However, clonazepam needs to be manipulated carefully because of its significant side effects, i.e., morning confusion or memory impairment, mainly in patients with neurodegenerative disorders with dementia.Demographically, 90% of RBD patients are males, and most are older than 50 years of age. However, this prevalence in males could be biased due to the fact that women tends to have a less violent type of RBD, which leads to lower reports at sleep centres and different clinical characteristics. While men might have more aggressive behaviour during dreaming, women have presented more disturbance in their sleep. RBD may be also influenced by a genetic compound, since primary relatives seem to have significantly more chance to develop RBD compared with non-relatives control group.Typical clinical features of REM sleep behavior disorder are:

Male gender predilection
Mean age of onset 50–65 years (range 20–80 years)
Vocalisation, screaming, swearing that may be associated with dreams
Motor activity, simple or complex, that may result in injury to patient or bed-partner
Occurrence usually in latter half of sleep period (REM sleep)
May be associated with neurodegenerative disease Acute RBD occurs mostly as a result of a side-effect in prescribed medication—usually antidepressants. Furthermore, substance abuse or withdrawal can result in RBD.Chronic RBD is idiopathic, meaning of unknown origin, or associated with neurological disorders. There is a growing association of chronic RBD with neurodegenerative disorders—Parkinsons disease, multiple system atrophy (MSA), or dementia—as an early indicator of these conditions by as much as 10 years.
Thoracic insufficiency syndrome is the inability of the thorax to support normal respiration. It is frequently associated with chest and/or spinal abnormalities. Treatment options are limited, but include supportive pulmonary care and surgical options (thoracoplasty and/or implantation of vertical expandable prosthetic titanium rib (VEPTR) devices). == References ==