REM sleep behavior disorder

History REM sleep behavior disorder (RBD) was first formally identified in 1986 by Schenck and Mahowald in five elderly subjects presenting similar motor behavioral patterns during REM sleep consisting of violent dream-enacting behaviors. Although there already existed anecdotal reports of similar episodes arising from REM sleep during tricyclic anti-depressant treatment and in the context of acute psychosis related to alcohol and drug abuse, Schenck and Mahowald were the first to recognize RBD as a distinct parasomnia with a clinical and polysomnographic (PSG) pattern similar to that seen 20 years earlier in animal models of RBD. In a review of their personal data and of the literature over the 16 years following the formal identification of RBD, these same authors highlighted the existence of acute and chronic, idiopathic and symptomatic forms of RBD, and also the idea that RBD may herald the onset of synucleinopathies. REM sleep behavior disorder first appeared, with clear diagnostic criteria, in the International Classification of Sleep Disorders (ICSD) in 1990. These criteria have recently been updated in the ICSD-2 2005 version, and in the American Academy of Sleep Medicine (AASM) atlas of sleep scoring. Even though RBD may occur in childhood, it generally has onset after the age of 50 years and shows a strong male prevalence. The frequency of occurrence of RBD in the general population is unknown.