The need for screening and screening methods for RBD

PSG is clearly necessary for establishing the diagnosis of RBD, but the procedure requires appropriate monitoring equipment, including time synchronized video recordings, specially trained technologists, bed availability in a sleep laboratory, and clinicians who can interpret the data. The procedure is costly, especially for patients with limited insurance coverage. Subjects must be willing and able to sleep in a sleep laboratory and undergo monitoring. Some patients with coexisting neurologic disorders are too cognitively or physically impaired to tolerate and undergo an adequate study, are too uncooperative to permit all of the monitoring equipment to remain in place, are at risk for falls during the night, or are institutionalized. RBD cannot be accurately assessed in the home. Due to the limited number of sleep disorder centers in many countries, PSG is not possible even when clearly medically warranted. As it is impractical to perform PSG in large numbers of subjects in epidemiologic studies of sleep disorders, the availability of a simple, short, reliable, and accurate measure to screen for the presence of various sleep disorders would be highly valuable (Boeve, 2010a). A recent study suggested that a clinical interview by expert clinicians could provide good sensitivity (100%) and specificity (99.6%) in diagnosing RBD in non-PD patients (Eisensehr et al, 2001). The interobserver reliability of ICSD-R criteria for RBD was also found to be substantial (Bologna, Genova, Parma and Pisa Universities group for the study of REM sleep Behaviour Disorder (RBD) in Parkinson's Disease, 2003). Nevertheless, conducting a useful clinical interview may require considerable expertise, training, time and resources. In addition, waiting times might be long for and access limited to clinical and PSG assessments in some medical settings. Hence, an easily applicable questionnaire may be considered as a supplemental assessment tool in clinical practice to provide a quick and accurate appraisal of RBD symptoms in order to prioritize assessment and intervention.

We describe RBD screening questionnaires such as the Mayo Sleep Questionnaire (MSQ), RBDSQ (English/German version and Japanese version) and RBDQ-HK.

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