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Author Notes:

Address correspondence to: Donald L. Bliwise, PhD, Emory University School of Medicine, Wesley Woods Center, 1841 Clifton Road, Room 509, Atlanta, GA 30329. Phone: 404-728-4751; Fax: 404-728-4756; Email: dbliwis@emory.edu

We gratefully acknowledge the assistance of Farzaneh Pour Ansari, MA, Liqiong He, MD, Monica Habib, MD, and Jacqueline Marcus, MD, in conducting this work.

This was not an industry supported study.

Dr. Rye has participated in speaking engagements for GlaxoSmithKline and has consulted for GlaxoSmithKline, Boehringer Ingelheim, Ortho-McNeill, and Sepracor.

Dr. Bliwise has received research support from Takeda, has consulted for Gerson Lehrman Group, Neurocrine, Cephalon, Pfizer, Takeda, and Sepracor and has participated in speaking engagements for Takeda, Boehringer Ingelheim, School of Sleep Medicine, and Sleep Medicine Educational Institute.


Research Funding:




  • Rapid eye movement sleep behavior disorder
  • electromyography
  • phasic
  • tonic

Elevated PEM (Phasic Electromyographic Metric) Rates Identify Rapid Eye Movement Behavior Disorder Patients on Nights Without Behavioral Abnormalities


Journal Title:



Volume 31, Number 6


, Pages 853-857

Type of Work:

Article | Post-print: After Peer Review


Objective: To determine the validity of the phasic electromyographic metric (PEM) to differentiate patients with a history suggestive of rapid eye movement behavior disorder (REMBD) on laboratory nights without overt dream-enactment behavior. Methods: PEM was quantified as the % of 2.5-sec intervals with phasic muscle activity of 100-msec duration with an amplitude of at least 4 times background activity in 11 patients and 31 elderly controls. Data were derived from both REM and NREM sleep from 5 muscle groups (mentalis, left/right anterior tibialis, left/right brachioradialis). Results: Relative to controls, REMBD patients had significantly higher levels of PEM activity in all recordings. The largest differences occurred during REM sleep for the mentalis and brachioradialis channels. Similar results were obtained by limiting quantification of PEM to the final REM period of the night and could be accomplished by individuals with no previous familiarity with polysomnography. Discussion: PEM may be a useful metric to characterize the REM related phasic muscle activity on patients with a history of REMBD, even when no overt dream-enactment behaviors are detected on a laboratory night. Citation: Bliwise DL; Rye DB. Elevated PEM (phasic electromyographic metric) rates identify rapid eye movement behavior disorder patients on nights without behavioral abnormalities. SLEEP 2008;31(6):853–857.

Copyright information:

© Associated Professional Sleep Societies, LLC

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