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. 2013 Aug 1;36(8):1147-52.
doi: 10.5665/sleep.2874.

REM sleep behavior disorder in the Korean elderly population: prevalence and clinical characteristics

Suk-Hoon Kang  1 , In-Young Yoon, Sang Don Lee, Ji Won Han, Tae Hui Kim, Ki Woong Kim
Affiliations

REM sleep behavior disorder in the Korean elderly population: prevalence and clinical characteristics

Suk-Hoon Kang et al. Sleep. .

Abstract

Study objectives: To examine the prevalence and clinical characteristics of REM sleep behavior disorder (RBD) and subclinical RBD in the Korean elderly population.

Design: A community-based Korean Longitudinal Study on Cognitive Aging and Dementia and time-synchronized video-polysomnography (vPSG) in a laboratory.

Setting: Sleep laboratory in a university hospital.

Participants: 348 individuals aged 60 years or older.

Intervention: N/A.

Measurements and results: Among 696 subjects who were invited to participate in a vPSG study, 348 completed the vPSG. RBD was diagnosed when subjects showed REM sleep without atonia (RSWA) in the vPSG, and had history of complex and vigorous behaviors during sleep or abnormal REM sleep behaviors in the vPSG. Subjects with RSWA but no abnormal REM sleep behaviors were diagnosed with subclinical RBD. Seven subjects (5 male, 2 female) had RBD, three of whom (1 male, 2 female) had Parkinson disease. Two subjects reported history of sleep-related injury. The crude prevalence of RBD and idiopathic RBD was 2.01% (95% confidence interval [CI] = 0.54% to 3.49%) and 1.15% (95% CI = 0.03% to 2.27%). An age and sex-adjusted prevalence estimate of RBD and idiopathic RBD in the Korean elderly was 2.01% and 1.34%. Eighteen subjects were diagnosed with subclinical RBD, and the prevalence of subclinical RBD was estimated to be 4.95%.

Conclusions: RBD and subclinical RBD are not rare in the elderly in the community with abnormal REM sleep behaviors of RBD being mild to injurious and violent. The clinical significance and long-term progression of subclinical RBD needs to be further explored, given the prevalence and its possible relation to RBD.

Keywords: REM sleep behavior disorder; prevalence; subclinical REM sleep behavior disorder.

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Figures

Figure 1
Figure 1
Flow chart summary of the study process. vPSG, video polysomnography; RSWA, REM sleep without atonia; DEB, dream enacting behavior; RBD, REM sleep behavior disorder
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