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Is REM Sleep Behavior Disorder Changing? Secular Changes Versus Referral Patterns.

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This summary is machine-generated.

Increased public awareness of isolated rapid eye movement (REM) sleep behavior disorder (iRBD) leads to earlier clinical presentation. This results in a longer time to phenoconversion, improving disease-free survival for patients.

Keywords:
Parkinson's diseaseREM sleep behavior disorderdementia with Lewy bodiesprevalencesecular trends

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Public Health

Background:

  • Public outreach for isolated/idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) has increased since 2014, particularly in Montreal.
  • Investigating the impact of increased awareness on disease progression and presentation timing.

Purpose of the Study:

  • To determine if milder iRBD cases are presenting earlier over time.
  • To compare disease-free survival between iRBD patient cohorts recruited in different time periods and by referral type.

Main Methods:

  • Retrospective analysis of iRBD patient data from three major centers, comparing two recruitment epochs (2004-2013 and 2014-2022).
  • Comparison of disease-free survival and time to phenoconversion based on referral type (self-referral vs. conventional referral).

Main Results:

  • In Montreal, patients diagnosed before 2014 showed a significantly shorter time to phenoconversion (42% at 5 years) compared to later diagnoses (23% at 5 years).
  • No significant differences in phenoconversion were observed in cohorts from Barcelona and Innsbruck.
  • In Montreal, increased survival in the later epoch was associated with a higher number of self-referrals, who had a 3-fold lower rate of phenoconversion compared to physician-referred patients.

Conclusions:

  • Increased patient awareness of iRBD facilitates earlier presentation to healthcare professionals.
  • Earlier clinical attention, driven by public outreach, correlates with a longer time to phenoconversion and improved disease-free survival.