Subclinical Rhythmic Electrographic Discharge of Adults (SREDA) in REM Sleep

We describe the first reported case of subclinical rhythmic electrographic discharge of adults (SREDA) during rapid eye movement (REM) sleep. This 48-year-old man, with a history of witnessed apneic spells, was sent for a baseline polysomnogram. Besides demonstrating obstructive sleep apnea, his study showed the occurrence of paroxysmal delta waves evolving into a theta frequency during REM sleep. A repeat polysomnogram with 16-channel electroencephalography confirmed SREDA in the bilateral temporal/parietal regions during REM sleep. This uncommon paroxysmal electrographic pattern should not be mistaken for seizure activity and is now recognized to occur in all stages of sleep, including REM.