title: Characteristics of REM sleep behavior disorder in childhood.
abstract: OBJECTIVE
  To describe our experience regarding the clinical and polysomnographic features of REM sleep behavior disorder (RBD) in childhood.
  
  
  METHODS
  This was a retrospective chart review of children and adolescents with RBD and REM sleep without atonia. Demographics, and clinical and polysomnographic information were tabulated. Our findings were compared with those in the existing literature.
  
  
  RESULTS
  The 15 subjects identified (13 RBD and 2 having REM sleep without atonia) had a mean age at diagnosis of 9.5 years (range 3-17 years); 11/15 (73%) were male. Nightmares were reported in 13/15 and excessive daytime sleepiness in 6/15. Two children had caused bodily harm to bedmate siblings. Comorbidities, which were multiple in some subjects, included anxiety (8/15), attention deficit disorder (10/15), nonspecific developmental delay (6/15), Smith-Magenis syndrome (1/15), pervasive developmental disorder (1/15), narcolepsy (1/15), idiopathic hypersomnia (1/15), and Moebius Syndrome (1/15). Abnormal MRI scans were seen in 5/8 evaluated subjects. Treatments consisted of clonazepam (10/15), melatonin (2/15), and discontinuation of a tricyclic agent (1/15), with a favorable response in 11 of 13. Two of 15 patients with REM sleep without atonia did not require pharmacotherapy.
  
  
  CONCLUSIONS
  RBD in children may be associated with neurodevelopmental disabilities, narcolepsy, or medication use. It seems to be modestly responsive to benzodiazepines or melatonin. The etiology is distinct from that of common childhood arousal parasomnias and RBD in adults; congenital and neurodevelopmental disorders, medication effect, and narcolepsy coexisted in some, but none had an extrapyramidal neurodegenerative disorder.
authors.affiliation: Center for Sleep Medicine and the Departments of Pediatrics and Neurology, Mayo Clinic, Rochester, MN 55905, USA. lloyd.robin @mayo.edu
authors.forename: Robin
authors.initials: R
authors.lastname: Lloyd
authors.forename: Maja
authors.initials: M
authors.lastname: Tippmann-Peikert
authors.forename: Nancy
authors.initials: N
authors.lastname: Slocumb
authors.forename: Suresh
authors.initials: S
authors.lastname: Kotagal
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology; D004569:Electroencephalography; D006801:Humans; D008297:Male; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012895:Sleep, REM / Q000502:physiology