Making the diagnosis: Idiopathic rapid eye movement sleep behavior disorder

Purpose: To present a clinical case of idiopathic rapid eye movement sleep behavior disorder (RBD), differential diagnoses, selected treatments, and the pathology involved. Data sources: An Ovid data base search (covering 635 medical, neurologic, and psychiatric journals) was conducted using the search term RBD and limited to the years 2005-2009. This search strategy was used to locate clinical, research, and review articles providing the state of the science about RBD. A hand search was also conducted for seminal research papers as well as recent publications within the specialty of sleep disorders.Conclusions: RBD is a parasomnia with symptoms common to other disorders making it important to identify unique symptoms and diagnostic testing that helps differentiates these diseases. RBD can put the patient and the bed partner at risk for injury. Its prevalence is estimated to be 0.5% in older adults. Implications for practice: Nurse practitioners are primary care providers for older adults who may have complaints about behaviors associated with RBD. Knowledge of this disease process as well as its relationship with four other neurodegenerative diseases may provide an opportunity for early diagnosis and treatment of RBD and surveillance for and early diagnosis of the other neurodegenerative diseases in these patients.