Chapter 28 - Sleep-related rhythmic movement disorder

Summary

Sleep-related rhythmic movement disorder (RMD) represents parasomnia characterized by slow and sustained rhythmic movements involving major muscle groups. RMD is characterized by recurrent episodes of stereotyped body movements in association with sleep. Movements may involve the head, neck, trunk, or limbs in isolation or combination, and are often accompanied by synchronous humming or moaning vocalizations. Sleep-related RMD is occasionally encountered in individuals with developmental disabilities or autism spectrum disorders who exhibit similar stereotypical movements arising during circumstances unrelated to sleep. Several case series have reported the association of RMD and attention deficit hyperactivity disorder (ADHD). Behavioral therapies have received limited investigation in the treatment of RMD. Case reports have documented successful treatment by applying omission training, selective reinforcement of desired behaviors, hypnosis, and forced awakening, and attempts to suppress rhythmic movements through the use of metronome set to identical frequency have yielded variable results.