Assessment Of RBD – How Can Questionnaire Help?

Abstract

REM sleep behaviour disorder (RBD) is a complex parasomnia characterised by a loss of normal skeletal muscle atonic during REM sleep and the distinct behavioural manifestations in response to vivid and action-packed dreams. Motor behaviours in RBD range from simple and mild acts to vigorous and elaborate motor activities (e.g. punching, kicking, falling out of bed), often resulting in sleep-related injuries (SRI) and violence to self and/or to bed-partner. In addition, the prognostic implication of RBD in predicting -synuclein-related neurodegeneration may imply an important therapeutic window of opportunity for neuroprotective agents to potentially slow or halt the disease progression. As such, there is an imperative need for timely and effective assessment of RBD for early clinical diagnosis and monitoring treatment progress in both clinical and research settings. Whilst polysomnography (PSG) remains the gold standard for confirming RBD diagnosis, it is time- and resource-consuming. There have been few instruments developed to facilitate screening possible RBD cases; yet limited scales are available for the purpose of quantifying and monitoring the severity and change of RBD presentation. In particular, the REM Sleep Behavior Disorder Questionnaire (RBDQ-HK) has been validated as an instrument for the diagnostic purposes, and as a measure with which to evaluate the clinical severity of RBD. Its modified version (RBDQ-3M) is designed to monitor the treatment progress over a short period of time. RBDQ-3M has been used to examine the treatment response in RBD patients treated with clonazepam. It has been shown to have good psychometric properties and may serve as a sensitive and valid tool for future randomised, controlled trials of symptomatic and neuroprotective therapy for RBD.