Wednesday, June 28, 2017

Strange Dreams and Alzheimer’s Prediction

Does your loved one act out dreams in their sleep? Besides being a dangerous sleep syndrome, REM Sleep Disorder may be a predictor of Alzheimer’s disease. A new study out of the University of Toronto shows that as many as 80-90% of seniors who have REM Sleep Disorder eventually develop brain disease.

What is REM Sleep Disorder?

People who physically act out their dreams while asleep are five times more likely to develop dementia, researchers have found. Moving around, walking, talking or hitting out while asleep is the strongest predictor they might develop Alzheimer's or dementia with Lewy bodies – the second most common form of dementia in the elderly after Alzheimer's.

Another example would be unconsciously mimicking the action of holding a steering wheel while dreaming about driving a car.

Physically acting out dreams is a condition known as rapid eye movement (REM) sleep behavior disorder.

Rapid Eye Movement (REM) Sleep Disorder is a type of behavioral disease that occurs during the REM sleep cycle. People who have REM Sleep Disorder lose paralysis during their sleep, which enables them to physically act out their dreams. The behaviors can be violent and can include grabbing, jumping out of bed, screaming, kicking and punching, and can, in some cases, cause injury to themselves or their partner. However, REM Sleep Disorder is usually treatable with medication.

How do you know if you have REM sleep behavior disorder? Oh, you’ll know. People with REM sleep behavior disorder act out their dreams, often hitting, kicking, yelling, screaming, or leaping out of bed during the REM phase of sleep.

If you have REMBD, you might find yourself grabbing or punching your sleeping companion (to the point of hurting them), or falling completely out of bed.

And while REMBD (also called REM behavior disorder, and alternatively abbreviated RBD, REMSBD, and REMBD) is often confused with sleepwalking, it’s not the same thing.

The easiest way to tell the difference: sleepwalkers have a hard time waking up, and are groggy and confused when you wake them up. Those with REMBD, on the other hand, pop awake completely alert and conscious of what they were doing. Also, when you sleepwalk you typically don’t remember your dream clearly, while if you have REMBD you usually remember exactly what you were doing and why.

Sleep occurs in five distinct phases, the fifth of which is REM, the sleep stage in which you’re most likely to dream. REM sleep is also the most active sleep phase, when you may find yourself twitching or tossing. However normally during REM sleep your brain sends a signal temporarily paralyzing your muscles. So even when you dream you’re running away from a criminal, for example, your legs don’t move. However, in people with REM sleep behavior disorder, this paralysis ceases to occur.

REMBD is most common in older men - 90 percent of people who develop it are male, and most are over the age of 50. Scientists already knew REMBD was associated with certain brain disorders, such as Parkinson’s; research has shown that approximately 30 percent of people diagnosed with REMBD will develop Parkinson’s within three years.

However previous studies have not found such an extreme correlation as the latest research; 80 to 90 percent is a large percentage.

Alzheimer’s and REM Sleep Disorder

A new study from the University of Toronto claims that REM Sleep Disorder is not only inconvenient and possibly violent, but it is also the best current predictor of Alzheimer’s and Parkinson’s disease.

Researchers evaluated over 700 older adults who did not have any known form of dementia. Through their research, they found that those seniors who had sleep fragmentation (i.e. REM Sleep Disorder) were more likely to develop Alzheimer’s and have a faster rate of cognitive decline than those who had healthy sleep habits.

Associate Professor and lead author on the study Dr. John Peever said, “Rapid-eye-movement sleep behavior disorder (RBD) is not just a precursor but also a critical warning sign of neurodegeneration that can lead to brain disease. In fact, as many as 80%-90% of people with RBD will develop a brain disease.”

Researchers think that cognitive decline may affect the areas of the brain that control sleep first which would explain the strong link between sleep disorders and Alzheimer’s disease. Peever hopes that clinicians will recognize REM Sleep Disorder as an indication of a cognitive issue so that diagnosis can occur earlier.

Researchers at the Mayo Clinic, in the U.S., also found that men with the condition are five times more likely to develop different forms of dementia than those who display other risk factors currently used to make the diagnosis, such as hallucinations.

Researchers at Mayo Clinic in Minnesota and Florida examined magnetic resonance imaging (MRI) scans of the brains of 75 patients diagnosed with probable dementia with Lewy bodies.

The researchers then checked the patients' histories to see if the sleep disorder had been diagnosed in them while they were under Mayo care.

‘While it is, of course, true that not everyone who has this sleep disorder develops dementia with Lewy bodies, as many as 75 to 80 per cent of men with dementia with Lewy bodies in our Mayo database did experience REM sleep behavior disorder,' said lead investigator Dr Melissa Murray, a neuroscientist at Mayo Clinic. 'So it is a very powerful marker for the disease.'

She added that the study's findings could improve the diagnosis of this form of dementia and that this can lead to better treatment.

‘Screening for the sleep disorder in a patient with dementia could help clinicians diagnose whether they are suffering from dementia with Lewy bodies or Alzheimer's disease,’ she says.

‘It can sometimes be very difficult to tell the difference between these two dementias, especially in the early stages, but we have found that only two to three per cent of patients with Alzheimer's disease have a history of this sleep disorder.’

The Importance of Sleep in Preventing Alzheimer’s Disease

The strong link between unhealthy sleep habits and Alzheimer’s is no secret. A study last year showed that sleep is just as important as diet and exercise when it comes to leading a healthy life. The study showed that when a person is asleep, their body filters out Alzheimer’s causing beta-amyloid proteins, and that lack of sleep can actually lead to Alzheimer’s disease.

Another recent study showed that sleep disruption can be an early symptom of Alzheimer’s. The study proved that the internal clock on Alzheimer’s patients still functions properly but that there is something else going on in the brain to make patients sleep and wake randomly.

How to Deal?

Once you’re diagnosed with REMBD, the usual treatment is a muscle relaxant such as clonazepam (Clomid or Klonopin). However, this new research suggests it’s a good idea for anyone diagnosed with REMBD to have a complete workup for Parkinson’s, Alzheimer’s, dementia, and other brain disorders.

Medications are available for many of these conditions that can delay or slow progression of the disease when taken early enough, so REMBD could serve as an alert to do so.

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