REM sleep behavioral disorder in Parkinson’s disease: preliminary results

Abstract

Introduction REM Sleep Behavioral Disorder (RBD) is a parasomnia characterized by acting out during REM sleep, with a higher prevalence in Parkinson‘s Disease (PD), which changes from 46% to 58%. Moreover, PD patients with RBD show motor and non-motor characteristics distinct from other PD patients without RBD. Objetives: to estimate the prevalence and characteristics of RBD among patients with PD. Materials and methods Methods and patients : Patients were consecutively evaluated at a third level Outpatient Clinics for Movement Disorders, through the following clinical scales: PD sleep Scale validated for the Brazilian population (PDSS-Br), Epworth’s daytime sleepiness scale, quality of life questionnaire in PD (PDQ- 39), unified PD rating scale (UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England’s functional evaluation scale. All patients were submitted to polysomnography and diagnose of RBD was defined according to the 2nd International Classification of Sleep Disorders. Results seventy third (73) patients have been included so far, among whom we have found a prevalence of 61.6% of RBD (45 patients). There was a lower respiratory disorder index (RDI) among patients with RBD (10.53 ± 11.07) as compared to those without RBD (20.58 ± 17.89) ( p = 0.020). We also found history of self inflicted injury or wounding someone else during sleep acting out periods in 15 patients (33.3%) with RBD. Somniloquy was reported in 97.7% of RBD patients and it was the most frequently reported behavior. We did not find statistically significant differences between groups of patients with or without RBD related to age, time duration of PD, as well as in regard to PD Sleep Scale validated for the Brazilian population (PDSS-Br), Epworth’s daytime sleepiness scale, quality of life questionnaire in PD (PDQ-39), unified PD rating scale (UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England’s functional evaluation scale. Conclusion RBD is a very prevalent condition among PD patients, being associated to a lower RDI and higher risk of wounding during sleep. We found no association between RBD and reduced quality of life in PD patients. Acknowledgements FAEPA (Fundacao de Apoio ao Ensino, Pesquisa e Assistencia do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo) CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior).