Idiopathic rapid-eye-movement sleep disorder: Associations with antidepressants, psychiatric diagnoses, and other factors, in relation to age of onset

Abstract 

Background

A retrospective, case–control chart review was performed to examine the relationship between the age of onset of idiopathic RBD and secondary associations.

Methods

Forty-eight idiopathic RBD patients were divided into early-onset and late-onset groups, compared to each other, and to their respective non-RBD controls.

Results

There were more females in the early-onset group as compared to their older counterparts (45% vs. 11%, p=0.007). Early-onset patients also had significantly more past and present psychiatric diagnoses [85% (both categories) vs. 46% and 36%, respectively, p<0.01 for both comparisons] and antidepressant use (80% vs. 46%, p=0.02) than the late-onset group. In comparison to non-RBD controls, early-onset patients again exhibited more psychiatric diagnoses (odds ratio=17.0 [3.5–83.4], equivalent for past and present diagnoses) and antidepressant use (odds ratio=12.0 [2.7–53.3]). Late-onset patients also had a higher frequency of past (odds ratio=7.2 [1.8–29.6]) and present (odds ratio=4.6 [1.1–19.3]) psychiatric diagnoses as compared to their non-RBD controls, but did not demonstrate a statistically significant difference in antidepressant use. There were otherwise no significant intergroup or intragroup differences with respect to the other assessed variables.

Conclusions

Although causality cannot be inferred, numerous implications can be entertained, particularly in the early-onset group, including direct or indirect correlations with medication use and/or psychopathology and the development of RBD. The relatively high number of females in the early-onset group suggests a unique clinical profile for a condition typically characterized as male-predominant.

Keywords: Antidepressants, Rapid-eye-movement (REM) sleep behavior disorder (RBD), Idiopathic RBD, Psychiatric diagnoses, Medications, Substances