Temporal distribution of electromyographic activity and behaviors in REM sleep in patients with isolated REM sleep behavior disorder

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-09-17 DOI:10.1016/j.sleep.2025.106805

Nathalie Mariño , Mónica Serradell , Gerard Mayà , Angelica Montini , Nuria Matos , Claustre Pont-Sunyer , Karol Uscamaita , Paula Marrero-González , Oriol de Fabregues , Mariateresa Buongiorno , Desiree Muriana , Carles Gaig , Alex Iranzo

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引用次数: 0

Abstract

Background

REM sleep behavior disorder (RBD) is characterized by excessive electromyographic (EMG) activity and abnormal behaviors in REM sleep. We aimed to examine the temporal distribution of EMG activity and behaviors in REM sleep in isolated RBD (IRBD) to better understand its nocturnal REM sleep circadian dynamics.

Methods

We examined the EMG activity in the mentalis and flexor digitorum superficialis muscles plus the clinical manifestations occurring in the first (from 11.00 p.m. to 3.00 a.m.) and last (from 3.01 a.m. to 7.00 a.m.) REM sleep episodes in the video-polysomnogram (V-PSG) of consecutive IRBD patients and controls without RBD.

Results

We assessed the V-PSG of 45 IRBD patients and 39 matched controls. The last REM sleep episode showed higher EMG activity than the first in both patients (p = 0.010) and controls (p = 0.024). In patients, movements and vocalizations were more frequent and severe in the last REM sleep episode than in the first, but differences were not significant. In controls, the last REM sleep episode showed more simple minor movements (p = 0.026) of mild severity (p = 0.032) than the first. In both first and last REM sleep episodes, patients showed higher EMG activity (≥0.001) and more behaviors (≥0.001) than controls. REM sleep percentage, REM sleep duration, REM sleep latency and number of REM sleep episodes were similar between patients and controls.

Conclusions

When compared to the first REM sleep episode, the last REM sleep episode shows higher EMG activity and more frequent behaviors in both patients and controls, which are greater in patients than in controls. IRBD represents a pathological overrepresentation of the temporal physiological distribution of EMG activity and behaviors in REM sleep across the night.

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孤立性快速眼动睡眠行为障碍患者快速眼动睡眠时肌电活动和行为的时间分布

REM睡眠行为障碍（RBD）以REM睡眠中过度的肌电活动和异常行为为特征。我们旨在研究孤立RBD （IRBD）在快速眼动睡眠中的肌电活动和行为的时间分布，以更好地了解其夜间快速眼动睡眠的昼夜动态。方法通过视频多导睡眠图（V-PSG）检测连续IRBD患者和非RBD对照组的脑瘫肌和指浅屈肌的肌电活动，以及第一次（晚上11点至凌晨3点）和最后一次（凌晨3点01分至7点）快速眼动睡眠发作的临床表现。结果我们评估了45例IRBD患者和39例匹配对照的V-PSG。两组患者最后一次快速眼动睡眠的肌电活动均高于第一次（p = 0.010）和对照组（p = 0.024）。在患者中，最后一次快速眼动睡眠的动作和发声比第一次更频繁和严重，但差异不显著。在对照组中，与第一次相比，最后一次快速眼动睡眠出现了更多轻微的简单运动（p = 0.026）和轻微的严重程度（p = 0.032）。在第一次和最后一次快速眼动睡眠发作中，患者的肌电图活动（≥0.001）和行为（≥0.001）均高于对照组。患者与对照组的快速眼动睡眠比例、持续时间、潜伏期及快速眼动睡眠发作次数相似。结论与第一次快速眼动睡眠期相比，最后一次快速眼动睡眠期患者和对照组均表现出较高的肌电活动和更频繁的行为，且患者明显高于对照组。IRBD代表了整个晚上REM睡眠中肌电活动和行为的时间生理分布的病理性过度表征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.