Associated factors for REM sleep behavior disorder in Parkinson disease

Aug 12, 2011Neurology

Factors linked to REM sleep behavior disorder in Parkinson's disease

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Abstract

The overall frequency of REM sleep behavior disorder (RBD) in Parkinson disease (PD) patients is 46%.

RBD is associated with older age in patients with PD.
Patients with PD and RBD have a longer disease duration compared to those without.
Higher Hoehn & Yahr stages are found in PD patients with RBD.
RBD is linked to more frequent falls and fluctuations in PD symptoms.
Psychiatric comorbidity and higher doses of levodopa are more prevalent in PD patients with RBD.
The presence of RBD is related to slightly increased sleep efficiency and a higher amount of REM sleep.

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OBJECTIVE: To investigate the frequency, phenomenology, and associated risk factors of REM sleep behavior disorder (RBD) in Parkinson disease (PD).

METHODS: An unselected cohort of sleep-disturbed patients with PD (n=457) was investigated with video-supported polysomnography. We determined the frequency of RBD and analyzed the influence of age, clinical disease features, disease duration, cognitive and physical impairment, medication, comorbidity, and sleep architecture.

RESULTS: The overall frequency of RBD was 46%. According to our cohort and modified definition, there was no preferred PD subtype for RBD (p=0.142). There was no gender preference (p=0.770). RBD was associated with older age (p=0.000). Adjusted for age and gender, patients with PD and RBD had longer disease duration (p=0.024), higher Hoehn & Yahr stages (p=0.002), more falls (p=0.018), more fluctuations (p=0.005), more psychiatric comorbidity (p=0.026), and a higher dose of levodopa (p=0.002). The presence of RBD was related to slightly increased sleep efficiency (p=0.007), a higher amount of REM sleep (p=0.000), and more periodic leg movements during sleep (p=0.019).

CONCLUSION: RBD is a frequent and clinically relevant nocturnal disturbance for all stages of PD. It increases with age and disease duration and may contribute to the nocturnal problems of patients with PD and their bed partners.

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Associated factors for REM sleep behavior disorder in Parkinson disease

Abstract

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