PMID: 18714790Aug 22, 2008Paper

Diagnosis of REM sleep behavior disorder by video-polysomnographic study: is one night enough?

Sleep
Jihui ZhangYun Kwok Wing

Abstract

Clinical features of RBD were typically episodic with limited data on the night-to-night reliability of the diagnostic video-PSGs. We aimed to assess on whether a single night study was adequate. Retrospective review. Sleep laboratory. 55 RBD patients with at least 2 consecutive video-PSGs. N/A. We analyzed 2 consecutive video-PSGs using REM-related EMG activity (REMREEA), REM sleep without atonia (RSWA), and video analysis of motor events. A weak first night effect with increased REM sleep latency, increased stage 1 sleep, and increased arousal index were found. No differences were found in phasic and tonic EMG activity scores between night 1 and night 2. The presence of OSAS, use of CPAP, and clonazepam treatment did not affect the night-to-night variability and diagnostic accuracy. The kappas were 0.64, 0.51, and 0.31 between night 1 and night 2 for 10% REMREEA, RSWA, and video analysis respectively. Over 80% of patients could be diagnosed by various criteria in the first night, but the diagnostic ability could be enhanced to nearly 95% when combining PSG with video analysis. While both of the EMG criteria as well as the combination criteria had good reliability, video-analysis had poorer night-to-night reliability. A single...Continue Reading

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