Demographic, Clinical and Polysomnographic Findings in 53 Patients with Rapid Eye Movement Sleep Behavior Disorder

Ji, Ki-Hwan; Joo, Eun Yeon; Hong, Seung Bong

doi:2012.9.2.41

J Korean Sleep Res Soc > Volume 9(2); 2012 > Article

ORIGINAL ARTICLE

J Korean Sleep Res Soc. 2012;9(2):41-45. doi: https://doi.org/10.13078/jksrs.12009

렘수면 행동장애로 진단된 53명의 인구학적, 임상적, 수면다원검사적 특징

지기환, 주은연, 홍승봉

¹인제대학교 의과대학 부산백병원 신경과학교실
²성균관대학교 의과대학 서울삼성병원 신경과학교실

Demographic, Clinical and Polysomnographic Findings in 53 Patients with Rapid Eye Movement Sleep Behavior Disorder

Ki-Hwan Ji, Eun Yeon Joo, Seung Bong Hong

¹Department of Neurology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
²Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Corresponding Author: Seung Bong Hong ,Tel: +82-2-2019-3320, Fax: +82-2-3462-5904, Email: koreasleep@empal.com

Received: November 30, 2012 Accepted: December 16, 2012 Published online: December 31, 2012

ABSTRACT

Objectives: We investigated the demographic, clinical and polysomnographic features in rapid eye movement (REM) sleep behavior disorder (RBD).
Methods: We enrolled the consecutive 53 patients with untreated RBD confirmed by ICSD-2 criteria. All patients showed typical sleep related injurious or disruptive behavior on history and REM sleep without atonia was revealed in polysomnography (PSG).
Results: Male (n=38) to female (n=15) ratio was 2.53 : 1. Mean age of RBD onset and age of diagnosis was 58.9 yrs and 62.9 yrs, respectively. The age of diagnosis was not different but the age of onset was younger in female. Twenty two (41.5%) showed sleep-related injury to self or bed partner in history. Twenty seven (50.9%) showed dream acting out using proximal muscle in PSG. Among them, 12 (44.4%) could recall their dream. Two patients with RBD met the diagnostic criteria of Parkinson’s disease. Nine patients who underwent the University of Pennsylvania Smell Identification test in any reason showed anosomia (n=1) or hyposomia (n=8). PSG showed increased N1, normal N2, decreased N3 and preserved REM sleep. Twenty-two (41.5%) patients could be diagnosed with obstructive sleep apnea (OSA).
Conclusions: We identified 53 patients with RBD confirmed with both clinical history and polysomnography. This study shows a higher proportion of female cases, and less association with neurodegenerative disease than earlier reports. OSA prevalence in RBD seems to be higher in this study compared with general population.

Keywords: REM sleep behavior disorder | Parasomnias | Dreams | Polysomonography | Obstructive sleep apnea.