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REM sleep behavior disorder in patients with Parkinson’s disease: clinical and polysomnographic characteristics

  • Manoel Alves Sobreira-Neto
  • Márcio Alexandre Pena-Pereira
  • Emmanuelle Silva Tavares Sobreira
  • Marcos Hortes Nisihara Chagas
  • Carlos Maurício Oliveira de Almeida
  • Regina Maria França Fernandes
  • Vitor Tumas
  • Alan Luiz Eckeli
Original Article
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Abstract

The objectives of this study were to describe the characteristics of RBD in a group of PD patients and verify the accuracy of the clinical interview in this group, determine the causes of failure of the interview, as well as to verify the clinical and polysomnographic differences between the groups of PD patients with and without RBD. So, a cross-sectional study was conducted in 88 consecutive PD patients from the outpatient clinic, during a period of 21 months. Participants underwent a clinical interview, assessment based on standardized scales (Epworth Sleepiness Scale, Parkinson’s disease Questionnaire, Pittsburgh Sleep Quality Index), and video polysomnography. Out of the 88 participants, 55 underwent vPSG which confirmed a diagnosis of RBD. The clinical interview had a high sensitivity (87.5%) but a low specificity (42.1%) for RBD diagnosis and thus the clinical interview alone may miss those without episodes of dream-enacting behavior. We note in this group a higher proportion of men (54.5%) and an average age of 60.4 years ± 10.6. In 54% of patients, RBD preceded motor symptoms of PD. In addition, patients with PD and RBD had lower Apnea–Hypopnea Index in REM sleep and a higher equivalent dose of levodopa than PD patients without RBD. RBD is a prevalent condition in patients with PD, requiring polysomnography for diagnostic confirmation, and is associated with certain particularities in PD.

Keywords

Parkinson disease Sleep REM sleep REM sleep behavior disorder 

Notes

Acknowledgements

We are grateful to the patients with PD whose collaboration was essential to the success of this study.

Compliance with ethical standards

Ethical Committee Permission

This study was approved by the Ethics Committee of Clinical Hospital of Faculty of Medicine of Ribeirão Preto—University of São Paulo, under the protocol number 13410.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Japanese Society of Sleep Research 2018

Authors and Affiliations

  • Manoel Alves Sobreira-Neto
    • 1
    • 2
  • Márcio Alexandre Pena-Pereira
    • 3
  • Emmanuelle Silva Tavares Sobreira
    • 3
  • Marcos Hortes Nisihara Chagas
    • 4
  • Carlos Maurício Oliveira de Almeida
    • 3
  • Regina Maria França Fernandes
    • 3
  • Vitor Tumas
    • 3
  • Alan Luiz Eckeli
    • 3
  1. 1.Department of Clinical Medicine, Faculty of Medicine of FederalUniversity of CearáFortalezaBrazil
  2. 2.Faculty of MedicineUniversity of FortalezaFortalezaBrazil
  3. 3.Department of Neuroscience, Faculty of Medicine of Ribeirão PretoUniversity of São PauloSão PauloBrazil
  4. 4.Department of GerontologyFederal University of São CarlosSão CarlosBrazil

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