REM sleep behaviour disorder in essential tremor: A polysomnographic study.
Paulo Bugalho1,2, Manuel Salavisa1, Cláudia Borbinha1
1Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Journal of Sleep Research
|April 24, 2020
Summary
A significant number of Essential Tremor patients exhibit REM sleep behaviour disorder (RBD), often with rest tremor. Polysomnography findings in these patients resemble those with Parkinson's disease, suggesting a link to alpha-synucleinopathies.
Area of Science:
- Neurology
- Sleep Medicine
- Movement Disorders
Background:
- Essential Tremor (ET) is a common movement disorder.
- REM sleep behaviour disorder (RBD) is characterized by loss of muscle atonia during REM sleep.
- Alpha-synucleinopathies, such as Parkinson's disease, are associated with RBD.
Purpose of the Study:
- To determine the prevalence of RBD in ET patients using video-polysomnography.
- To compare RBD features in ET patients with those in alpha-synucleinopathies.
- To analyze clinical and polysomnographic differences in ET patients with and without RBD.
Main Methods:
- Screening of 49 ET patients using the REM Sleep Behaviour Disorder Screening Questionnaire.
- Video-polysomnography for patients with positive screening or spontaneous RBD complaints.
- Comparison of clinical features and polysomnography data between ET subgroups and with Parkinson's disease and idiopathic RBD cohorts.
Main Results:
- 11.6% of ET patients had polysomnography-confirmed RBD.
- ET patients with RBD predominantly exhibited rest tremor (p=0.009).
- Polysomnography findings in ET with RBD resembled those in Parkinson's disease with RBD, but showed worse sleep dysfunction and lower RBD severity than idiopathic RBD.
Conclusions:
- RBD is highly prevalent in a subgroup of ET patients.
- The presence of RBD in ET is associated with rest tremor.
- Polysomnographic similarities between ET with RBD and Parkinson's disease suggest a potential shared pathway involving alpha-synucleinopathies.
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