Rhythmic Movement Disorder in Rapid Eye Movement Sleep in an Adult Patient Triggered by Abnormal Respiratory Events

Abstract

Rhythmic movement disorder (RMD) is usually observed in children during drowsiness. However, here we present an adult patient experiencing RMD associated with Obstructive Sleep Apnea syndrome (OSAS) during rapid eye movement (REM) sleep. A 50-year old male was admitted with a complaint of head rocking during sleep for about one year. Video-polysomnography revealed OSAS (43/hour) and RMD. Following positive airway therapy, all the symptoms related to OSAS and head rocking disappeared. Adult-onset RMD occurring in REM sleep is rare; OSAS related arousals, increased cyclic alternating pattern, and possible association with REM sleep without atonia were suggested to be the underlying reasons for the condition.