Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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A Review on Sleep Disorders Similar to REM Sleep Behavior Disorder

렘수면 행동장애 유사 수면장애에 대한 고찰

  • Eunyoung, Lee (Department of Psychiatry, Veteran Health Service Medical Center) ;
  • Jihye, Song (Department of Psychiatry, Veteran Health Service Medical Center) ;
  • Heewon, Bae (Veterans Medical Research Institute, Veteran Health Service Medical Center) ;
  • Hayun, Choi (Department of Psychiatry, Veteran Health Service Medical Center)
  • 이은영 (중앙보훈병원 정신건강의학과 ) ;
  • 송지혜 (중앙보훈병원 정신건강의학과 ) ;
  • 배희원 (중앙보훈병원 보훈의학연구소) ;
  • 최하연 (중앙보훈병원 정신건강의학과 )
  • Received : 2022.12.14
  • Accepted : 2022.12.22
  • Published : 2022.12.31
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Abstract

REM sleep behavior disorder is parasomnia characterized by unpleasant dreams and dream-enactment behaviors associated with excessive electromyography activity in REM sleep. This may appear idiopathic or secondary to other neurological or medical conditions. REM sleep behavior disorder, which appears to be idiopathic, most often implies the possibility of later neurodegenerative diseases due to synucleinopathy, so accurate diagnosis is important in predicting prognosis. For the diagnosis of REM sleep behavioral disorder, REM sleep without atonia, which appears in the polysomnography, is essential. Obstructive sleep apnea, trauma-related sleep disorders, and vigorous periodic leg movements during sleep are known as diseases that show dream enactment behavior in elderly patients. Considering that it may be accompanied by other sleep disorders that can mimic REM sleep behavioral disorders, it is important to differentiate sleep

렘수면 행동장애는 렘수면에서 과도한 근전도 활동과 관련된 불쾌한 꿈과 격렬한 행동이 특징인 사건수면이다. 이는 특발성으로 나타날 수 있고, 다른 신경학적 또는 의학적 상태에 이차적으로 나타날 수 있는 등 여러 이질적인 기저 질환이 있을 수 있다. 특발성으로 나타나는 렘수면 행동장애는 대부분 시누클레인 병증으로 인한 신경퇴행성 질환이 나타날 가능성을 의미하므로, 정확한 진단이 예후를 예측하는데 중요하다. 렘수면 행동장애의 진단을 위해서는 수면다원검사에서 나타나는 무긴장증이 없는 렘수면이 필수적이다. 노인 환자에서 수면 중 꿈을 꾸면서 행동을 보이는 질환으로는 폐쇄성 수면 무호흡증, 외상 관련 수면 장애, 수면 중 격렬한 주기적인 다리 운동 등이 알려져 있다. 렘수면 행동장애를 모방할 수 있는 다른 수면장애가 동반되어 나타날 수 있음을 고려하여 신중한 병력 청취와 수면다원검사 등을 이용하여 수면장애의 감별 진단 및 치료가 중요하겠다.

Keywords

Acknowledgement

본 연구는 보건복지부의 재원으로 한국보건산업진흥원의 보건의료기술연구개발사업 지원에 의하여 이루어진 것임(과제고유번호 HI21C0852).

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