Trastorno de conducta durante el sueño REM: a propósito de un caso concomitante con depresión

REM sleep behaviour disorder (RBD) is classified as a parasomnia. However, it should not be considered as a simple sleep disorder, but as a manifestation of a neurological disease, since it can be an initial symptom of a neurodegenerative disorder in up to 50% of cases (especially Parkinson's disease and Lewy bodies dementia). It is essential that psychiatrists are aware of this syndrome, as many of these patients are first seen in psychiatric outpatient clinics. Psychiatrists should be redirected to complete the study and make the final diagnosis, which also requires confirmation by polysomnography. RBD manifests as vivid dreams or nightmares associated with simple or complex vigorous motor and vocal behaviours during REM sleep. This will facilitate early diagnosis of neurological disease. Patients appear to 'act out their dreams', which often include themes of persecution or fight. It usually occurs in men over 55 years. Its prevalence is unknown, but is estimated at between 0.5% and 2%. Antidepressants, especially SSRIs, seem to trigger the disorder. Comorbid depression is common. The most effective treatment is clonazepam at low doses (0.5-3 mg before sleep), which is successful in up to 89.5% of patients, with associated counselling.