Materiały źródłowe

• #1 REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6095693/

  Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). […] Rapid eye movement sleep behavior disorder appears to be more common in men than women in older adults, yet below the age of 50 years it is equally frequent in women and men. […] Rapid eye movement sleep behavior disorder is idiopathic when unassociated with neurological disorders or symptomatic when underlying causes such as autoimmune or inflammatory disorders, brain lesions, or provoking antidepressant medications are present. […] Diagnosis of RBD requires either a clinical history of sleep-related complex motor behaviors or REM sleep complex vocal or motor behaviors recorded during polysomnography, accompanied by RSWA.

• #1 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder characterized by the loss of normal voluntary muscle atonia during REM sleep, in association with complex motor behavior while dreaming. […] The specific DSM-5-TR criteria for rapid eye movement sleep behavior disorder are as follows: Recurrent episodes of arousal during sleep associated with vocalization and/or complex motor behaviors that arise during rapid eye movement (REM) sleep. On waking from these episodes, the individual is not confused or disoriented and is completely alert. Either of the following is present: REM sleep without atonia on polysomnographic recordings; or a history suggestive of REM sleep behavior disorder and an established synucleinopathy diagnosis (e.g., Parkinsons disease, multiple system atrophy). The episodes cause significant distress or impairment in social, occupational or other areas of functioning which may include serious injury to self or the bed partner. The disturbance cannot be explained by the effects of a drug of abuse or medication. The episodes cannot be attributed to another mental disorder or medical condition.

• #1 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  The International Classification of Sleep Disorders, Third Edition, Text Revision requires all the following criteria for the diagnosis of RBD: Repeated episodes of sleep-related vocalization and/or complex motor behaviors. These behaviors are documented by polysomnography to occur during REM sleep, or based on clinical history of dream enactment, are presumed to occur during REM sleep. Presence of REM sleep without atonia (RSWA) on polysomnography (PSG). Sleep disorder not better explained by another sleep disorder, a medical or neurologic disorder, a mental disorder, medication use, or a substance use disorder. […] Based on findings from sleep studies, most individuals (50%) with initially idiopathic RBD will eventually develop a neurodegenerative disease. RBD is thought to be a prodromal marker of neurodegenerative synucleinopathies and is present in a majority of patients with Parkinson disease (50%), multiple system atrophy (80-90%), dementia with Lewy bodies (80%). REM sleep behavior disorder often predates any other sign of these disorders by many years (often more than a decade).

• #1 REM sleep behavior disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/diagnosis-treatment/drc-20352925

  To diagnose REM sleep behavior disorder, your doctor reviews your medical history and your symptoms. Your evaluation may include: […] Your doctor conducts a physical and neurological exam and evaluates you for REM sleep behavior disorder and other sleep disorders. REM sleep behavior disorder may have symptoms similar to other sleep disorders, or it may coexist with other sleep disorders such as obstructive sleep apnea or narcolepsy. […] Your doctor may ask your sleeping partner whether he or she has ever seen you appear to act out your dreams while sleeping, such as punching, flailing your arms in the air, shouting or screaming. Your doctor may also ask your partner to fill out a questionnaire about your sleep behaviors. […] Doctors may recommend an overnight study in a sleep lab. During this test, sensors monitor your heart, lung and brain activity, breathing patterns, arm and leg movements, vocalizations, and blood oxygen levels while you sleep. Typically, you’ll be videotaped to document your behavior during REM sleep cycles.

• #1

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  These findings reveal the importance of thorough clinical assessment when patients present with iRBD symptomology, as lack of initial recognition can hinder the diagnostic process and reduce opportunities for disease management, especially early ND identification and potential treatment. […] Once initial suspicion of iRBD has been raised and referral made to a Neurology or Sleep Medicine service, thorough history taking, including direct questioning of iRBD symptomatology, is one of the most valuable tools to assist in diagnosis. […] Including the patients bed partner in the interview process is crucial as many patients with iRBD have no awareness that they act out their dreams during sleep. […] The most commonly used questionnaire in clinical populations is the REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ).

• #1 Rapid eye movement sleep behavior disorder – Wikipedia

  https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep_behavior_disorder

  Rapid eye movement sleep behavior disorder or REM sleep behavior disorder (RBD) is a sleep disorder in which people act out their dreams. […] There are two ways to diagnose RBD: by documenting a history of complex, dream-enactment sleep behaviors, or by polysomnography recording of these behaviors along with REM sleep atonia loss. […] RBD may be established from clinical interview as well as several validated questionnaires, when sleep studies cannot be performed. […] Individuals with RBD may not be able to provide a history of dream enactment behavior, so bed partners are also consulted. […] The REM Sleep Behavior Disorder Single-Question Screen offers diagnostic sensitivity and specificity in the absence of polysomnography with one question: „Have you ever been told, or suspected yourself, that you seem to 'act out your dreams’ while asleep (for example, punching, flailing your arms in the air, making running movements, etc.)?”

• #1

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  This is a 10-item questionnaire examining the main clinical features of iRBD, that is self-rated by the person suspected of having iRBD and has been validated in many cross-cultural populations. […] However, when including patients with other sleep disorders, the specificity drops to only 56%. […] The IRBDSG now states that definitive diagnosis of iRBD requires a gold-standard, Level 1, video polysomnography (vPSG) to capture REM sleep without atonia and/or dream enactment behaviour. […] The utility of vPSG is well-established in the diagnosis of iRBD, with the identification of RSWA an essential requirement. […] However, it is challenging for most neurologists to access vPSG for their patients. […] There is an urgent need for vPSG availability within the home, to increase accessibility and improve early diagnosis in this high-risk population. […] Recent advances in technologies such as actigraphy and contactless devices presents an exciting and much more accessible way of detecting iRBD; however, there have been limited studies so far and further research is needed.

• #1

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  The International RBD Study Group (IRBDSG) also recently published definitive guidelines for RBD diagnosis stating that video PSG (vPSG) is mandatory for the identification of iRBD, and must find either isolated RSWA or motor events (i.e., any type of movement in sleep captured on video). […] Thus, for a confirmed diagnosis of iRBD, a documented history of dream enactment behaviour, along with a full vPSG to obtain evidence of RSWA or motor events during sleep is required. […] Lack of awareness among neurologists and other specialists may also contribute to diagnostic delay, with one study finding that 31% of patients did not receive a timely diagnosis of iRBD (mean delay of 8.7 years from symptom onset) due to failure of their specialist (including neurologists) to recognise the symptoms.

• #1 REM Sleep Behavior Disorder Diagnosis and Tests

  https://www.webmd.com/sleep-disorders/diagnosing-rem-sleep-behavior-disorder

  When trying to diagnose REM sleep behavior disorder, or RBD, the neurologic exam is often normal. However, symptoms and signs of Parkinson’s disease, such as hand tremor at rest, slowness in movement, and muscle stiffness (rigidity) that may suggest an underlying neurologic cause of RBD, should be considered. […] Polysomnographic video recording is the single most important diagnostic test in persons with RBD. This test is usually conducted in a sleep study center. The person undergoing testing is required to sleep at the center while the following parameters are monitored: […] In persons with RBD, the polysomnogram shows an increase in the muscle tone associated with the EEG pattern of REM sleep, whereas in healthy persons, the EEG pattern of REM sleep is associated with an absence of muscle tone (atonia).

• #1 SciELO Brasil – REM sleep behavior disorder: update on diagnosis and management REM sleep behavior disorder: update on diagnosis and management

  https://www.scielo.br/j/anp/a/NyW6ysTnXjDj8kRrWFKmyLp/

  REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. Diagnostic assessment should begin with a detailed clinical history with the patient and bed partner or roommate and the examination of any recorded home videos. Polysomnography (PSG) is necessary to verify the loss of sleep atonia and, when documented, the behaviors during sleep. […] The diagnostic evaluation should begin with a detailed clinical history with the patient and bed partner and the examination of recorded home videos, if available. After this initial stage, polysomnography (PSG) is necessary to identify and quantify RWA and to document sleep behaviors.

• #1 Diagnostic Tools for REM Sleep Behavior Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3327886/

  REM sleep behavior disorder (RBD) is a parasomnia characterized by loss of muscle atonia during REM sleep that results in motor behaviors. Diagnosis of RBD involves a clinical interview in which history of dream enactment behaviors is elicited and a subsequent overnight polysomnography (PSG) evaluation to assess for REM sleep without atonia (RWA) and/or observe motor behaviors during REM sleep. […] The primary aim of the current study was to identify and summarize the available clinical measurements that have been used for RBD assessment. […] Fifty-eight studies were found to meet review criteria. The objective measurements for assessment of RBD reviewed included visual electromygraphic (EMG) scoring methods, computerized EMG scoring methods, cardiac 123I-MIBG scintigraphy, actigraphy, behavioral classification and video analysis. Subjective measurements of RBD included interviews and questionnaires.

• #1 Diagnostic Tools for REM Sleep Behavior Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3327886/

  Sleep history may be sufficient for diagnosis of RBD in some populations. However, PSG is necessary for a definitive diagnosis. EMG scoring methods vary in definition used and there is no single accepted approach to scoring muscle activity. […] Over the years a dynamic scientific debate has been unfolding in the literature regarding the appropriate diagnostic tools and definitions used for RBD assessment. […] The aim of this review was to identify and summarize the available subjective and objective clinical tools that have been used for RBD assessment, identify their psychometric value, and report available evidence for their validity and reliability. […] The scoring definition of the EMG channel in the American Academy of Sleep Medicine (AASM) scoring manual, which is evidence-based, was not able to provide a precise definition of what is considered excessive amounts of tonic and phasic EMG activity or a complete method of how muscle activity should be measured.

• #1 Diagnosing REM Sleep Behavior Disorder | California Sleep Society

  https://californiasleepsociety.org/news/diagnosing-rem-sleep-behavior-disorder/

  Few topics in sleep medicine have in the recent years gained as much attention and scientific insights than REM sleep behavior disorder (RBD). […] Reliable and accurate diagnosis of RBD is of critical importance as if diagnosed early, patients may be amenable to neuroprotective treatments. […] The current definition of RBD relies on the polysomnographic finding of REM sleep without atonia (RWA), or excessive electromyographic (EMG) activation during REM sleep. […] In practice, scoring RWA can become a daunting task. […] When RBD is clinically suspected, more experienced technologists and clinicians need to waive this rule and delve into the delicate task of quantifying RWA, epoch-by-epoch, and mini-epoch by mini-epoch. […] For all these reasons and until better diagnostic procedures are available for RBD, this disorder will likely be underdiagnosed.

• #1 REM Sleep Behavior Disorder Diagnosis and Tests

  https://www.webmd.com/sleep-disorders/diagnosing-rem-sleep-behavior-disorder

  Imaging studies (for example, a CT scan and MRI of the brain) are not routinely indicated in persons who have no neurologic cause of RBD, but they may be done if some abnormality is detected during the neurologic exam. Imaging studies should also be considered in younger patients (younger than age 40) where there is no known precipitant cause such as alcohol or medication use.

• #1 AI Tool Aims to Ease Detection of REM Sleep Behavior Disorder | Sleep Review

  https://sleepreviewmag.com/sleep-disorders/parasomnias/rem-parasomnias/ai-tool-aims-ease-detection-rem-sleep-behavior-disorder/

  An Innsbruck research team has developed a diagnostic tool using artificial intelligence (AI) to detect and manage isolated REM sleep behavior disorder (iRBD), which can be a harbinger of Parkinsons and other diseases of the nervous system. […] A sleep disorder is easy to detect when the person concerned has trouble sleeping. For disorders such as iRBD, a diagnosis is much more difficult to come by. […] A person older than 50 who suddenly starts to move or behave strangely (with or without dreams) during their sleep is advised to consult a sleep lab. Physicians can prescribe medication that can ease the symptoms of iRBD, but the disorder is a clear indication of the loss of nerve cells and is thus often associated with other diseases. […] For the moment, sleep disorders can only be reliably diagnosed in sleep labs. Data from polysomnography are collected and manually assigned to the various sleep stages.

• #1 Sleep Trackers Can Be Used to Screen for Parkinson’s Disease

  https://sleepreviewmag.com/sleep-disorders/parasomnias/rem-parasomnias/screen-rem-sleep-behavior-disorder/

  This new screening method could diagnose a very common subtype of Parkinsons disease years before the conventional methods of diagnosis, which require a clinical examination by an experienced neurologist. […] A two-step approach using questionnaire first, followed by ambulatory actigraphy for 10 days in those who screen positive, could select individuals at highest risk of idiopathic REM sleep behavior disorder and thereby result in higher positive predictive value (100% in this small sample of 84 subjects), before confirmatory video polysomnography.

• #1 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  REM (rapid eye movement) sleep behaviour disorder (RBD) is characterised by vivid dreams and dream enactment behaviour such as kicking, shouting, and punching. It is important to recognise potential RBD because it is also strongly associated with neurodegenerative disease (NDD): RBD affects approximately 50% of people with Parkinsons disease (PD), 80% of people with dementia with Lewy bodies (DLB), and almost 100% of people with multiple system atrophy (MSA). RBD is also an early sign of neurodegenerative disease and can occur in otherwise healthy individuals when it is known as idiopathic or isolated RBD (iRBD). This isolated form is associated with an 80-90% risk of progression to an NDD, such as PD or DLB, within 10 years of first diagnosis. Thus, identifying iRBD provides a rare opportunity to modify future risk of neurodegeneration and there are anticipated opportunities for patients with iRBD to enrol in neuroprotective drug trials to prevent progression to an overt NDD.

• #1 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  A validated single screening question for probable RBD is: Have you been told, or suspected yourself, that you seem to act out your dreams while asleep (for example, punching, flailing your arms in the air, making running movements, etc.)? An answer of yes should prompt a referral for further investigations. The diagnostic accuracy of this question is 94% sensitivity/87% specificity when compared with the gold standard of vPSG; however, this should be used only as an initial screening for onward referral. […] While there remains uncertainty around iRBD and its association with different types of NDD, it is clear that iRBD is a prodrome of neurodegeneration. This means there is an opportunity for dementia risk reduction through managing potentially modifiable dementia risk factors. GPs therefore play a vital role in recognising potential iRBD and applying preventive medicine approaches with the aim of trying to alter iRBD trajectories. Furthermore, GPs will play a similarly vital role in timely referral to specialist settings when cognitive impairment and/or parkinsonism emerge.

• #1 Perspectives: Dr. Carlos Schenck discusses REM-sleep behavior disorder | MedLink Neurology

  https://www.medlink.com/articles/perspectives-dr-carlos-schenck-discusses-rem-sleep-behavior-disorder

  RBD can emerge as an isolated parasomnia, or it can emerge with an NREM parasomnia, designated as parasomnia overlap disorder with generalized motor dyscontrol across REM and NREM sleep. Parasomnia overlap disorder was formally described and named by our sleep center in 1997 with a series of 33 cases that emerged idiopathically or symptomatically with neurologic and other disorders. The risk for future neurodegeneration remains unknown in patients with idiopathic parasomnia overlap disorder who are under age 50 years, just as with idiopathic RBD in the younger adult age group. […] The phenotype of RBD in patients under 50 years of age has now been recognized to differ from the traditional RBD phenotype of middle-aged or older men with aggressive RBD behaviors. Younger patients with RBD have greater gender parity, less severe RBD, greater association with narcolepsy-cataplexy, greater association with psychiatric disorders and with antidepressant use, greater association with the parasomnia overlap disorder, and, perhaps, also greater association with autoimmune diseases. RBD in children and adolescents, although rare, is usually associated with narcolepsy-cataplexy, parasomnia overlap disorder, brainstem tumors, and antidepressants as therapy for depression and cataplexy. […] In conclusion, RBD is a rapidly expanding clinical and research field.

• #2 REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6095693/

  Rapid eye movement sleep behavior disorder diagnosis also requires that the sleep disturbance is not better explained by another disorder, such as obstructive sleep apnea or an alternative non-rapid eye movement (NREM) sleep parasomnia. […] Confirmatory collateral history from a bed partner is necessary, especially when the patient has cognitive impairment. […] Loss of REM sleep atonia, known as RSWA, is required for diagnosis, although probable RBD may be diagnosed on clinical grounds when a clear history of dream enactment-type behaviors is present. […] There are several well-validated RBD screening measures for the diagnosis of probable RBD when polysomnography is unavailable or when REM sleep is not captured during polysomnogram recording. […] Rapid eye movement sleep without atonia may also be an incidental or isolated finding during polysomnography without clinical accompaniment. […] Rapid eye movement sleep without atonia amounts have also been shown to progress over time in patients with idiopathic RBD and have been associated with a higher risk of phenoconversion to PD in idiopathic RBD.

• #2 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  The International Classification of Sleep Disorders, Third Edition, Text Revision requires all the following criteria for the diagnosis of RBD: Repeated episodes of sleep-related vocalization and/or complex motor behaviors. These behaviors are documented by polysomnography to occur during REM sleep, or based on clinical history of dream enactment, are presumed to occur during REM sleep. Presence of REM sleep without atonia (RSWA) on polysomnography (PSG). Sleep disorder not better explained by another sleep disorder, a medical or neurologic disorder, a mental disorder, medication use, or a substance use disorder. […] Based on findings from sleep studies, most individuals (50%) with initially idiopathic RBD will eventually develop a neurodegenerative disease. RBD is thought to be a prodromal marker of neurodegenerative synucleinopathies and is present in a majority of patients with Parkinson disease (50%), multiple system atrophy (80-90%), dementia with Lewy bodies (80%). REM sleep behavior disorder often predates any other sign of these disorders by many years (often more than a decade).

• #2 Rapid eye movement sleep behavior disorder – Wikipedia

  https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep_behavior_disorder

  Diagnostic criteria for RBD from the International Classification of Sleep Disorders (ICSD-3) are: Repetition of vocalizations and/or complex motor behaviors during sleep; Polysomnography (PSG) show that these behaviors occur during REM sleep; If documentation of these behaviors by PSG is not possible, they must at least be assumed to take place during REM sleep based on records of dream enactment; REM sleep without atonia (RWA) can be seen in polysomnographic recordings; Episodes cannot be explained by another mental disorder, sleep disorder, substance abuse or medication. […] Because of the similarities between the conditions, polysomnography plays an important role in confirming RBD diagnosis.

• #2 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  Most people with RBD are unaware of it, but some present to their GP reporting frequent vivid dreams, unexplained injuries (related to thrashing into a wall or furniture when dreaming), or falling out of bed. More commonly, presentation to a GP is initiated by a bed partner who notices kicking and punching movements during sleep. Unfortunately, it can be challenging for clinicians to disentangle such symptoms from other sleep disorders that have similar symptoms, and therefore RBD is generally under-recognised. […] GPs have a crucial role in identifying the symptoms of RBD (and other sleep disorders) and referring patients on to a neurologist or sleep specialist for further assessment. The International RBD Study Group state that an overnight sleep study (video polysomnography [vPSG]) in a sleep laboratory is mandatory for the identification of RBD. A neurologist may also assess cognitive and motor symptoms to determine any current evidence of a recognisable NDD. In the absence of an overt NDD, diagnosis of iRBD can lead to treatment (associated with improved quality of life), as well as opportunities for risk modification and clinical trial recruitment that hold potential to slow or even stop progression to NDD.

• #2 REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6095693/

  Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). […] Rapid eye movement sleep behavior disorder appears to be more common in men than women in older adults, yet below the age of 50 years it is equally frequent in women and men. […] Rapid eye movement sleep behavior disorder is idiopathic when unassociated with neurological disorders or symptomatic when underlying causes such as autoimmune or inflammatory disorders, brain lesions, or provoking antidepressant medications are present. […] Diagnosis of RBD requires either a clinical history of sleep-related complex motor behaviors or REM sleep complex vocal or motor behaviors recorded during polysomnography, accompanied by RSWA.

• #2 Perspectives: Dr. Carlos Schenck discusses REM-sleep behavior disorder | MedLink Neurology

  https://www.medlink.com/articles/perspectives-dr-carlos-schenck-discusses-rem-sleep-behavior-disorder

  The traditional clinical profile of RBD involves predominantly middle-aged and older men with aggressive, dream-enacting behaviors, with more than 80% of them eventually developing an overt alpha-synucleinopathy. This profile now needs to be modified, given a recent population-based study of middle-aged to older adults with polysomnography-confirmed RBD that found a 1.06% prevalence of RBD–and with gender parity. Because women generally have less aggressive and injurious RBD, they present for medical attention much less frequently than men. Therefore, the traditional RBD profile has reflected a clinical referral bias on account of more aggressive and injurious RBD behaviors in men compared to women. However, because both male and female middle-aged and older patients with RBD are equally at risk for eventually developing alpha-synucleinopathies, once a promising neuroprotective (disease-modifying) agent becomes available, a concerted effort must be initiated to find the women with RBD who had not sought medical attention; it is the presence of REM without atonia or RBD, and not its severity, that carries the strong risk for future parkinsonism.

• #2 REM sleep behaviour disorder More than just a parasomnia

  https://www.racgp.org.au/afp/2013/november/rem-sleep-behaviour-disorder

  Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterised by loss of the usual muscle atonia that occurs during REM sleep, allowing patients to act out their dreams. […] This article focuses on the role of the general practitioner (GP) in the diagnosis and management of RBD. […] The gold standard diagnosis of RBD relies on polysomnography (PSG), which shows excessive tonic chin electromyography (EMG) activity and excessive submental or limb twitching during REM sleep identified by EEG. […] Given the limited access to PSG, attempts have been made to identify RBD from clinical interview as well as questionnaires. […] A positive answer to the RBDQ1, Have you ever been told or suspected yourself, that you seem to act out your dreams while asleep (for example, punching, flailing your arms in the air, making running movement etc.)? should encourage the medical practitioner to consider the diagnosis of RBD as it offers good sensitivity (94%) and specificity (87%).

• #2 Diagnostic Code Aids in Predicting Isolated REM Sleep Behavior Disorder in Outpatient Setting

  https://www.neurologylive.com/view/diagnostic-code-proves-feasible-predicting-irbd-outpatient-setting

  Patients with iRBD had a significantly higher risk of being diagnosed with neurodegenerative parkinsonian disorders or dementia in real-world settings. […] The study demonstrated the feasibility of using statistical models developed from EHR data to accurately predict iRBD in outpatient settings. […] Authors of the review recommended that neurologists and other clinicians diagnosing iRBD should conduct questionnaires to help them make a more „probable diagnosis” but this approach should not be used as the only diagnostic tool for iRBD. […] Thus, the detection of iRBD presents an important opportunity for clinicians to intervene early in the condition, through therapies or risk modification, to adjust its trajectory or even prevent the development of neurodegenerative diseases in the future. […] Authors from the prior review noted that there is an increasing interest in pharmaceutical clinical trials for iRBD that is further increasing the criticalness of diagnosis and raising awareness of the key role neurologists play to accurately diagnose this disorder early on.

• #2 Diagnostic Tools for REM Sleep Behavior Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3327886/

  The RBD PSG scoring method has been extensively used in RBD populations including both iRBD and symptomatic RBD, and in studies with only iRBD patients or sRBD. […] The current gold standard for appropriate diagnosis of clinical RBD includes history of abnormal movements, sleep-related injuries, or dream-enactment behaviors that are supported with PSG findings indicating the loss of REM sleep muscle atonia and/or excessive phasic muscle twitching, or actual observation of RBD occurrences.

• #2 REM Sleep Behavior Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd

  REM sleep behavior disorder (RBD) is a sleep disorder in which you physically act out your dreams unknowingly while you’re asleep. […] If you have symptoms of REM sleep behavior disorder (RBD), it’s important to see a healthcare provider. They’ll ask you questions about your symptoms and medical history. If you have a bed partner or housemates, your provider will likely want to ask them questions about your sleeping behavior. […] To receive a diagnosis of REM sleep behavior disorder, you’ll undergo an in-lab video sleep study or polysomnogram (PSG). Sleep studies are tests that record specific body functions during sleep, such as your heart rate, breathing rate and airflow, brain wave activity, eye movements, and muscle movements of your chin and upper extremities. […] According to the International Classification of Sleep Disorders, a diagnosis of RBD requires all of the following: You have repeated episodes of sleep-related vocalization and/or complex movement behaviors. The behaviors are documented by a sleep study (polysomnography) and occur during REM sleep or can be assumed to happen during REM sleep based on your clinical history. The sleep study shows that you experience REM sleep without atonia (muscle paralysis). You don’t have seizure-related activity during REM sleep. The sleep disturbances aren’t better explained by another sleep disorder, medical condition or mental health condition. They’re also not caused by medication side effects or substance use disorder.

• #2 SciELO Brasil – REM sleep behavior disorder: update on diagnosis and management REM sleep behavior disorder: update on diagnosis and management

  https://www.scielo.br/j/anp/a/NyW6ysTnXjDj8kRrWFKmyLp/

  Type 1 PSG is essential for RBD diagnosis. It is necessary to detect RWA, as required in the International Classification of Sleep Disorders, 3rd edition (ICSD-3). Additionally, it allows documentation of complex motor behaviors and vocalizations during REM sleep. […] The PSG aimed at evaluating complex nocturnal behaviors should ideally include, in addition to the routine parameters, a series of additional variables. Therefore, it is necessary to use equipment with enough monitoring channels. […] The PSG analysis for diagnosing parasomnias involves a series of considerations related to the monitored parameters, careful analysis of muscle activity, and detailed examination of synchronized video. These make PSG analysis for diagnosing complex movements during sleep more sophisticated than routine sleep lab exams, used, for example, to diagnose sleep-related breathing disorders.

• #2 Diagnostic Tools for REM Sleep Behavior Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3327886/

  Sleep history may be sufficient for diagnosis of RBD in some populations. However, PSG is necessary for a definitive diagnosis. EMG scoring methods vary in definition used and there is no single accepted approach to scoring muscle activity. […] Over the years a dynamic scientific debate has been unfolding in the literature regarding the appropriate diagnostic tools and definitions used for RBD assessment. […] The aim of this review was to identify and summarize the available subjective and objective clinical tools that have been used for RBD assessment, identify their psychometric value, and report available evidence for their validity and reliability. […] The scoring definition of the EMG channel in the American Academy of Sleep Medicine (AASM) scoring manual, which is evidence-based, was not able to provide a precise definition of what is considered excessive amounts of tonic and phasic EMG activity or a complete method of how muscle activity should be measured.

• #2 Diagnosing REM Sleep Behavior Disorder | California Sleep Society

  https://californiasleepsociety.org/news/diagnosing-rem-sleep-behavior-disorder/

  Few topics in sleep medicine have in the recent years gained as much attention and scientific insights than REM sleep behavior disorder (RBD). […] Reliable and accurate diagnosis of RBD is of critical importance as if diagnosed early, patients may be amenable to neuroprotective treatments. […] The current definition of RBD relies on the polysomnographic finding of REM sleep without atonia (RWA), or excessive electromyographic (EMG) activation during REM sleep. […] In practice, scoring RWA can become a daunting task. […] When RBD is clinically suspected, more experienced technologists and clinicians need to waive this rule and delve into the delicate task of quantifying RWA, epoch-by-epoch, and mini-epoch by mini-epoch. […] For all these reasons and until better diagnostic procedures are available for RBD, this disorder will likely be underdiagnosed.

• #2 From mechanisms to future therapy: a synopsis of isolated REM sleep behavior disorder as early synuclein-related disease | Molecular Neurodegeneration | Full Text

  https://molecularneurodegeneration.biomedcentral.com/articles/10.1186/s13024-025-00809-0

  Parkinson disease (PD), dementia with Lewy bodies (DLB) and multiple system atrophy are synucleinopathies, characterized by neuronal loss, gliosis and the abnormal deposition of -synuclein in vulnerable areas of the nervous system. […] The isolated form of REM sleep behavior disorder (RBD), a parasomnia with dream enactment behaviors and excessive muscle activity during REM sleep, is an early stage synucleinopathy. […] Diagnostic criteria proposed by the American Academy of Sleep Medicine (AASM) require repeated episodes of vocalization or complex motor behaviors during REM sleep and the demonstration of REM sleep without atonia (RSWA). […] The AASM and the International RBD Study Group have established scoring guidelines for RSWA. […] Several RBD questionnaires have been developed and might be useful for screening purposes but their specificity is low.

• #2 REM sleep behaviour disorder More than just a parasomnia

  https://www.racgp.org.au/afp/2013/november/rem-sleep-behaviour-disorder

  RBD can be mimicked by different pathologies such as severe obstructive sleep apnoea (OSA), NREM parasomnia (eg. sleepwalking, sleep talking), nocturnal panic attacks, post-traumatic stress disorder and nocturnal seizures. […] The recognition of RBD as a treatable parasomnia that could otherwise lead to serious injury is imperative in general practice.

• #2 REM Sleep Behavior Disorder Workup: Approach Considerations

  https://emedicine.medscape.com/article/1188651-workup

  The most important diagnostic studies in rapid eye movement sleep behavior disorder (RBD) include the following: Polysomnographic video recording – This is the most important diagnostic test in RBD; on PSG, at least some tonic or phasic abnormalities of muscle tone are observed during REM sleep accompanying the attack, although usually patients have both. […] Routine laboratory tests are usually not helpful. Imaging studies are not indicated in idiopathic cases but are indicated if neurologic dysfunction is suggested by history and neurologic examination. Moreover, a study demonstrated that IPT-SPECT may be a useful tool in the diagnosis of RBD.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20250109/AI-enhanced-algorithm-improves-diagnosis-of-REM-sleep-behavior-disorder.aspx

  A Mount Sinai-led team of researchers has enhanced an artificial intelligence (AI)-powered algorithm to analyze video recordings of clinical sleep tests, ultimately improving accurate diagnosis of a common sleep disorder affecting more than 80 million people worldwide. […] RBD is extremely difficult to diagnose because its symptoms can go unnoticed or be confused with other diseases. A definitive diagnosis requires a sleep study, known as a video-polysomnogram, to be conducted by a medical professional at a facility with sleep-monitoring technology. […] This automated approach could be integrated into clinical workflow during the interpretation of sleep tests to enhance and facilitate diagnosis, and avoid missed diagnoses. […] An automated algorithm that calculated the motion of pixels between consecutive frames in a video was able to detect movements during REM sleep. […] They analyzed these five features of short movements to achieve the highest accuracy to date by researchers, at 92 percent.

• #2 AI Tool Aims to Ease Detection of REM Sleep Behavior Disorder | Sleep Review

  https://sleepreviewmag.com/sleep-disorders/parasomnias/rem-parasomnias/ai-tool-aims-ease-detection-rem-sleep-behavior-disorder/

  Hgls research group has addressed this shortcoming by creating an automated solution for diagnosing iRBD. Their goal was to come up with a tool that could also be used to screen healthy people in order to detect the risk of developing a neurodegenerative disease early on. […] To diagnose iRBD, the system needs to identify the movement data from the REM stage. […] A person developing iRBD requires a solid diagnosis, consultation, and check-ups, Hgl says in the release. They should understand their condition and know that it is possible to delay the progress of a neurodegenerative disease.

• #2 Neurodegenerative Disorder Risk in Idiopathic REM Sleep Behavior Disorder: Study in 174 Patients | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089741

  To estimate the risk for developing a defined neurodegenerative syndrome in a large cohort of idiopathic REM sleep behavior disorder (IRBD) patients with long follow-up. […] Using the Kaplan-Meier method, we estimated the disease-free survival rate from defined neurodegenerative syndromes in all the consecutive IRBD patients diagnosed and followed-up in our tertiary referral sleep center between November 1991 and July 2013. […] The risk of a defined neurodegenerative syndrome from the time of IRBD diagnosis was 33.1% at five years, 75.7% at ten years, and 90.9% at 14 years. […] In a large IRBD cohort diagnosed in a tertiary referral sleep center, prolonged follow-up indicated that the majority of patients are eventually diagnosed with the synucleinopathies PD, DLB and less frequently MSA.

• #2 REM Sleep Behavior Disorder Causes

  https://www.webmd.com/sleep-disorders/rem-sleep-behavior-disorder

  In a person with REM sleep behavior disorder (RBD), the paralysis that normally happens during REM sleep is incomplete or absent, allowing the person to „act out” their dreams. […] RBD is usually seen in middle-aged to elderly people and more often in men. […] RBD often happens several years before the development of these neurodegenerative diseases. In one study, 38% of people diagnosed with RBD developed Parkinson’s disease within an average of 12 to 13 years after RBD symptoms began. […] The relationship between RBD and Parkinson disease is complex; not everyone with RBD will develop Parkinson’s disease.

• #2

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  The International RBD Study Group (IRBDSG) also recently published definitive guidelines for RBD diagnosis stating that video PSG (vPSG) is mandatory for the identification of iRBD, and must find either isolated RSWA or motor events (i.e., any type of movement in sleep captured on video). […] Thus, for a confirmed diagnosis of iRBD, a documented history of dream enactment behaviour, along with a full vPSG to obtain evidence of RSWA or motor events during sleep is required. […] Lack of awareness among neurologists and other specialists may also contribute to diagnostic delay, with one study finding that 31% of patients did not receive a timely diagnosis of iRBD (mean delay of 8.7 years from symptom onset) due to failure of their specialist (including neurologists) to recognise the symptoms.

• #2 From mechanisms to future therapy: a synopsis of isolated REM sleep behavior disorder as early synuclein-related disease | Molecular Neurodegeneration | Full Text

  https://molecularneurodegeneration.biomedcentral.com/articles/10.1186/s13024-025-00809-0

  Therefore, the current thinking in the field is that iRBD is one of the earliest detectable symptoms of synucleinopathies. […] Video-polysomnographic confirmation of iRBD is the gold standard for diagnosis. However, it should be remembered that the goal of disease modifying trials is to detect early prodromal synucleinopathy, not iRBD per se.

• #3 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  REM (rapid eye movement) sleep behaviour disorder (RBD) is characterised by vivid dreams and dream enactment behaviour such as kicking, shouting, and punching. It is important to recognise potential RBD because it is also strongly associated with neurodegenerative disease (NDD): RBD affects approximately 50% of people with Parkinsons disease (PD), 80% of people with dementia with Lewy bodies (DLB), and almost 100% of people with multiple system atrophy (MSA). RBD is also an early sign of neurodegenerative disease and can occur in otherwise healthy individuals when it is known as idiopathic or isolated RBD (iRBD). This isolated form is associated with an 80-90% risk of progression to an NDD, such as PD or DLB, within 10 years of first diagnosis. Thus, identifying iRBD provides a rare opportunity to modify future risk of neurodegeneration and there are anticipated opportunities for patients with iRBD to enrol in neuroprotective drug trials to prevent progression to an overt NDD.

• #3 REM Sleep Behavior Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd

  REM sleep behavior disorder (RBD) is a sleep disorder in which you physically act out your dreams unknowingly while you’re asleep. […] If you have symptoms of REM sleep behavior disorder (RBD), it’s important to see a healthcare provider. They’ll ask you questions about your symptoms and medical history. If you have a bed partner or housemates, your provider will likely want to ask them questions about your sleeping behavior. […] To receive a diagnosis of REM sleep behavior disorder, you’ll undergo an in-lab video sleep study or polysomnogram (PSG). Sleep studies are tests that record specific body functions during sleep, such as your heart rate, breathing rate and airflow, brain wave activity, eye movements, and muscle movements of your chin and upper extremities. […] According to the International Classification of Sleep Disorders, a diagnosis of RBD requires all of the following: You have repeated episodes of sleep-related vocalization and/or complex movement behaviors. The behaviors are documented by a sleep study (polysomnography) and occur during REM sleep or can be assumed to happen during REM sleep based on your clinical history. The sleep study shows that you experience REM sleep without atonia (muscle paralysis). You don’t have seizure-related activity during REM sleep. The sleep disturbances aren’t better explained by another sleep disorder, medical condition or mental health condition. They’re also not caused by medication side effects or substance use disorder.

• #3

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  These findings reveal the importance of thorough clinical assessment when patients present with iRBD symptomology, as lack of initial recognition can hinder the diagnostic process and reduce opportunities for disease management, especially early ND identification and potential treatment. […] Once initial suspicion of iRBD has been raised and referral made to a Neurology or Sleep Medicine service, thorough history taking, including direct questioning of iRBD symptomatology, is one of the most valuable tools to assist in diagnosis. […] Including the patients bed partner in the interview process is crucial as many patients with iRBD have no awareness that they act out their dreams during sleep. […] The most commonly used questionnaire in clinical populations is the REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ).

• #3 REM sleep behaviour disorder: the importance of early identification in primary care | British Journal of General Practice

  https://bjgp.org/content/73/726/40

  A validated single screening question for probable RBD is: Have you been told, or suspected yourself, that you seem to act out your dreams while asleep (for example, punching, flailing your arms in the air, making running movements, etc.)? An answer of yes should prompt a referral for further investigations. The diagnostic accuracy of this question is 94% sensitivity/87% specificity when compared with the gold standard of vPSG; however, this should be used only as an initial screening for onward referral. […] While there remains uncertainty around iRBD and its association with different types of NDD, it is clear that iRBD is a prodrome of neurodegeneration. This means there is an opportunity for dementia risk reduction through managing potentially modifiable dementia risk factors. GPs therefore play a vital role in recognising potential iRBD and applying preventive medicine approaches with the aim of trying to alter iRBD trajectories. Furthermore, GPs will play a similarly vital role in timely referral to specialist settings when cognitive impairment and/or parkinsonism emerge.

• #3

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  This is a 10-item questionnaire examining the main clinical features of iRBD, that is self-rated by the person suspected of having iRBD and has been validated in many cross-cultural populations. […] However, when including patients with other sleep disorders, the specificity drops to only 56%. […] The IRBDSG now states that definitive diagnosis of iRBD requires a gold-standard, Level 1, video polysomnography (vPSG) to capture REM sleep without atonia and/or dream enactment behaviour. […] The utility of vPSG is well-established in the diagnosis of iRBD, with the identification of RSWA an essential requirement. […] However, it is challenging for most neurologists to access vPSG for their patients. […] There is an urgent need for vPSG availability within the home, to increase accessibility and improve early diagnosis in this high-risk population. […] Recent advances in technologies such as actigraphy and contactless devices presents an exciting and much more accessible way of detecting iRBD; however, there have been limited studies so far and further research is needed.

• #3 REM Sleep Behavior Disorder Diagnosis and Tests

  https://www.webmd.com/sleep-disorders/diagnosing-rem-sleep-behavior-disorder

  When trying to diagnose REM sleep behavior disorder, or RBD, the neurologic exam is often normal. However, symptoms and signs of Parkinson’s disease, such as hand tremor at rest, slowness in movement, and muscle stiffness (rigidity) that may suggest an underlying neurologic cause of RBD, should be considered. […] Polysomnographic video recording is the single most important diagnostic test in persons with RBD. This test is usually conducted in a sleep study center. The person undergoing testing is required to sleep at the center while the following parameters are monitored: […] In persons with RBD, the polysomnogram shows an increase in the muscle tone associated with the EEG pattern of REM sleep, whereas in healthy persons, the EEG pattern of REM sleep is associated with an absence of muscle tone (atonia).

• #3 Rapid Eye Movement (REM) Sleep Behaviour Disorder | North Bristol NHS Trust

  https://www.nbt.nhs.uk/our-services/a-z-services/neuropsychiatry/rapid-eye-movement-rem-sleep-behaviour-disorder

  A detailed sleep history is sometimes enough on its own to make a diagnosis of an REM sleep behaviour disorder, especially if there is already a diagnosis of an associated condition such as Parkinsons Disease. […] A one or two night inpatient sleep study may be needed. This is known as Polysomnography (which means taking multiple measurements during sleep). […] Polysomnography involves the use of a number of wires which are stuck to the patient, which are used to take various measurements of the body during sleep. The important thing we look for in REM behaviour disorder is muscle tension during REM sleep.

• #3 Diagnosing REM Sleep Behavior Disorder | California Sleep Society

  https://californiasleepsociety.org/news/diagnosing-rem-sleep-behavior-disorder/

  Few topics in sleep medicine have in the recent years gained as much attention and scientific insights than REM sleep behavior disorder (RBD). […] Reliable and accurate diagnosis of RBD is of critical importance as if diagnosed early, patients may be amenable to neuroprotective treatments. […] The current definition of RBD relies on the polysomnographic finding of REM sleep without atonia (RWA), or excessive electromyographic (EMG) activation during REM sleep. […] In practice, scoring RWA can become a daunting task. […] When RBD is clinically suspected, more experienced technologists and clinicians need to waive this rule and delve into the delicate task of quantifying RWA, epoch-by-epoch, and mini-epoch by mini-epoch. […] For all these reasons and until better diagnostic procedures are available for RBD, this disorder will likely be underdiagnosed.

• #3 SciELO Brasil – REM sleep behavior disorder: update on diagnosis and management REM sleep behavior disorder: update on diagnosis and management

  https://www.scielo.br/j/anp/a/NyW6ysTnXjDj8kRrWFKmyLp/

  REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. Diagnostic assessment should begin with a detailed clinical history with the patient and bed partner or roommate and the examination of any recorded home videos. Polysomnography (PSG) is necessary to verify the loss of sleep atonia and, when documented, the behaviors during sleep. […] The diagnostic evaluation should begin with a detailed clinical history with the patient and bed partner and the examination of recorded home videos, if available. After this initial stage, polysomnography (PSG) is necessary to identify and quantify RWA and to document sleep behaviors.

• #3 A Machine Learning Approach for Detecting Idiopathic REM Sleep Behavior Disorder

  https://www.mdpi.com/2075-4418/12/11/2689

  A Machine Learning Approach for Detecting Idiopathic REM Sleep Behavior Disorder […] Background and purpose: Growing evidence suggests that Machine Learning (ML) models can assist the diagnosis of neurological disorders. However, little is known about the potential application of ML in diagnosing idiopathic REM sleep behavior disorder (iRBD), a parasomnia characterized by a high risk of phenoconversion to synucleinopathies. This study aimed to develop a model using ML algorithms to identify iRBD patients and test its accuracy. […] The diagnosis is based on the clinical history in combination with video-polysomnography (PSG) confirmation of REM atonia loss during sleep. At present, the screening of iRBD patients is performed using the RBD Single-Question Screen (RBD1Q), a screening question for dream enactment with a simple yes/no response, validated in relation to gold-standard PSG diagnosis.

• #3 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20250109/AI-enhanced-algorithm-improves-diagnosis-of-REM-sleep-behavior-disorder.aspx

  A Mount Sinai-led team of researchers has enhanced an artificial intelligence (AI)-powered algorithm to analyze video recordings of clinical sleep tests, ultimately improving accurate diagnosis of a common sleep disorder affecting more than 80 million people worldwide. […] RBD is extremely difficult to diagnose because its symptoms can go unnoticed or be confused with other diseases. A definitive diagnosis requires a sleep study, known as a video-polysomnogram, to be conducted by a medical professional at a facility with sleep-monitoring technology. […] This automated approach could be integrated into clinical workflow during the interpretation of sleep tests to enhance and facilitate diagnosis, and avoid missed diagnoses. […] An automated algorithm that calculated the motion of pixels between consecutive frames in a video was able to detect movements during REM sleep. […] They analyzed these five features of short movements to achieve the highest accuracy to date by researchers, at 92 percent.

• #3 Diagnostic Code Aids in Predicting Isolated REM Sleep Behavior Disorder in Outpatient Setting

  https://www.neurologylive.com/view/diagnostic-code-proves-feasible-predicting-irbd-outpatient-setting

  Patients with iRBD had a significantly higher risk of being diagnosed with neurodegenerative parkinsonian disorders or dementia in real-world settings. […] The study demonstrated the feasibility of using statistical models developed from EHR data to accurately predict iRBD in outpatient settings. […] Authors of the review recommended that neurologists and other clinicians diagnosing iRBD should conduct questionnaires to help them make a more „probable diagnosis” but this approach should not be used as the only diagnostic tool for iRBD. […] Thus, the detection of iRBD presents an important opportunity for clinicians to intervene early in the condition, through therapies or risk modification, to adjust its trajectory or even prevent the development of neurodegenerative diseases in the future. […] Authors from the prior review noted that there is an increasing interest in pharmaceutical clinical trials for iRBD that is further increasing the criticalness of diagnosis and raising awareness of the key role neurologists play to accurately diagnose this disorder early on.

• #3 REM Sleep Behavior Disorder: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1188651-overview

  The International Classification of Sleep Disorders, Third Edition, Text Revision requires all the following criteria for the diagnosis of RBD: Repeated episodes of sleep-related vocalization and/or complex motor behaviors. These behaviors are documented by polysomnography to occur during REM sleep, or based on clinical history of dream enactment, are presumed to occur during REM sleep. Presence of REM sleep without atonia (RSWA) on polysomnography (PSG). Sleep disorder not better explained by another sleep disorder, a medical or neurologic disorder, a mental disorder, medication use, or a substance use disorder. […] Based on findings from sleep studies, most individuals (50%) with initially idiopathic RBD will eventually develop a neurodegenerative disease. RBD is thought to be a prodromal marker of neurodegenerative synucleinopathies and is present in a majority of patients with Parkinson disease (50%), multiple system atrophy (80-90%), dementia with Lewy bodies (80%). REM sleep behavior disorder often predates any other sign of these disorders by many years (often more than a decade).

• #3 Diagnosing REM Sleep Behavior Disorder | California Sleep Society

  https://californiasleepsociety.org/news/diagnosing-rem-sleep-behavior-disorder/

  Until such tools are validated, the single-night, in-lab, attended PSG will remain the gold-standard procedure for RBD. […] It is however clear that human-scored PSG not only lacks accuracy and reliability for the diagnosis of RBD but does not seem to be a viable option in todays practice of sleep medicine. […] Automated scoring is not just inevitable. If well done, it could improve our diagnostic procedures, and serve not as a replacement but as a complement to human scoring.

• #3 Rapid eye movement sleep behavior disorder – UpToDate

  https://www.uptodate.com/contents/rapid-eye-movement-sleep-behavior-disorder

  Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by dream-enactment behaviors that emerge during a loss of REM sleep atonia. […] A careful history should distinguish RBD from related parasomnias such as sleepwalking. In-laboratory video polysomnography can exclude other sleep disorders, quantify REM atonia and capture dream-enactment behaviors, confirming the diagnosis. […] The main focus of treatment is to reduce behavioral events and prevent sleep-related injury; this can be achieved through changes in the sleeping environment and, if necessary, pharmacotherapy (eg, melatonin, clonazepam).

• #4

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  These findings reveal the importance of thorough clinical assessment when patients present with iRBD symptomology, as lack of initial recognition can hinder the diagnostic process and reduce opportunities for disease management, especially early ND identification and potential treatment. […] Once initial suspicion of iRBD has been raised and referral made to a Neurology or Sleep Medicine service, thorough history taking, including direct questioning of iRBD symptomatology, is one of the most valuable tools to assist in diagnosis. […] Including the patients bed partner in the interview process is crucial as many patients with iRBD have no awareness that they act out their dreams during sleep. […] The most commonly used questionnaire in clinical populations is the REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ).

• #4 A Machine Learning Approach for Detecting Idiopathic REM Sleep Behavior Disorder

  https://www.mdpi.com/2075-4418/12/11/2689

  A Machine Learning Approach for Detecting Idiopathic REM Sleep Behavior Disorder […] Background and purpose: Growing evidence suggests that Machine Learning (ML) models can assist the diagnosis of neurological disorders. However, little is known about the potential application of ML in diagnosing idiopathic REM sleep behavior disorder (iRBD), a parasomnia characterized by a high risk of phenoconversion to synucleinopathies. This study aimed to develop a model using ML algorithms to identify iRBD patients and test its accuracy. […] The diagnosis is based on the clinical history in combination with video-polysomnography (PSG) confirmation of REM atonia loss during sleep. At present, the screening of iRBD patients is performed using the RBD Single-Question Screen (RBD1Q), a screening question for dream enactment with a simple yes/no response, validated in relation to gold-standard PSG diagnosis.

• #4 Rapid Eye Movement (REM) Sleep Behavior Disorder Quiz: Check Possibility & Treatment with Ubie AI Symptom Checker

  https://ubiehealth.com/diseases/rapid-eye-movement-rem-sleep-behavior-disorder

  Rapid eye movement sleep behavior disorder (RBD) is a condition in which a person abnormally acts out dreams during rapid-eye-movement (REM) sleep, a phase of sleep that is normally characterized by random, rapid movements of the eyes, vivid dreams, and muscle paralysis. The acting out can range from calm limb movements to violent arm and leg thrashing, talking, and/or shouting. Although RBD can be caused by certain medications or sleep conditions such as narcolepsy, RBD is a most commonly a precursor to later onset of Parkinson disease. 75% of RBD patients develop Parkinson disease by 12 years after RBD diagnosis. […] Your doctor may ask these questions to check for this disease: Do your sleep abnormalities occur just before waking up? Do your abnormal sleep behaviors occur with nightmares? Are you usually able to recall your dreams? Do your uncontrollable movements happen at night? Do you wake up easily?

• #4 From mechanisms to future therapy: a synopsis of isolated REM sleep behavior disorder as early synuclein-related disease | Molecular Neurodegeneration | Full Text

  https://molecularneurodegeneration.biomedcentral.com/articles/10.1186/s13024-025-00809-0

  Therefore, the current thinking in the field is that iRBD is one of the earliest detectable symptoms of synucleinopathies. […] Video-polysomnographic confirmation of iRBD is the gold standard for diagnosis. However, it should be remembered that the goal of disease modifying trials is to detect early prodromal synucleinopathy, not iRBD per se.

• #4 Perspectives: Dr. Carlos Schenck discusses REM-sleep behavior disorder | MedLink Neurology

  https://www.medlink.com/articles/perspectives-dr-carlos-schenck-discusses-rem-sleep-behavior-disorder

  The traditional clinical profile of RBD involves predominantly middle-aged and older men with aggressive, dream-enacting behaviors, with more than 80% of them eventually developing an overt alpha-synucleinopathy. This profile now needs to be modified, given a recent population-based study of middle-aged to older adults with polysomnography-confirmed RBD that found a 1.06% prevalence of RBD–and with gender parity. Because women generally have less aggressive and injurious RBD, they present for medical attention much less frequently than men. Therefore, the traditional RBD profile has reflected a clinical referral bias on account of more aggressive and injurious RBD behaviors in men compared to women. However, because both male and female middle-aged and older patients with RBD are equally at risk for eventually developing alpha-synucleinopathies, once a promising neuroprotective (disease-modifying) agent becomes available, a concerted effort must be initiated to find the women with RBD who had not sought medical attention; it is the presence of REM without atonia or RBD, and not its severity, that carries the strong risk for future parkinsonism.

• #5

  https://link.springer.com/article/10.1007/s00415-022-11213-9

  This is a 10-item questionnaire examining the main clinical features of iRBD, that is self-rated by the person suspected of having iRBD and has been validated in many cross-cultural populations. […] However, when including patients with other sleep disorders, the specificity drops to only 56%. […] The IRBDSG now states that definitive diagnosis of iRBD requires a gold-standard, Level 1, video polysomnography (vPSG) to capture REM sleep without atonia and/or dream enactment behaviour. […] The utility of vPSG is well-established in the diagnosis of iRBD, with the identification of RSWA an essential requirement. […] However, it is challenging for most neurologists to access vPSG for their patients. […] There is an urgent need for vPSG availability within the home, to increase accessibility and improve early diagnosis in this high-risk population. […] Recent advances in technologies such as actigraphy and contactless devices presents an exciting and much more accessible way of detecting iRBD; however, there have been limited studies so far and further research is needed.

• #5 A Machine Learning Approach for Detecting Idiopathic REM Sleep Behavior Disorder

  https://www.mdpi.com/2075-4418/12/11/2689

  In the context of emerging tools for RBD screening, heart rate variability (HRV) analysis, a simple and non-invasive measure of cardiac impulses, has been demonstrated to be useful in accurately differentiating patients with PD associated with RBD from those without RBD. […] To the best of our knowledge, there are no previous reports using an ML approach on HRV data to identify iRBD patients. Owing to this lack of investigation, here, we tested the accuracy of HRV features and ML models (Logistic Regression (LR), Extreme Gradient Boosting (XGBoost) and Random Forest (RF)) to correctly identify patients with iRBD. […] Our findings indicate that ML models applied on HRV features may help in distinguishing iRBD patients from controls. Our ML model could be easily implemented in a software application as a rapid screening tool, thus supporting neurologists in the early detection of this fascinating disorder.

• #5 From mechanisms to future therapy: a synopsis of isolated REM sleep behavior disorder as early synuclein-related disease | Molecular Neurodegeneration | Full Text

  https://molecularneurodegeneration.biomedcentral.com/articles/10.1186/s13024-025-00809-0

  RBD can be classified into isolated (formerly idiopathic) RBD (iRBD) and secondary RBD. […] Isolated RBD occurs in the absence of an associated clinically manifest neurological disease. […] A high proportion of individuals affected by iRBD eventually develop synuclein-specific neurodegenerative disorders (i.e., synucleinopathies) such as PD, DLB or MSA. […] The largest international study to date that examined 1280 patients with RBD and revealed a phenoconversion rate of 6.3% per year; 73% of this study cohort developed a synucleinopathy within a 12-year follow up period. […] This review aims at providing an overview of RBD with a focus on its isolated form as early synucleinopathy, highlighting how RBD research can shed light into synucleinopathy pathophysiology and provide insights into neuromodulating or neuroprotective treatments for these neurodegenerative diseases from the earliest stages.

• #6 Sleep Trackers Can Be Used to Screen for Parkinson’s Disease

  https://sleepreviewmag.com/sleep-disorders/parasomnias/rem-parasomnias/screen-rem-sleep-behavior-disorder/

  Diagnosing REM sleep behavior disorder based on history alone can be challenging for sleep specialists, particularly since video polysomnography is not always accepted by patients or the dream-enacting behaviors required for diagnosis may not manifest during a single night of sleep testing. […] Researchers have now identified a two-step convenient screening method to detect REM sleep behavior disorder at home using technology already present in most wearable sleep and fitness trackers. […] A machine learning classifier using high-frequency (1-second resolution) actigraphy and a short patient survey for detecting idiopathic REM sleep behavior disorder with high accuracy and precision. […] The findings showed that sleep disturbances related to Parkinsons disease are detectable using wearable wrist devices such as Apple Watch or Fitbit.

• #7 Sleep Trackers Can Be Used to Screen for Parkinson’s Disease

  https://sleepreviewmag.com/sleep-disorders/parasomnias/rem-parasomnias/screen-rem-sleep-behavior-disorder/

  This new screening method could diagnose a very common subtype of Parkinsons disease years before the conventional methods of diagnosis, which require a clinical examination by an experienced neurologist. […] A two-step approach using questionnaire first, followed by ambulatory actigraphy for 10 days in those who screen positive, could select individuals at highest risk of idiopathic REM sleep behavior disorder and thereby result in higher positive predictive value (100% in this small sample of 84 subjects), before confirmatory video polysomnography.

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