렘수면행동장애 환자의 수면다원검사에 대한 정량적 분석을 통한 진단적 접근

Abstract

Rapid eye movement sleep behavior disorder (RBD) is characterized by the intermittent absence of electromyogram (EMG) atonia during rapid eye movement (REM) sleep and the increase of motor activity associated with dream mentation. However, ICSD-2 criteria did not suggest validated diagnostic criteria and previous studies had no consistency with value ranged 10-20% of REM sleep without atonia (RSWA) in polysomnography (PSG). We investigated standard value about RSWA of Korean RBD patients. Methods: Thirty one patients diagnosed with RBD and 31 normal age- and sex-matched controls were selected. All RBD patients and normal controls were studied using PSG from 2007 to 2012. ICSD-2 criteria was used to select RBD patients and RSWA. We defined RSWA as increasing amplitude by 4 times that of baseline EMG and occupying at least 50% of each epoch or five 3 second mini-epochs. Results: PSG findings showed increased N1 sleep, periodic leg movement index and decreased N2 sleep in RBD patients compared to normal controls. Mean RSWA was 19.21% [±9.93, standard deviation (SD)], with a range of 5.21-38.22% in RBD patients, whereas the mean RSWA in normal control was 0.43% (±0.74, SD) with a range of 0-2.3%. Conclusions: We quantitatively figured out the characteristics of PSG and RSWA in Korean RBD patients. The outcome shows definite differences between RBD patients and normal controls. This study suggest that we may diagnose RBD who have RSWA over 5% of the REM sleep periods.