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Related Concept Videos

REM Sleep Behavior Disorder01:15

REM Sleep Behavior Disorder

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REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
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Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
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REM Sleep Behavior Disorder Diagnostic Code Accuracy and Implications in the Real-World Setting.

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Data Science

Background:

  • Isolated REM sleep behavior disorder (iRBD) is a risk factor for neurodegenerative diseases like parkinsonian disorder or dementia (NPD).
  • Accurate community screening for iRBD is challenging.
  • Electronic health records (EHR) offer a potential resource for identifying iRBD cases.

Purpose of the Study:

  • To determine the positive predictive value (PPV) of an International Classification of Disorders (ICD) code for REM sleep behavior disorder (RBD) in identifying actual iRBD cases.
  • To assess the risk of subsequent NPD diagnosis in individuals with iRBD.
  • To explore the feasibility of using EHR data to develop a statistical model for predicting iRBD.

Main Methods:

  • Retrospective cohort study analyzing EHR data from 2011-2021.
  • Manual review of EHRs for patients with RBD ICD codes to confirm iRBD and exclude secondary causes.
  • Utilized Least Absolute Shrinkage and Selection Operator (LASSO) regression to build and validate a predictive model for iRBD using EHR data.

Main Results:

  • The PPV of an RBD ICD code for actual iRBD was 73.25% after excluding secondary causes.
  • Patients with iRBD showed a significantly higher risk of NPD diagnosis (subdistribution hazard ratio = 10.4) over a median follow-up of 4.7 years.
  • The developed LASSO prediction model demonstrated strong performance with an area under the receiver operating characteristic curve of 0.844.

Conclusions:

  • An RBD ICD code has moderate PPV for identifying iRBD in real-world clinical settings.
  • Patients diagnosed with iRBD have a substantially elevated risk of developing NPD.
  • Statistical models utilizing EHR data can effectively predict iRBD, aiding in early identification and management.