@article{ref1,
title="Violent behaviour during sleep",
journal="CMAJ : Canadian Medical Association journal",
year="2023",
author="Cuperfain, Ari B. and Chang, Brian Po-Yen and Mak, Michael",
volume="195",
number="27",
pages="E932-E932",
abstract="Rapid eye movement (REM) sleep behaviour disorder (RBD) causes dream enactment behaviours such as vocalizations and motor actions, which can be violent  Patients who report a history of injuries to themselves (e.g., falling from bed) or to their bed partner should be assessed for RBD.1 With clinical suspicion through patient or bed partner history, or use of validated scales (e.g., RBD screening questionnaire),1 diagnosis is confirmed with polysomnography showing REM sleep without atonia (sensitivity 83%-100%; specificity 88%-100%).2  Personal and environmental factors are associated with RBD  The prevalence of the disorder among adults aged 40-80 years is about 1%, with a spectrum of severity. Risk factors include older age, male sex, smoking, traumatic brain injury and environmental exposures (e.g., pesticides). 3 Antidepressants may cause symptoms to emerge.4  The disorder should be differentiated from other mimics  Specific features differentiate RBD from non-REM parasomnias (e.g., sleepwalking, night terrors) and obstructive sleep apnea (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.221820/tab-related-content); RBD occurs more frequently in the second half of the night, and patients reorient quickly upon awakening. Treatment of RBD differs from non-REM parasomnias and obstructive sleep apnea...<p /> <p>Language: en</p>",
language="en",
issn="0820-3946",
doi="10.1503/cmaj.221820",
url="http://dx.doi.org/10.1503/cmaj.221820"
}