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

Address for correspondence Seung Bong Hong, MD, PhD Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea Tel: +82-2-3410-3592 Fax: +82-2-3410-0052 E-mail: sbhong@skku.edu 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. Twentytwo (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. J Korean Sleep Res Soc 2012;9:41-45