Rapid eye movement sleep behaviour disorder in young- and older-onset Parkinson disease: a questionnaire-based study.
BACKGROUND
Rapid eye movement sleep behavior disorder (RBD) is common in Parkinson disease (PD).


OBJECTIVE
To determine the frequency of clinically probable RBD (cpRBD) in young-onset (21 to < or =40 years; YOPD) and older-onset PD (>40 years; OOPD) and characterize its pattern.


METHODS
A total of 156 patients with PD (YOPD-51, OOPD-105) were clinically examined and the presence of RBD was diagnosed using the minimal criteria for diagnosis of RBD (International Classification of Sleep Disorders, ICSD-1). RBD screening questionnaire based on the minimal criteria was used. The bed-partners were also interviewed with Mayo sleep questionnaire. Other scales included Unified Parkinson Disease Rating Scale part III (UPDRS III), Hoehn & Yahr stage, Mini Mental Status Examination, Pittsburgh Sleep Quality Index, Parkinson Disease Sleep Scale, Epworth Sleep Scale, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale.


RESULTS
cpRBD was diagnosed in 30 (19.2%) patients, majority being OOPD rather than YOPD (86.7% vs. 13.3%; P=0.01). The frequency of RBD was significantly higher (P=0.016) in OOPD (24.8%) compared to those with YOPD (7.8%). Most often (72.4%) RBD occurred after the onset of parkinsonian symptoms. RBD was independently associated with higher global PSQI scores, total ESS scores and total PDSS scores after adjusting for the effects of age, gender, Hoehn & Yahr stage and duration of illness.


CONCLUSIONS
Patients with RBD were older with later-onset motor symptoms, a more advanced stage, poorer sleep quality, and more frequent daytime sleepiness. Older-onset PD had a higher frequency of RBD than young-onset PD.
Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India.
R
R
Mahale
Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India.
R
R
Yadav
Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India. Electronic address: pal.pramod@rediffmail.com.
P K
PK
Pal
D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D020187:REM Sleep Behavior Disorder / Q000209:etiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
Older-onset PD; Parasomnia; Parkinson disease; REM behaviour disorder of sleep; Sleep; Young-onset PD