REM sleep behavior disorder rhythms
REM sleep behavior disorder (RBD) is an intriguing parasomnia that is characterized by repeated dream enactment associated with increased muscle tone and twitch burst activity in REM sleep. This article explores a unique perspective on the relationship of RBD with various neurophysiological rhythms. We describe the clinical and polysomnographic characteristics of this disorder with diagnostic considerations. Arousal disorders simulating RBD, including Non REM Sleep Arousal Parasomnias, Obstructive Sleep Apnea and Periodic Limb Movement Disorder, are also described. The pathophysiological basis is discussed with reference to the physiological substrates of RBD subtypes. Periodic Leg Movements associated with RBD, Rhythmic Masticatory Muscle Activity (Sleep Bruxism) and Oromandibular Myoclonus Associated with RBD, Rhythmic Movement Disorder associated with RBD, interface of RBD with epileptic abnormalities, and sleep spindles are also elaborated upon. Correspondence to: Muna Irfan, Department of Neurology, Minnesota Regional Sleep Disorders Center and Department of Neurology, University of Minnesota, Hennepin County Medical Center, Minneapolis, USA, E mail: irfan007@umn.edu