J Korean Sleep Res Soc.  2013 Dec;10(2):62-65.

Two Cases of REM Sleep Behavior Disorder Combined with Severe Obstructive Sleep Apnea: Misdiagnosed as "Pseudo-REM Sleep Behavior Disorder" by Diagnostic Polysomnography

• Jang HJ
• Kim B
• Ryu HS
• Lee GH
• Lee SA

Abstract

REM sleep behavior disorder (RBD) is a sleep disorder characterized by loss of normal voluntary muscle atonia during REM sleep associated with complex motor behavior while dreaming. Dream-enacting behaviors can also occur in patients with other sleep disorders such as obstructive sleep apnea (OSA). This clinical situation has been termed "pseudo-RBD". In contrast, OSA causes frequent arousal, which may consequently result in masking of RBD symptoms. We reported two patients with severe OSA, who were initially diagnosed with "pseudo-RBD" but on continuous positive airway pressure (CPAP) titration, rediagnosed with "true-RBD". When RBD is clinically suspected but is not confirmed by diagnostic overnight polysomnography, we have to keep in mind that RBD could be detected during CPAP titration.

Keyword

REM sleep behavior disorder; Pseudo-REM sleep behavior disorder; Obstructive sleep apnea; REM sleep without atonia

MeSH Terms

Arousal
Continuous Positive Airway Pressure
Dreams
Humans
Masks
Muscle, Skeletal
Polysomnography*
REM Sleep Behavior Disorder*
Sleep Apnea, Obstructive*
Sleep Wake Disorders
Sleep, REM*