Validation of the Innsbruck REM sleep behavior disorder inventory

A diagnosis of definite REM sleep behavior disorder requires both a positive history for REM sleep behavior disorder and polysomnographic demonstration of REM sleep without atonia. To improve and facilitate screening for REM sleep behavior disorder, there is a need for simple clinical tools with sufficient sensitivity and specificity for the identification of subjects with probable REM sleep behavior disorder. We developed a short REM sleep behavior disorder screening questionnaire with 7 REM sleep behavior disorder– and 2 non‐REM sleep behavior disorder–specific control items and performed a validation study in 70 REM sleep behavior disorder subjects and 140 sleep disorder controls. Response patterns to all 7 REM sleep behavior disorder–specific items differed between REM sleep behavior disorder and non‐REM sleep behavior disorder patients (all P < 0.05), whereas the 2 non‐REM sleep behavior disorder–specific control items did not differentiate between REM sleep behavior disorder and non‐REM sleep behavior disorder (all P > .05). In 5 of the 7 REM sleep behavior disorder–specific items, AUC was greater than 0.700. These 5 items were included in the Innsbruck REM sleep behavior disorder inventory. In this questionnaire, a cutoff of 0.25 (number of positive symptoms divided by number of answered questions) had a sensitivity of 0.914 and a specificity of 0.857 for both idiopathic and Parkinson's‐related REM sleep behavior disorder (AUC, 0.886). The Innsbruck REM sleep behavior disorder inventory is a promising, easy‐to‐use, short screening tool for REM sleep behavior disorder with excellent sensitivity and specificity for both idiopathic and Parkinson's‐related REM sleep behavior disorder. © 2012 Movement Disorder Society

[1]  M. Vendette,et al.  Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder , 2009, Neurology.

[2]  José Luis Molinuevo,et al.  Rapid-eye-movement sleep behaviour disorder as an early marker for a neurodegenerative disorder: a descriptive study , 2006, The Lancet Neurology.

[3]  V. Mok,et al.  Validation of a new REM sleep behavior disorder questionnaire (RBDQ-HK). , 2010, Sleep medicine.

[4]  J. Santamaria,et al.  Severe obstructive sleep apnea/hypopnea mimicking REM sleep behavior disorder. , 2005, Sleep.

[5]  M. Mahowald,et al.  Potentially Lethal Behaviors Associated With Rapid Eye Movement Sleep Behavior Disorder: Review of the Literature and Forensic Implications , 2009, Journal of forensic sciences.

[6]  C. Guilleminault,et al.  Nocturnal wandering and violence: review of a sleep clinic population. , 1998, Journal of forensic sciences.

[7]  B. Vaughn,et al.  Nocturnal Seizures Mimic REM Behavior Disorder , 1997 .

[8]  M W Mahowald,et al.  Chronic behavioral disorders of human REM sleep: a new category of parasomnia. , 1986, Sleep.

[9]  W. Oertel,et al.  Environmental risk factors for REM sleep behavior disorder , 2012, Neurology.

[10]  S. Noachtar,et al.  REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson's disease: is there a need for polysomnography? , 2001, Journal of the Neurological Sciences.

[11]  J. Carrier,et al.  REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease , 2002, Neurology.

[12]  Joan Santamaria,et al.  The clinical and pathophysiological relevance of REM sleep behavior disorder in neurodegenerative diseases. , 2009, Sleep medicine reviews.

[13]  M. Silber,et al.  REM sleep behavior disorder preceding other aspects of synucleinopathies by up to half a century , 2010, Neurology.

[14]  Ronald C Petersen,et al.  Validation of the Mayo Sleep Questionnaire to screen for REM sleep behavior disorder in an aging and dementia cohort. , 2011, Sleep medicine.

[15]  T. Wetter,et al.  Polysomnographic measures in Parkinson's disease: a comparison between patients with and without REM sleep disturbances. , 2001, Wiener klinische Wochenschrift.

[16]  M W Mahowald,et al.  Rapid Eye Movement Sleep Behavior Disorder: A Treatable Parasomnia Affecting Older Adults , 1987 .

[17]  Poul Jennum,et al.  A single‐question screen for rapid eye movement sleep behavior disorder: A multicenter validation study , 2012, Movement disorders : official journal of the Movement Disorder Society.

[18]  Mark W. Mahowald,et al.  Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder , 1996, Neurology.

[19]  Geert Mayer,et al.  The REM sleep behavior disorder screening questionnaire—A new diagnostic instrument , 2007, Movement disorders : official journal of the Movement Disorder Society.

[20]  W. Poewe,et al.  REM sleep behavior disorder in 703 sleep-disorder patients: the importance of eliciting a comprehensive sleep history. , 2010, Sleep medicine.

[21]  B. Mollenhauer,et al.  Associated factors for REM sleep behavior disorder in Parkinson disease , 2011, Neurology.

[22]  G. Plazzi,et al.  REM sleep behavior disorders in multiple system atrophy , 1997, Neurology.

[23]  Werner Poewe,et al.  Video analysis of motor events in REM sleep behavior disorder , 2007, Movement disorders : official journal of the Movement Disorder Society.

[24]  E. Tolosa,et al.  Characteristics of idiopathic REM sleep behavior disorder and that associated with MSA and PD , 2005, Neurology.

[25]  James J. Gugger,et al.  Neurology: Rapid Eye Movement Sleep Behavior Disorder , 2007 .