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Sleep disordered breathing and REM sleep behavior disorder in military Veterans with Parkinson’s disease

A. Sarwar, S. Moore (Houston, TX, USA)

Meeting: 2019 International Congress

Abstract Number: 594

Keywords: Excessive daytime sleepiness(EDS), Parkinsonism, Sleep disorders. See also Restless legs syndrome: Clinical features

Session Information

Date: Monday, September 23, 2019

Session Title: Restless Leg Syndrome, RBD and Other Sleep Disorders

Session Time: 1:45pm-3:15pm

Location: Les Muses Terrace, Level 3

Objective: To study the association of sleep disordered breathing with REM sleep behavior disorder in US military Veterans with Parkinson’s disease.

Background: Both REM sleep behavior disorder (RBD) and sleep disordered breathing (SDB) are common in patients with Parkinson’s disease (PD). Prior smaller studies involving non-Veterans from other countries have found SDB to be more frequent and severe in PD patients with RBD. No such observation in US military Veterans has been reported.

Method: 126 Veterans with PD followed in our movement disorders clinic were evaluated for the presence of RBD using the English language version of the REM Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-HK) [cut off score 20]. Groups with and without RBD were assessed for risk for SDB using modified Berlin Questionnaire. All subjects were screened for excessive daytime sleepiness using Epworth Sleepiness Scale (ESS) [cut off score 10]. PD disease severity and cognition were assessed using Hoehn and Yahr rating scale (H&Y) and Unified Parkinson’s Disease Rating Scale (UPDRS), respectively.

Results: The groups with and without RBD included 64 and 62 subjects respectively. SDB risk as estimated by three category 1 questions of modified Berlin questionnaire (Snoring, Gasping, Observed Apneas) was significantly increased in the group with RBD as compared to the one without. However, when the groups were sub-divided into “Sleepy” (ESS ≥ 10) and “Non-Sleepy” (ESS <10), the significant difference was only noted in the “Sleepy” group.The groups were comparable with respect to age, gender distribution, disease severity (H&Y, median=2.0 for both), and cognition (UPDRS question 1, median=1 for both).

Conclusion: The risk for sleep disordered breathing is higher in US military Veterans with Parkinson’s disease who also endorse symptoms suggestive of REM sleep behavior disorder. Day time sleepiness may be a biomarker for this association in this group of patients. Additional work is needed to confirm these findings.

To cite this abstract in AMA style:

A. Sarwar, S. Moore. Sleep disordered breathing and REM sleep behavior disorder in military Veterans with Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/sleep-disordered-breathing-and-rem-sleep-behavior-disorder-in-military-veterans-with-parkinsons-disease/. Accessed June 14, 2025.
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