The Link Between Parkinson’s Disease and REM Sleep Behavior Disorder: Exploring the Telltale Sleep Disorder

2023-10-03 22:09:11
Parkinson’s disease: telltale sleep disorder – spectrum of science

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Parkinson’s disease: telltale sleep behavior

Most people barely move while they dream. But anyone who thrashes around wildly in their sleep has an increased risk of developing a neurodegenerative disease.

© pcruciatti / Getty Images / iStock (detail)

At a glance

Moving dreams as harbingers

During REM sleep, most people are temporarily paralyzed. This REM atony prevents us from living out our dreams.

However, in around one percent of adults, especially older ones, this process is disrupted. During their sleep they occasionally carry out movements that they are dreaming about.

Those affected have a greatly increased risk of later developing Parkinson’s disease or a similar neurodegenerative disease.

Alan Alda ran for his life. However, the actor, who played a leading role in the television series “M*A*S*H” in the 1970s and 1980s, was not on set. The threat was real – at least that’s how it felt to him. When he saw a sack of potatoes in front of him, he grabbed it and threw it towards the pursuer. Then the scene suddenly changed. Alda found himself in his bedroom, wide awake. The supposed potato sack was a pillow that he had just thrown at his wife.

When people live out their dreams in this way, they may have REM sleep behavior disorder. This is a parasomnia – a behavioral disorder that occurs during sleep or during the sleep-wake transition. In this case it affects the REM phase (REM stands for “rapid eye movements”). This is the phase of sleep that we commonly associate with dreams. Normally people are almost completely immobile; In the healthy brain, certain mechanisms prevent us from carrying out dream actions. In people with REM sleep behavior disorder, these brakes are loosened. An estimated 0.5 to 1.25 percent of the general population is affected. Parasomnia occurs more frequently in older adults, especially men.

REM sleep behavior disorder not only poses a risk of injury for dreamers and their partners. According to a growing number of studies, it can precede a neurodegenerative disease. Synucleinopathies in particular, in which the protein a-synuclein forms toxic clumps in the brain, are more common among restless sleepers. The connection is strongest with Parkinson’s disease…

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The author is a journalist for medicine and life sciences. She lives in Berlin.

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Högl, B. et al.: Rapid eye movement sleep behaviour disorder: Past, present, and future. Journal of Sleep Research 31, 2022

Iranzo, A. et al.: Detection of α-synuclein in CSF by RT-QuIC in patients with isolated rapid-eye-movement sleep behaviour disorder: A longitudinal observational study. Lancet Neurology 20, 2021

Schenck, C. H. et al.: Delayed emergence of a parkinsonian disorder or dementia in 81% of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: A 16-year update on a previously reported series. Sleep Medicine 14, 2013

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