SLEEP-RELATED VIOLENCE, INJURY, AND REM-SLEEP BEHAVIOR DISORDER IN PARKINSONS-DISEASE

Objective: To determine the occurrence of REM sleep behavior disorder (RE and sleep-related injury (SRI) in an outpatient PD practice. Backg round: RED is a frequent cause of SRI in older individuals. Although R ED is seen in PD, the association of SRI and RED in PD has not been pr eviously assessed. Design/Methods: Consecutive patients with PD and th eir caregivers were interviewed using a structured questionnaire asses sing the presence of RED and SRI. Patients fulfilling the Internationa l Classification of Sleep Disorders (ICSD) criteria for RED were compa red with non-RED patients. In a separate analysis, patients with a pri or SRI were compared to those without. Results: Of the 61 patient/care giver pairs, 15% (7 men and 2 women) met the clinical criteria for RED . There were more episodes of SRI in the RED group, with 33% causing i njury to themselves or to their caregivers compared with 6% of the non -RED group (chi(2) = 13, p = 0.005). In the second analysis, 15% tall men) patient/caregiver pairs reported SRI. Of these, 66% of the patien ts had behaviors resembling those seen in RED, and 33% had recalled dr eam content. There isa significant association between SRI and RED for dream-enacting sleep behaviors (Fisher's exact test, p = 0.0001). Con clusion; PD patients with SRI frequently have behavioral features of R ED. If RED underlies most SRI, treatment with appropriate pharmacologi c agents, such as clonazepam, may prevent future occurrences of SRI.