title: The Prevalence and Characteristics of REM Sleep without Atonia (RSWA) in Patients Taking Antidepressants.
abstract: OBJECTIVE
  The association of REM sleep without atonia (RSWA) as well as REM sleep behavior disorder (RBD) with the intake of selective serotonin reuptake inhibitors (SSRI) and selective norepinephrine reuptake inhibitors (SNRI) is well established. Our study objective was to determine the prevalence of RSWA and RBD among a group of sleep center patients taking SSRI and SNRI.
  
  
  METHODS
  A retrospective chart review was done at our tertiary sleep center, and 10,746 consecutive records from October 1, 2007, through October 31, 2013, were searched for SSRI and SNRI names using the Sleep Cataloguer Software.
  
  
  RESULTS
  The search resulted in 1,444 records, which were then reviewed for keywords of RSWA and RBD. The AASM scoring criteria were used to determine RSWA. Reports of 41 patients with known narcolepsy or α-synucleinopathies were excluded. The remaining records were mined for age, sex, presence of obstructive sleep apnea (OSA), type of antidepressant (SSRI or SNRI), and diagnosis for which antidepressant was prescribed. We used logistic regression analysis to adjust for age, OSA, and sex. Of the 1,444 participants on antidepressants, 176 (12.2%) had RSWA (all confirmed by the investigators) compared to 226 of the entire sleep lab population of 10,746 (2.1%), risk ratio (95% CI) 9.978 (8.149, 12.22). Seven of the 176 patients on antidepressants had RBD (0.48%) compared to 108 of 10,746 (1%), p = 0.005.
  
  
  CONCLUSIONS
  SSRI and SNRI are associated with a higher prevalence of RSWA but not of RBD. This is independent of medication type.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lee
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Kelly
authors.initials: K
authors.lastname: Baron
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Soca
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Hrayr
authors.initials: H
authors.lastname: Attarian
mesh_terms: D000928:Antidepressive Agents / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009123:Muscle Hypotonia; D017286:Polysomnography; D015995:Prevalence; D020187:REM Sleep Behavior Disorder / Q000139:chemically induced* / Q000503:physiopathology; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000494:pharmacology*; D012895:Sleep, REM / Q000187:drug effects* / Q000502:physiology
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors
keywords: REM sleep behavior disorder; REM sleep without atonia; antidepressants; selective serotonin reuptake inhibitors