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    parkinsons and rbd
    An_249572 posted:
    I would be curious to know how many Parkinson's patients have had REM sleep behavior disease (RBD) before their diagnosis of Parkinson's? And if so, how long before?
    minnie1 responded:
    I started having these dreams about 3 years before I was
    diagnosed with PD
    Mark A Stacy, MD replied to minnie1's response:
    Dear An_349572 and minnie1,
    RBD is seen in about 10% of PD patients, and often these vivid dreams are present prior to the onset of motor symptoms. These symptoms often respond to medications like clonazepam, but a sleep study would be important to make sure the vivid dreaming is from RBD, and not other causes - linked to sleep deprivation, such as Sleep Apnea.
    lables30 replied to Mark A Stacy, MD's response:
    Dr Stacy,

    I am hoping you can answer a couple questions for me. I was recently diagnose with RBD and I am 30. I am concerned about the possibility of developing Parkinson's Disease later in life. All of the studies indicating a correlation between RBD and PD seemed to use subjects over the age of 60 years old.

    1) Are there studies of younger individuals with RBD that later developed PD?

    2) Is there a reason only older adults were studied? Is there any reason to think younger people with RBD are more or less likely to develop PD?

    Thank you for any information or assistance in this matter. As it is a rare disorder, my sleep MD doesn't seem to know the answers to these questions.

    Mark A Stacy, MD replied to lables30's response:
    Dear Lee,
    You are correct that RBD association with PD, is in a older aged cohort - which I think is good for you. I also cannot answer your concern about whether you are at increased risk for PD, but my guess: not likely to increase your risk.

    Study of the older group is because that is the population. I searched pubmed to see if there is a better answer. Below is the best I could do.

    Sleep Med. 2011 Mar;12(3):278-83. doi: 10.1016/j.sleep.2010.07.022. Epub 2011 Feb 12.
    Changing demographics in REM sleep behavior disorder: possible effect of autoimmunity and antidepressants.
    Ju YE, Larson-Prior L, Duntley S.
    Washington University Multidisciplinary Sleep Medicine Center, USA.
    Rapid eye movement (REM) sleep behavior disorder (RBD) has been described predominantly in elderly men and in association with neurodegenerative disease. But an increasing proportion of cases in recent reports and in clinical practice do not fit this description; thus we sought to describe a current RBD population and possibly identify new subgroups with RBD.
    Records of 115 consecutive patients with polysomnogram-confirmed RBD at an academic sleep center were retrospectively reviewed.
    Male to female ratio was 2:1, and 1.25:1 for early-onset (age <50) cases. Mean age at diagnosis was 53.7?16.4years. Most (60%) cases were idiopathic, and neurodegenerative disease was coincident primarily in older men. Autoimmune disease was unexpectedly common in women (20%) particularly in the 30-49 age groups (40%). Antidepressant use was frequent (46.1%), especially in early-onset cases (57.8%).
    RBD is diagnosed more equally between men and women and in younger individuals than previously reported. While neurodegenerative disease is frequently co-incident with RBD in older men, most women and early-onset cases have "idiopathic" RBD. High prevalence of autoimmune disease among women with RBD suggests an intriguing link between immune dysfunction and RBD. A high rate of antidepressant use provides support for a potentially causal role for antidepressants in RBD.
    lables30 replied to Mark A Stacy, MD's response:
    Dr. Stacy,

    Thank you so much for your informative response! It makes me feel so much better to have clarity on that issue!

    You can add me to the list of people with young-onset RBD (I am 30 and have exhibited symptoms for over 10 years), that are associated with anti-depressants. I took anti-depressants in high school and college, and now have RBD. I hope you can get enough research to turn "associated" into "definitive causal role."

    Let me know if I can be of any help to your RBD research.

    Mark A Stacy, MD replied to lables30's response:
    Thank you for your kind words. Sleep well!

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