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Sleep Disorder Could Signal Neurological Disease

By Tate Gunnerson
HealthDay Reporter

People with a disorder that causes them to kick or cry out during deep sleep are more likely to develop dementia or Parkinson's disease, a new Canadian study suggests.

"It's basically a disorder where you act out your dreams at night," explained study author Dr. Ronald B. Postuma, of McGill University in Montreal. "When people who have RBD [REM Sleep Behavior Disorder] dream they are in a fight, which is very common, they will make punching movements."

Researchers followed 93 RBD patients and examined them after five, 10 and 12 years for signs of neurological disorders such as dementia or Parkinson's disease. After 12 years, researchers found the majority of people with RBD developed either dementia or Parkinson's, with 26 developing neurodegenerative disease, 15 developing Parkinsons and 11 developing dementia.

"These disorders happen to 1 to 2 percent of the general population in their entire lives, so 50 percent at 12 years is much, much higher," Postuma said. His report was published in the Dec. 24 online issue of Neurology.

While sleep disorders are common, researchers emphasized that the majority are due to the stress of modern life and will not necessarily lead to neurological diseases.

"Half the population has a sleep problem, but most of the time, they're benign," said Michael Jakowec, an assistant professor of neurology at George and Mary Lou Boone Parkinson's Disease and Movement Disorders Research Center at the University of Southern California Keck School of Medicine. "We live in a society with anxiety, stress, late night TV and cappucinos."

"It's important to point out that this is a relatively dramatic disorder that comes on in your 50s and 60s, so it's not something that happens once in awhile your entire life," Postuma explained. "A little bit of sleep talking or waking up a little confused and then falling back asleep again are normal things that happen in the population."

Researchers hope that identifying those at risk for these diseases will help them develop new treatments to either slow or possibly even halt their progression.

"The main thing is to see if we can predict which of these people with RBD are going to get a disease and which are not," said Postuma. "We don't have ways to prevent those diseases now, but maybe that's because by the time a person has these diseases, it's too late to intervene."

"Unfortunately, we live in a society that doesn't do very much in terms of preventive medicine, but this may be one of those things where we do know there are lots of factors that can modify disease progression, so let's intervene now," said Jakowec. "Let's get you into things that we believe are protective against some of these diseases, such as changes in diet or lifestyle, which may add quite a few years of quality life to a patient."

"Everybody who has strong signs of REM sleep behavior disorder should probably be evaluated and probably be followed by a neurologist to make sure that everything's OK and to pick up early signs," Postuma said.

More information

For more on REM Sleep Behavior Disorder, go to Washington University.

SOURCES: Ronald B. Postuma, M.D., department of neurology, McGill University, Montreal, Quebec, Canada; Michael Jakowec, assistant professor, neurology, George and Mary Lou Boone Parkinson's Disease and Movement Disorders Research Center, University of Southern California Keck School of Medicine, Los Angeles; Dec. 24, 2008, Neurology, online.


PDF Interprets: Sleep Disorder May Predict Parkinson’s Risk

 A study published online in the journal Neurology found that about half of people diagnosed with REM sleep behavior disorder developed a neurodegenerative disease, most commonly Parkinson’s disease (PD), within 12 years.

People with REM sleep behavior disorder (RBD) kick, punch, or cry out as they act out their dreams, which are often vivid and violent.  This dramatic sleep disorder, long associated with Parkinson’s, tends to affect people in their 50s or 60s.  The new study is the largest to attempt to quantify the risk of developing neurodegenerative disease for people with RBD. 

Lead researcher Ronald B. Postuma, M.D. and his colleagues followed the health status of 93 people diagnosed with RBD between 1989 and 2006 at the Hôpital du Sacré Coeur in Montreal, Canada.  The patients were on average 65 years old.  During the course of the study, 26 went on to develop a neurodegenerative disease.  14 of these were diagnosed with classic Parkinson’s, while seven were defined as having Lewy body dementia, and four met all criteria for Alzheimer’s disease.  The scientists estimate that 12 years after a diagnosis of RBD, the risk of developing neurodegenerative disease is about 52 percent.  In the general population only one to two percent of people develop these diseases during their lifetime.

Further research is needed to better understand the relationship between RBD and Parkinson’s, knowledge which may help researchers find ways to predict which people with RBD will develop PD and to test treatments that may prevent the disease or slow its progression.

Source Date: Dec 26 2008
Source Publication: Washington Post: HealthDay News
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