Objective: Evaluation of patients with idiopathic Parkinson’s disease regarding the presence of RBD, application of the questionnaires, and correlation between the diagnosis of RBD by Polysomnography.

Background: Patients with Parkinson’s disease may present with a series of non-motor manifestations, including sleep-related disorders such as REM Sleep Behavior Disorder (RBD), a parasomnia characterized by dream enacting behaviors associated with REM sleep without muscle atonia in Polysomnography.  RBD is commonly associated with neurodegenerative diseases, mainly of the class of diseases called synucleinopathies, which includes Parkinson’s Disease (PD). The clinical history is given by the patient’s report or a family member of vivid dreams with presence of vocalization or complex motor behavior, such as punches, kicks. The “Rapid Eye Movement Sleep Behavior Disorder Questionnaire (RBDSQ)” and “Mayo Sleep Questionnaire” can help in a standardized clinical evaluation.

Method: It was a longitudinal, prospective, observational study, which was approved by the Research Ethics Committee on Human Beings of the Institute of Neurology of Curitiba in June of 2017. The sample consisted of patients with idiopathic Parkinson’s disease, followed in the ambulatory of movement disorders of Institute of Neurology of Curitiba. The final n was 49 patients from 71 patients initially selected. The study consisted of 2 steps, the application of RBDSQ to all patients and the Mayo Sleep Questionnaire informant version for some of the caregivers; The second step consisted of polysomnography after indication based on the RBDSQ score (≥ 5 Points).

Results: The RBSQ score was ≥ 5 points in 25 of the 49 questionnaires obtained, for which the Polysomnography examination was indicated. Of the 25 polysomnograms indicated, 13 were performed and the analysis showed a wide combination of sleep related disorders, besides the confirmation of REM sleep behavior disorder in 3 of the 13 patients, a prevalence of 23%.

Conclusion: The use of the questionnaires may help to select patients for polysomnography, but despite good sensitivity, it has low specificity, since other sleep-related disorders may be present, such as Sleep Apnea, mimicking compatible complaints with RBD. Thus, polysomnography is the gold standard method for the confirmatory diagnosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/applicability-of-questionnaires-and-study-of-the-prevalence-of-rem-sleep-behavior-disorder-rbd-in-parkinsons-disease/