A single-question screen for rapid eye movement sleep behavior disorder: A multicenter validation study

REM sleep behavior disorder (RBD) is a parasomnia characterized by dream-enactment behavior, diagnosed by clinical history in combination with video-polysomnography to document REM atonia loss. Idiopathic RBD (iRBD) is receiving increased attention as an important risk factor for neurodegenerative diseases, especially alpha-synucleinopathies.2–4 Despite increasing recognition of its importance, knowledge of RBD epidemiology is limited. Except for two studies, which primarily screened for sleep injury (a subtype of RBD)5,6 no large-scale epidemiologic surveys have estimated RBD prevalence. A major barrier to conducting prevalence studies is that RBD is probably uncommon, thus requiring very large epidemiologic surveys. Such large surveys are generally broad, assessing many nonsleep outcomes, with strict limitations upon the time demands upon respondents. This precludes the use of polysomnographic diagnosis and lengthy screening questionnaires. Therefore, simple (i.e., one- or two-question) screens are needed to assess RBD in large-scale epidemiologic surveys. To meet this need, we designed the RBD Single-Question Screen (RBD1Q) a single “yes-no” question that queries the classic dream-enactment behavior of RBD. We present here the validation results of this question, in relation to gold-standard polysomnographic diagnosis, in a 12-center case-control study.