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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