Obstructive Sleep Apnea and REM Sleep Behavior Disorder

Introduction to OSA and RBD

Vigorous arousals during respiratory events in OSA can produce behaviors that clinically resemble RBD, with patients exhibiting dream-enactment behaviors and unpleasant dreams, according to the American Academy of Sleep Medicine 1
RBD often heralds neurodegenerative disorders, particularly synucleinopathies, as stated by the American Academy of Sleep Medicine 1
OSA has significant cardiovascular and metabolic consequences if left untreated, as reported by the American Geriatrics Society 2

A comprehensive sleep evaluation is essential when OSA is suspected, to identify or exclude other comorbid sleep complaints, as recommended by the American Academy of Sleep Medicine 3
Polysomnography is mandatory to establish the diagnosis of RBD and identify or exclude other causes of dream-enacting behaviors, according to the American Academy of Sleep Medicine 1
The STOP-BANG questionnaire can help screen for OSA, while specific questions about dream enactment behaviors can help identify possible RBD, as suggested by the European Urology association 4

If RBD is confirmed, referral to neurology is recommended, particularly given the association with neurodegenerative disorders, as advised by the European Urology association 4