Instruments for screening, diagnosis and assessment of RBD severity and monitoring treatment outcome

Abstract

REM sleep behaviour disorder (RBD) is a distinct parasomnia characterised by a loss of normal skeletal muscle atonia during REM sleep and a clinical presentation of dream enacting behaviours. As a consequence of the vigorous nocturnal motor activities, sleep-related injuries to self and bed partner are common sequelae in RBD patients. Meanwhile, RBD is increasingly being recognised as a precursor of synucleinopathy neurodegeneration. This prognostic implication in predicting future neurodegeneration underscores the need for early detection and the timely and accurate diagnosis of RBD. Although video-polysomnography remains the gold standard to confirm a diagnosis of RBD, it is resource-intensive and time-consuming. To facilitate screening, diagnosis and monitoring symptom severity of RBD, several instruments have been developed in the past several years. The present chapter provides a summary of the recent research on the development of these instruments and reviews their properties and unique strengths for use in different clinical and research settings.