Context-dependency of the REM sleep behavior disorder screening questionnaire - Clinical utility under scrutiny

Sinah Röttgen; Christopher E J Doppler; Aline Seger; Elke Kalbe; Gereon R Fink; Michael Sommerauer; Anja Ophey

doi:10.1016/j.parkreldis.2024.107211

Context-dependency of the REM sleep behavior disorder screening questionnaire - Clinical utility under scrutiny

Parkinsonism Relat Disord. 2025 Jan:130:107211. doi: 10.1016/j.parkreldis.2024.107211. Epub 2024 Nov 17.

Authors

Sinah Röttgen¹, Christopher E J Doppler², Aline Seger³, Elke Kalbe⁴, Gereon R Fink⁵, Michael Sommerauer⁶, Anja Ophey⁷

Affiliations

¹ Cognitive Neuroscience, Institute for Neuroscience and Medicine, INM-3, Research Centre Juelich, Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: [email protected].
² Cognitive Neuroscience, Institute for Neuroscience and Medicine, INM-3, Research Centre Juelich, Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: [email protected].
³ Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: [email protected].
⁴ Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: [email protected].
⁵ Cognitive Neuroscience, Institute for Neuroscience and Medicine, INM-3, Research Centre Juelich, Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: [email protected].
⁶ Cognitive Neuroscience, Institute for Neuroscience and Medicine, INM-3, Research Centre Juelich, Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center of Neurology, Department of Parkinson, Sleep and Movement Disorders, University of Bonn, Bonn, Germany. Electronic address: [email protected].
⁷ Cognitive Neuroscience, Institute for Neuroscience and Medicine, INM-3, Research Centre Juelich, Juelich, Germany; Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. Electronic address: [email protected].

PMID: 39608327
DOI: 10.1016/j.parkreldis.2024.107211

Abstract

Introduction: The REM Sleep Behavior Disorder (RBD) Screening Questionnaire (RBDSQ) is a widely established screening tool for detecting isolated RBD (iRBD). However, its accuracy may depend on its application context, e.g., the individuals' awareness of their RBD status. The present work aims to describe the context-dependency and retest reliability of the RBDSQ in an iRBD cohort setting.

Methods: Ninety-four individuals with video-polysomnography confirmed iRBD answered the RBDSQ during pre-polysomnography screening (V0) and post-diagnosis (V1).

Results: The RBDSQ total score significantly differed between V0 and V1 (F(1,92) = 8.02, p = .006, η_p² = 0.019). The intraclass correlation coefficient (ICC_2,1) of the RBDSQ showed moderate reliability between consecutive timepoints (^V0-V1ICC_2,1 = 0.544). The highest Cohen's κ was reached for items 5, 6.3, 6.4, 8, and 9 across timepoint comparisons (0.409 ≤ Cohen's κ ≤ 0.660).

Conclusion: Our findings underscore the context-dependency of the RBDSQ and fluctuations in self-awareness of sleep-related behaviors, necessitating a critical appraisal of questionnaire-based RBD screening tools. Future studies should explore strategies to improve the reliability and accuracy of RBD screening tools, considering the dynamic nature of sleep-related behavior.

Keywords: Disease awareness; REM sleep behavior disorder; Reliability; Screening questionnaire.

MeSH terms

Aged
Female
Humans
Male
Middle Aged
Polysomnography
REM Sleep Behavior Disorder* / diagnosis
Reproducibility of Results
Surveys and Questionnaires / standards