REM sleep behavior disorder and REM sleep without atonia in Parkinson's disease.
OBJECTIVE
To determine the frequency of REM sleep behavior disorder (RBD) among patients with PD using both history and polysomnography (PSG) recordings and to further study REM sleep muscle atonia in PD.


BACKGROUND
The reported occurrence of RBD in PD varies from 15 to 47%. However, no study has estimated the frequency of RBD using PSG recordings or analyzed in detail the characteristics of REM sleep muscle atonia in a large group of unselected patients with PD.


METHODS
Consecutive patients with PD (n = 33) and healthy control subjects (n = 16) were studied. Each subject underwent a structured clinical interview and PSG recording. REM sleep was scored using a method that allows the scoring of REM sleep without atonia.


RESULTS
One third of patients with PD met the diagnostic criteria of RBD based on PSG recordings. Only one half of these cases would have been detected by history. Nineteen (58%) of 33 patients with PD but only 1 of 16 control subjects had REM sleep without atonia. Of these 19 patients with PD, 8 (42%) did not present with behavioral manifestations of RBD, and their cases may represent preclinical forms of RBD associated with PD. Moreover, the percentage of time spent with muscle atonia during REM sleep was lower among patients with PD than among healthy control subjects (60.1% vs 93.2%; p = 0.003).


CONCLUSIONS
RBD and REM sleep without atonia are frequent in PD as shown by PSG recordings.
Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Coeur de Montréal, Québec, Canada.
J F
JF
Gagnon
M A
MA
Bédard
M L
ML
Fantini
D
D
Petit
M
M
Panisset
S
S
Rompré
J
J
Carrier
J
J
Montplaisir
D000368:Aged; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009122:Muscle Hypertonia / Q000150:complications* / Q000175:diagnosis*; D009129:Muscle Tonus; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017286:Polysomnography; D011237:Predictive Value of Tests; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology