Polysomnographic and neuropsychological characteristics of rapid eye movement sleep behavior disorder patients.

OBJECTIVES: To compare the sleep characteristics and cognition between rapid eye movement sleep behavior disorder (RBD) patients and non-RBD (nRBD) healthy control subjects and to determine the correlation between sleep and cognition in RBD patients.

METHODS: Polysomnography (PSG) was performed to confirm and exclude RBD. Fifteen iRBD patients, 12 PD with RBD patients, and 23 matched nRBD healthy control subjects were enrolled. Subjective sleep and neuropsychological evaluations were performed.

RESULTS: No differences were found in the subjective sleep among the three groups. Compared to the nRBD subjects, iRBD patients showed higher PLMI, the PD with RBD patients showed an increased proportion of N1 sleep, a decreased proportion of N2 and N3 sleep, and an increased periodic leg movement index. The iRBD patients performed worse on RCFT time than the nRBD subjects, the PD with RBD patients performed worse than the nRBD subjects on the following evaluations: the Mini-Mental State Examination; auditory verbal learning test (AVLT); Rey Complex Figure Test (RCFT) time, Clock drawing test (CDT); delay memory score of RCFT; Symbol digit modalities test (SDMT); Trail Making Test (TMT); and Stroop Test B and C, all significant changes (all p < 0.05). Furthermore, in RBD patients, lower sleep efficiency was correlated with decreased SDMT scores (r = 0.694, p < 0.01), longer time on the TMT A (r = -0.589, p < 0.01), and lower city fluency test scores(r = 0.556, p < 0.01). Less total sleep time was correlated with lower RCFT scores (r = 0.392, p = 0.043), longer time on the TMT A (r = -0.417, p = 0.031), and lower city fluency test scores (r = 0.405, p = 0.036).

CONCLUSIONS: PD with RBD patients suffered from abnormal sleep architecture and extensive cognition dysfunction. Decreased total sleep time and sleep efficiency may contribute to cognitive deterioration in RBD patients.