;9:425–33.

    Article  Google Scholar 

  33. Chou KL, Moro-De-Casillas ML, Amick MM, Borek LL, Friedman JH. Testosterone not associated with violent dreams or REM sleep behavior disorder in men with Parkinson’s. Mov Disord. 2007;22:411–4.

    Article  Google Scholar 

  34. Sawada H, Ibi M, Kihara T, Urushitani M, Akaike A, Shimohama S. Estradiol protects mesencephalic dopaminergic neurons from oxidative stress-induced neuronal death. J Neurosci Res. 1998;54:707–19.

    Article  CAS  Google Scholar 

  35. McEwen BS, Alves SE. Estrogen actions in the central nervous system. Endocr Rev. 1999;20:279–307.

    PubMed  CAS  Google Scholar 

  36. Schwarz PB, Yee N, Mir S, Peever JH. Noradrenaline triggers muscle tone by amplifying glutamate-driven excitation of somatic motoneurones in anaesthetized rats. J Physiol. 2008;586:5787–802.

    Article  CAS  Google Scholar 

  37. Iranzo A, Santamaria J, Vilaseca I, de Osaba MJ. Absence of alterations in serum sex hormone levels in idiopathic REM sleep behavior disorder. Sleep. 2007;30:803–6.

    Article  Google Scholar 

  38. McCarter SJ, St Louis EK, Boeve BF, Sandness DJ, Silber MH. Greatest rapid eye movement sleep atonia loss in men and older age. Ann Clin Transl Neurol. 2014;1:733–8.

    Article  Google Scholar 

  39. Stefani A, Gabelia D, Mitterling T, Poewe W, Hogl B, Frauscher B. A prospective video-polysomnographic analysis of movements during physiological sleep in 100 healthy sleepers. Sleep. 2015;38:1479–87.

    Article  Google Scholar 

  40. Iranzo A, Fernandez-Arcos A, Tolosa E, Serradell M, Molinuevo JL, Valldeoriola F, Gelpi E, Vilaseca I, Sanchez-Valle R, Llado A, et al. Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients. PLoS One. 2014;9:e89741.

    Article  CAS  Google Scholar 

  41. Schenck CH, Lee SA, Bornemann MA, Mahowald MW. Potentially lethal behaviors associated with rapid eye movement sleep behavior disorder: review of the literature and forensic implications. J Forensic Sci. 2009;54:1475–84.

    Article  Google Scholar 

  42. Ingravallo F, Schenck CH, Plazzi G. Injurious REM sleep behaviour disorder in narcolepsy with cataplexy contributing to criminal proceedings and divorce. Sleep Med. 2010;11:950–2.

    Article  Google Scholar 

  43. Zhou J, Liang B, Du L, Tan L, Tang X. A patient with childhood-onset aggressive parasomnia diagnosed 50 years later with idiopathic REM sleep behavior disorder and a history of sleepwalking. Clin Neurol Neurosurg. 2017;160:105–7. https://doi.org/10.1016/j.clineuro.2017.07.001.

    Article  Google Scholar 

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Note Added in Proof:

Equal RBD gender ratio was recently found in the first general population-based study of PSG-confirmed RBD (in contrast to male gender predominance in RBD patients presenting to sleep clinics): Haba-Rubio J, Frauscher B, Marques-Vidal P, et al. Prevalence and determinants of REM sleep behavior disorder in the general population. Sleep 2017; doi: 10.1093/sleep/zsx197.

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Authors and Affiliations

  1. Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA

    Cynthia L. Bodkin

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  1. Cynthia L. Bodkin
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Correspondence to Cynthia L. Bodkin .

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Editors and Affiliations

  1. Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, University of Minnesota Medical School and Hennepin County Medical Center, Minneapolis, MN, USA

    Carlos H. Schenck

  2. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Birgit Högl

  3. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Aleksandar Videnovic

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Bodkin, C.L. (2019). RBD: Gender Implications. In: Schenck, C., Högl, B., Videnovic, A. (eds) Rapid-Eye-Movement Sleep Behavior Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-90152-7_16

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  • DOI: https://doi.org/10.1007/978-3-319-90152-7_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90151-0

  • Online ISBN: 978-3-319-90152-7

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