REM Sleep Behavior Disorder Workup

Updated: Mar 10, 2019
  • Author: Syed M S Ahmed, MD; Chief Editor: Selim R Benbadis, MD  more...
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Approach Considerations

The most important diagnostic studies in rapid eye movement sleep behavior disorder (RBD) include the following:

  • Polysomnographic video recording - This is the most important diagnostic test in RBD [31] ; on PSG, at least some tonic or phasic abnormalities of muscle tone are observed during REM sleep accompanying the attack, although usually patients have both.

  • Monitoring electro-oculogram (EOG)

  • EEG [3, 11]

  • Electrocardiogram (ECG)

  • PSG to evaluate respiration for sleep apnea

  • Multiple electromyography (EMG) channels using chin, bilateral extensor digitorum, and tibialis anterior muscles [32]

Routine laboratory tests are usually not helpful. Imaging studies are not indicated in idiopathic cases but are indicated if neurologic dysfunction is suggested by history and neurologic examination. [4] Moreover, a study demonstrated that IPT-SPECT may be a useful tool in the diagnosis of REM sleep behavior disorder (RBD).