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. 2011 May;12(5):445-53.
doi: 10.1016/j.sleep.2010.12.009. Epub 2011 Feb 23.

Validation of the Mayo Sleep Questionnaire to screen for REM sleep behavior disorder in an aging and dementia cohort

Bradley F Boeve  1 , Jennifer R Molano, Tanis J Ferman, Glenn E Smith, Siong-Chi Lin, Kevin Bieniek, Wael Haidar, Maja Tippmann-Peikert, David S Knopman, Neill R Graff-Radford, John A Lucas, Ronald C Petersen, Michael H Silber
Affiliations

Validation of the Mayo Sleep Questionnaire to screen for REM sleep behavior disorder in an aging and dementia cohort

Bradley F Boeve et al. Sleep Med. 2011 May.

Abstract

Objective: To validate a questionnaire focused on rapid eye movement sleep (REM) sleep behavior disorder (RBD) among participants in an aging and dementia cohort.

Background: RBD is a parasomnia that can develop in otherwise neurologically-normal adults as well as in those with a neurodegenerative disease. Confirmation of RBD requires polysomnography (PSG). A simple screening measure for RBD is desirable for clinical and research purposes.

Methods: We had previously developed the Mayo Sleep Questionnaire (MSQ), a 16 item measure, to screen for the presence of RBD and other sleep disorders. We assessed the validity of the MSQ by comparing the responses of patients' bed partners with the findings on PSG. All subjects recruited in the Mayo Alzheimer's Disease Research Center at Mayo Clinic Rochester and Mayo Clinic Jacksonville from 1/00 to 7/08 who had also undergone a PSG were the focus of this analysis.

Results: The study sample was comprised of 176 subjects (150 male; median age 71 years (range 39-90)), with the following clinical diagnoses: normal (n = 8), mild cognitive impairment (n = 44), Alzheimer's disease (n = 23), dementia with Lewy bodies (n = 74), as well as other dementia and/or parkinsonian syndromes (n = 27). The core question on recurrent dream enactment behavior yielded a sensitivity (SN) of 98% and specificity (SP) of 74% for the diagnosis of RBD. The profile of responses on four additional subquestions on RBD and one on obstructive sleep apnea improved specificity.

Conclusions: These data suggest that among aged subjects with cognitive impairment and/or parkinsonism, the MSQ has adequate SN and SP for the diagnosis of RBD. The utility of this scale in other patient populations will require further study.

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Figures

Figure
Figure
Examples of polysomnographic fragments (30 second epochs) of REM sleep in four different patients, showing definitely normal EMG atonia (A), definitely increased EMG tone and hence definite REM sleep without atonia (B), and equivocally increased EMG tone (C and D). Note the low amplitude EMG activity in C which persists through most of this epoch, and is present in most but not all epochs of REM sleep; the patient has no clinical findings suggesting motor neuron disease or a peripheral neuropathy. The sample in D shows an approximately 10 second fragment during phasic REM with brief bursts of EMG activity (left of double vertical lines), and an approximately 20 second epoch during a REM sleep episode later in the night with more obvious and persistent EMG activity during phasic and tonic REM (right of double vertical lines). Neither patient in C or D exhibited any apparent motor activity on the synchronous video at any time during REM sleep. Note that in cases B, C and D, the equivocal or definitely increased EMG activity was present on the leg derivation, but atonia was normal in each case in the submentalis derivation.
None
Mayo Sleep Questionnaire-Informant
Permission is granted for non-commercial use in the context of patient care and research provided that no fee is charged. ©2009 Mayo Foundation for Medical Education and Research. All Rights Reserved.
None
Mayo Sleep Questionnaire-Informant
Permission is granted for non-commercial use in the context of patient care and research provided that no fee is charged. ©2009 Mayo Foundation for Medical Education and Research. All Rights Reserved.
None
Mayo Sleep Questionnaire-Informant
Permission is granted for non-commercial use in the context of patient care and research provided that no fee is charged. ©2009 Mayo Foundation for Medical Education and Research. All Rights Reserved.
See this image and copyright information in PMC

Comment in

References

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