Department of Sleep Medicine, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
Third Faculty of Medicine, Charles University, Prague, Czech Republic.
BMC Psychiatry. 2020 Oct 1;20(1):482. doi: 10.1186/s12888-020-02879-4.
Isolated REM sleep without atonia (RSWA) as a main polysomnograhic feature of REM sleep behaviour disorder (RBD) is thought to be a prodromal or subclinical state of the disease. RSWA/RBD occurence in psychiatric population is much more frequent than in general population but its associated factors are still not known.
We invited 88 psychiatry in-patients to undervent video-polysomnography. The visual scoring was focused on RSWA in submentales and flexores digitales superficiales muscles. This parametr was subsequently correlated mainly with age/gender, their medication and mental status.
The RWSA was mostly still in normal range despite the fact, that selected psychiatry patients (≤ 50 years) were taking several classes of psychoactive medication. 3,6% had convincingly RBD, although 35.7% reported rare lifetime occurence of dream-enacting behaviour and 62.8% sporadic nightmares. We found correlation between RSWA and SNRI medication class (p = 0.015), specifically venlafaxine (p = 0.029) as well as quetiapine (p = 0.030). Another significant associated factors were current anxiety (p < 0.001) and depressive symptoms (p = 0.05), but we found no relation between RSWA and given diagnosis.
Isolated RSWA in younger psychiatry patients might be a result of multiple factors, including medication and current mental status but these factors are in most cases not sufficient to manifest RBD.
孤立性 REM 睡眠无张力（RSWA）作为 REM 睡眠行为障碍（RBD）的主要多导睡眠图特征，被认为是疾病的前驱或亚临床状态。RSWA/RBD 在精神科人群中的发生率远高于普通人群，但其相关因素仍不清楚。
我们邀请了 88 名精神科住院患者进行视频多导睡眠图检查。视觉评分集中在颏下肌和指浅屈肌的 RSWA 上。该参数随后主要与年龄/性别、他们的药物治疗和精神状态相关联。
尽管选择的精神科患者（≤ 50 岁）正在服用几类精神活性药物，但 RSWA 大多仍在正常范围内。3.6%的患者有明显的 RBD，尽管 35.7%的患者报告有罕见的梦境行为发生，62.8%的患者有偶发性噩梦。我们发现 RSWA 与 SNRI 药物类别（p=0.015），特别是文拉法辛（p=0.029）和喹硫平（p=0.030）之间存在相关性。另一个显著相关的因素是当前的焦虑（p<0.001）和抑郁症状（p=0.05），但我们发现 RSWA 与给定的诊断之间没有关系。
年轻精神科患者的孤立性 RSWA 可能是多种因素的结果，包括药物和当前的精神状态，但这些因素在大多数情况下不足以表现出 RBD。
