Objective: To study the gender differences in probable REM Sleep Behavior Disorder (RBD) and other sleep characteristics in a cohort of Parkinson’s disease (PD) patients.

Background: Studies regarding the gender distribution and gender clinical presentation of RBD, a parasomnia characterized by the absence of muscle atonia during REM sleep, are scarce.

Method: 47 PD patients with probable RBD (pRBD) were included in the present study. The REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) and REM Sleep Behavior Disorder Questionnaire Hong-Kong (RBDQ-HK) were used to assess the presence of pRBD (cut-off scores of 3.3 or greater and 19 or greater respectively) as well as RBD characteristics in genders. Sleep dysfunction was assessed by Parkinson’s Disease Sleep Scale-2 (PDSS-2). Quality of life (QoL) and cognitive dysfunction were evaluated with Parkinson’s Disease Questionnaire-39 (PDQ-39) and Mini-Mental State Examination (MMSE). Other clinical characteristics included age, disease duration, modified Hoehn and Yahr (H-Y) stage and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS III).

Results: 53.1% (n=25) were male. There were no significant differences in RBDSQ and RBDQ-HK total scores, however females presented higher scores in RBDQ-HK factor 1- dream-related factor (20.1±6.9 vs. 18.9±5.3, p=0.5) while males presented higher scores in RBDQ-HK factor 2- behavioral factor (15.2±5.3 vs. 14.5±5.5, p=0.6). Both males (76%) and females (68.1%) reported increased presence of nightmares and disturbed sleep (40%, both). Emotional and frightening dreams were more prevalent in females (77.2% vs. 60%, p=0.2 and 50% vs. 24%, p=0.06 respectively) while violent or aggressive dreams were more prevalent in males (76% vs. 54.5%, p=0.1). Both males and females reported sleep talking and movements during sleep with no significant differences between genders and a low incidence of sleep-related injuries (<10% in both genders). There were no significant differences in sleep and cognitive dysfunction, QoL scores, motor performance and disease duration between genders.

Conclusion: No clear differences were found regarding the severity and frequency of pRBD among genders. There can be significant gender differences regarding the clinical manifestation of pRBD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-differences-in-rem-sleep-behavior-disorder-in-parkinsons-disease/