Questionnaire-based diagnosis of REM sleep behavior disorder in Parkinson's disease

Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is present in around 40% of Parkinson's disease (PD) patients. Definitive diagnosis requires a polysomnogram, but that is costly, time intensive, and not practical for large-scale studies. Therefore, we assessed using a questionnaire-based diagnostic approach. Methods: The patient-administered RBD questionnaire and bed-partner-administered question 1 of the Mayo questionnaire were prospectively validated. Results: Seventy-five PD patients (51 male, 68 Hoehn and Yahr stages I and II) participated. Forty-eight had a clinical history of RBD. Sensitivity was 100% (95% CI, 86.3%-100%) when a combination of both questionnaires was compared with the gold standard of polysomnogram-confirmed RBD. Among those who achieved REM sleep (n = 65), specificity was highest for the patient questionnaire used alone, at 82.4% (95% CI, 64.8%-92.6%). Conclusions: A combination of patient and bed-partner questionnaires is a useful tool to detect RBD. (C) 2013 Movement Disorder Society