ABSTRACT
Rhythmic movement disorder (RMD) is usually observed in children during drowsiness. However, here we present an adult patient experiencing RMD associated with Obstructive Sleep Apnea syndrome (OSAS) during rapid eye movement (REM) sleep. A 50-year old male was admitted with a complaint of head rocking during sleep for about one year. Video-polysomnography revealed OSAS (43/hour) and RMD. Following positive airway therapy, all the symptoms related to OSAS and head rocking disappeared. Adult-onset RMD occurring in REM sleep is rare; OSAS related arousals, increased cyclic alternating pattern, and possible association with REM sleep without atonia were suggested to be the underlying reasons for the condition.
Keywords:
Sleep-related rhythmic movement disorders, REM sleep stage, Obstructive Sleep Apnea syndrome
References
1
American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.
2
Kohyama J, Matsukura F, Kimura K, Tachibana N. Rhythmic movement disorder: polysomnographic study and summary of reported cases. Brain Dev 2002;24:33-8.
3
Manni R, Terzaghi M. Rhythmic movements during sleep: a physiological and pathological profile. Neurol Sci 2005;26(Suppl 3):181-5.
4
Mayer G, Wilde-Frenz J, Kurella B. Sleep related rhythmic movement disorder revisited. J Sleep Res 2007;16:110-6.
5
Lucey BP, Molin CJ. A patient with rhythmic movements during REM sleep. Narcolepsy with cataplexy associated with sleep-relatedrhythmic movements. J Clin Sleep Med 2013;9:620-3.
6
DelRosso LM, Liegmann J. Unusual rhythmic movements during sleep. Ann Am Thorac Soc 2013;10:704-7.
7
Stepanova I, Nevsimalova S, Hanusova J. Rhythmic Movement Disorder in Sleep Persisting Into Childhood and Adulthood. Sleep 2005;28:851-7.
8
Kempenaers C, Bouillon E, Mendlewicz J. A rhythmic movement disorder in REM sleep: a case report. Sleep 1994;17:274-9.
9
Kaneda R, Furuta H, Kazuto K, Arayama K, Sano J, Koshino Y. An Unusual Case of Rhythmic Movement Disorder. Psychiatry Clin Neurosci 2000;54:348-9.
10
Winkelman JW, James L. Serotonergic antidepressants are associated with REM sleep without atonia. Sleep 2004;27:317-21.
