Sex Differences at Presentation in Isolated Rapid Eye Movement Sleep Behavior Disorder (P6-13.003)

Abstract

<h3>Objective:</h3> To compare clinical and demographic characteristics of iRBD at diagnosis in men and women. <h3>Background:</h3> Isolated REM sleep behavior disorder (iRBD) is male-predominant in older adults, yet has approximately equal frequency between women and men in younger adults. Data concerning clinical and demographic characteristics in women with iRBD remain limited. <h3>Design/Methods:</h3> We identified 130 women with PSG confirmed iRBD and matched them with 132 PSG-confirmed iRBD men who underwent PSG within 1 month of their female counterparts. Chart review was performed to extract relevant clinical and demographic information. Group comparisons were made with t-tests and chi square analyses. <h3>Results:</h3> Age at RBD symptom onset (50.4 ± 20.0 vs. 55.4 ±16.9 years, p=0.03) and diagnosis (56.4 ±16.7 vs. 62.5 ± 13.3 years, p&lt;0.01) was younger in women than in men. RBD-related injury frequency was similar between groups. Antidepressant use prior to RBD diagnosis (80.8% vs 53.0%, p&lt;0.01), psychiatric comorbidities (79.8% vs. 50.8%, p&lt;0.01) and chronic pain syndromes (39.2% vs. 17.4%, p&lt;0.01) were more frequent in women than men. Women also had more frequent comorbid insomnia (31.5% vs. 18.2%, p= 0.01), hypersomnia (50.8% vs 37.9%, p=0.04) and trended toward more frequent overlap parasomnia disorder (13.8% vs 9.8%, p=0.06) while obstructive sleep apnea (43.1% vs. 70.5%, p &lt; 0.01.) and vascular disease (62.3% vs 83.3%, p&lt;0.01) were more common in men. There were no differences in systemic autoimmune disease between sexes. <h3>Conclusions:</h3> Women with iRBD are younger at symptom onset and diagnosis, more likely to have psychiatric comorbidities and antidepressant use, and differ in profiles of comorbid sleep disturbances and medical comorbidities than men with iRBD. Awareness of key differences between the sexes in iRBD provides insight into possible etiologic factors and will enable clinicians to accurately diagnose iRBD and provide individualized recommendations. <b>Disclosure:</b> Dr. Alexandres has nothing to disclose. Dr. McCarter has nothing to disclose. Dr. Tabatabai has nothing to disclose. Mr. Feemster has nothing to disclose. Mr. Gossard has nothing to disclose. Paul Timm has nothing to disclose. Dr. Sandness has nothing to disclose. The institution of Dr. Carvalho has received research support from NIH. Mr. Jagielski has nothing to disclose. Emma Strainis has nothing to disclose. Laurene Leclair-Visonneau has nothing to disclose. Dr. Junna has nothing to disclose. Dr. Tippmann-Peikert has nothing to disclose. Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from GE Healthcare. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care. Dr. Lipford has nothing to disclose. Dr. Moore has nothing to disclose. Dr. St. Louis has received publishing royalties from a publication relating to health care. Dr. St. Louis has received publishing royalties from a publication relating to health care. Dr. Silber has received publishing royalties from a publication relating to health care. Dr. Silber has received personal compensation in the range of $500-$4,999 for serving as a Topic writer with UpToDate.