수면정신생리

수면정신생리 (1권1호 99-106)

A Case of REM Sleep Behavior Disorder Confirmed with Polysomnography

수면다원기록(睡眠多元記錄)으로 확인(確認)된 급속수구운동수면(急速眼球運動睡眠) 행동장애(行動障碍) 1례(例)

Jeong, Do-Un;Yoon, In-Young;

Department of Neuropsychiatry and Division of Sleep Studies, Seoul National University Hospital;Department of Neuropsychiatry and Division of Sleep Studies, Seoul National University Hospital;

Abstract

The authors report a case of REM sleep behavior disorder which occurred in a 69-year-old business man. He began experiencing episodic 'acting out' behavior of his dream at the age of 66. The episodes tended to be associated with dream contents, mainly being chased or threatened. Before that, his sleep was relatively quiet despite occasional nightmares, midsleep arousal, and shallowness. Injuries resulted from leaping out of bed, jumping onto furnitures, and grabbing and biting the spouse''s arm. Most recent dream-incurred laceration of chin required 5 sutures. Medical and psychiatric history revealed no significant findings except that he had been overanxious all his life within himself with others'' reputation of himself as pleasant and easy-going. A nocturnal polysomnogram showed repeatedly intermittent increase of chin and/or leg muscle tones during otherwise characteristic REM sleep period. The overnight video recording revealed head lifting and limb movements during REM sleep periods. Brain MRI and EEG were normal. Job-related stress was presumed to be an etiological possibility. Clonazepam 0.25-0.5mg nightly almost completely relieved the symptoms.

Keywords

REM sleep;REM sleep behavior disorder;Polysomnography;Clonazepam;