快速動眼期睡眠行為障礙

Rapid Eye Movement Sleep Behavior Disorder

快速動眼期睡眠行為障礙症可以是一種獨立存在的疾病，也可以是繼發於其他神經系統的退化性疾病，在大多數情況之下，獨立的快速動眼期睡眠行為障礙症暗示著，由於潛在的突觸核蛋白病灶導致的神經退化性疾病(Howell MJ, et al)，因此，快速動眼期睡眠行為障礙症的臨床辨別，對於疾病的預後意義重大；多導極的睡眠腦電波圖上沒有張力的快速動眼期行為障礙，是此病的診斷黃金標準，而不同情況之下，有些疾病可能會模仿快速動眼期睡眠行為障礙症，最常見的是睡眠期間的阻塞性睡眠呼吸中止症、非快速動眼期睡眠行為障礙的異態性睡眠(異睡症)，與睡眠相關性癲癇等，這些疾病也可能與快速動眼期睡眠行為障礙症合併出現，對於診斷快速動眼期睡眠行為障礙症嚴重程度是一項挑戰，與快速動眼期睡眠行為障礙症治療的選擇和對治療的反應等，Video-PSG(Video-Polysomnography,多項生理睡眠檢查錄影)是確立診斷的黃金標準，藉此可以區分出不同的或合併的睡眠障礙症，而仔細的詢問病史和使用腕動計(actigraphy)可用來作為鑑別診斷快速動眼期睡眠行為障礙症，以及提供睡眠障礙的重要的線索。

Rapid Eye Movement (REM) sleep behavior disorder (RBD) can occur in isolation or as a secondary condition to other neurological or medical disorders. Isolated RBD is often an early indicator of a neurodegenerative condition, typically associated with underlying synucleinopathies, making its recognition critical for prognostic purposes. The presence of REM sleep without atonia on polysomnography is a mandatory diagnostic criterion for RBD. Several conditions can mimic RBD, with the most common being obstructive sleep apnea, non-REM parasomnias, and sleep-related hypermotor epilepsy. These disorders may also coexist with RBD, complicating the assessment of disease severity, treatment decisions, and evaluation of treatment response. Video-polysomnography (Video-PSG) is the gold standard for accurate diagnosis, as it can differentiate between distinct or comorbid sleep disorders. Additionally, a thorough patient history, combined with actigraphy, can provide valuable insights for differential diagnosis.