Rates and Predictors of Rapid Eye Movement Sleep Behavior Disorder Symptoms Among Post-9/11 Veterans
Melissa B Jones1, Juliann Tea1, Matthew Meyers1
1Mental Health Care Line (Jones, Jorge), Research Care Line (Jones, Villalon), and Medical Care Line (Agrawal), Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston; Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences (Jones, Villalon, Jorge), and Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine (Agrawal), Baylor College of Medicine, Houston; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Tea); Division of Clinical Pharmacology, Department of Medicine, and Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Meyers); Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Houston (Li).
Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are linked to rapid eye movement (REM) sleep behavior disorder (RBD) in veterans. PTSD severity and number of TBIs independently predicted RBD symptoms in a screening study.
Area of Science:
- Neurology
- Sleep Medicine
- Military Health
Background:
- Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are common among post-9/11 veterans.
- These conditions are associated with an increased risk of rapid eye movement (REM) sleep behavior disorder (RBD) and degenerative synucleinopathy.
Purpose of the Study:
- To investigate the rates and predictors of RBD symptoms in post-9/11 veterans.
- To screen veterans for RBD using a validated questionnaire.
Main Methods:
- A cross-sectional analysis of consecutive patients at the Houston Translational Research Center for TBI and Stress Disorders (TRACTS).
- Screening using the English translation of the RBD Questionnaire-Hong Kong (RBDQ-HK).
- Systematic chart review to identify sleep disorders mimicking RBD.
Main Results:
- 60% and 55% of 119 veterans screened positive for RBD based on different cutoff scores.
- Univariable analyses showed associations between positive RBD screening and sleep quality, TBI exposure, and PTSD severity.
- Multivariable analysis identified PTSD severity and number of TBIs as independent predictors of positive RBD screening.
Conclusions:
- Interdisciplinary assessment of parasomnias is crucial.
- Further validation of RBD screening tools is needed.
- Standardized reporting of REM sleep without atonia can elucidate the links between PTSD, TBI, RBD, and synucleinopathy risk.
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