Objective rest–activity cycle analysis by actigraphy identifies isolated rapid eye movement sleep behavior disorder

Background and purpose Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by abnormal behaviours during REM sleep. Several studies showed that iRBD is a prodromal stage of synucleinopathies. Therefore, identifying iRBD in the general population is of utmost importance....

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Bibliographic Details
Published in:European journal of neurology 2020-10, Vol.27 (10), p.1848-1855
Main Authors: Filardi, M., Stefani, A., Holzknecht, E., Pizza, F., Plazzi, G., Högl, B.
Format: Article
Language:English
Subjects:
actigraphy
Apnea
Behavior disorders
Disorders
Diurnal
Eye movements
Human motion
Motor activity
Nocturnal
Nonparametric statistics
non‐parametric analysis
Questionnaires
REM sleep
REM sleep behaviour disorder
Rest
rest–activity rhythm
Rhythm
screening
Sleep
Sleep and wakefulness
Sleep disorders
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Summary:Background and purpose Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by abnormal behaviours during REM sleep. Several studies showed that iRBD is a prodromal stage of synucleinopathies. Therefore, identifying iRBD in the general population is of utmost importance. In this study, we explore whether the assessment of rest–activity rhythm features can distinguish patients with iRBD from patients with disorders characterized by other pathological motor activity during sleep and healthy controls. Methods Nineteen patients with video‐polysomnographic diagnosis of iRBD, 39 patients with other disorders with motor activity during sleep [19 with restless leg syndrome (RLS) and 20 with untreated sleep apnea syndrome (SAS)] and 16 healthy controls underwent 2‐week actigraphy and video‐polysomnography, and completed REM sleep behavior disorder screening questionnaires. Non‐parametric analyses were applied to assess the rest–activity rhythm features. Results Patients with iRBD showed lower sleep efficiency, increased estimated wake after sleep onset and increased frequency of prolonged activity bouts compared to those with RLS and controls, while no difference emerged compared with SAS patients. Moreover, patients with iRBD presented increased occurrence of estimated nap in comparison to those with RLS, those with SAS and controls. The I 
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.14386