Abstract
Aim: Abnormally prominent motor activity in rapid eye movement (REM) sleep is a major polysomnographic (PSG) feature of idiopathic REM sleep behavior disorder. The diagnosis is based on the complex nature of the movements, but more discreet motor manifestations can be seen in the video recording during PSG.
The aim of this work was to perform a systematic video analysis of REM sleep movements. Patients and methods: The motor manifestations identified in the video recording of PSG in 32 patients aged 67.4 +- 7.3 years were classified into four categories according to clinical severity (elementary, exces sive, scenic and violent).
In addition, topographic distribution, brief and slow characterization of movement, as sociation with vocalization, subsequent wakefulness and emotional subtext were determined for each motor event. Results: An average of 114.6 +- 85.1 motor phenomena was identified.
Of these, 67.8% were clas sified as elementary, 9.1% as exces sive, 22.3% as scenic, and 0.7% as violent. However, 31.3% of patients experienced violent manifestations.
Brief movements were more frequent than slow ones (P = 0.001). Vocalization occur red in 34.4% of patients.
Movement caused wakefulness in 9.4% of patients and was at least once as sociated with distinct emotion in 21.9%. Conclusion: This study shows a large number of motor phenomena in REM sleep with extensive variability.
Elementary events represent the vast majority. Although violent manifestations are captured in relative minority, they were detected in 31% of patients