What is the REM Sleep Behaviour Disorder Screening Questionnaire?

Introduction

The REM Sleep Behaviour Disorder Screening Questionnaire (RBDSQ) is a specific questionnaire for rapid eye movement behaviour disorder (RBD) developed by Stiasny-Kolster and team, to assess the most prominent clinical features of RBD.

It is a 10-item, patient self-rating instrument with short questions to be answered by either ‘yes’ or ‘no’.

The validity of the questionnaire was studied by researchers and they have observed it to perform with high sensitivity and reasonable specificity in the diagnosis of RBD.

Refer to Parasomnia.

Use

RBDSQ has the potential to be useful as a screening instrument for neurodegenerative disorder, such as the α-synucleinopathies, Parkinson’s disease or multiple system atrophy which may enable early diagnosis and also recruitment of people with RBD necessary for research studies.

Format

RBDSQ contains a set of 10 items that are to be answered by either ‘yes’ or ‘no’.

  • Items 1 to 4 address the frequency and content of dreams and their relationship to nocturnal movements and behaviour.
  • Item 5 asks about self-injuries and injuries of the bed partner.
  • Item 6 consists of four subitems assessing nocturnal motor behaviour more specifically, e.g. questions about nocturnal vocalisation, sudden limb movements, complex movements, or bedding items that fell down.
  • Items 7 and 8 deal with nocturnal awakenings.
  • Item 9 focuses on disturbed sleep in general.
  • Item 10 focuses on the presence of any neurological disorder.

The maximum total score of the RBDSQ is 13 points.

Book: Make Sense of Sleep: A Guide to Physical and Mental Wellness

Book Title:

Make Sense of Sleep: A Guide to Physical and Mental Wellness

Author(s): L.J. Simpson.

Year: 2021.

Edition: First (1st).

Publisher: ?.

Type(s): Kindle.

Synopsis:

This book focuses on the importance of achieving a good nights sleep. The book focuses on all of those factors and variables that may impact your sleep, as well as those considerations that can help pave the way for a better nights rest.

This book also focuses on how to achieve and maintain good mental and physical health, while drilling into the impacts this can have on our sleep.

Book: Sleep Medicine and Mental Health

Book Title:

Sleep Medicine and Mental Health – A Guide for Psychiatrists and Other Healthcare Professionals.

Author(s): Karim Sedky, Racha Nazir, and David Bennett (Editors).

Year: 2020.

Edition: First (1st).

Publisher: Springer.

Type(s): Hardcover and Kindle.

Synopsis:

Advances in sleep medicine research are improving our clinical work for individuals with sleep problems. The aim of this book is to educate psychiatrists and other mental health professionals about the importance of understanding sleep disorders, including their bidirectional relationship with psychiatric conditions.

This book consists of six major sections with seventeen chapters. It is led off by an introduction on the function of sleep, its neurophysiology, and types of sleep problems. Since insomnia represents a common and significant challenge for patients with psychiatric disorders, its clinical presentation and treatments are reviewed in the second section. Cognitive behavioural therapy for insomnia (CBT-I), mindfulness-based CBT, acceptance and commitment therapy (ACT), and the medication management of insomnia are reviewed.

A third section addresses sleep related breathing disorders. The pathology of sleep apnea, its treatments, and therapeutic modalities to address non-compliance with positive pressure ventilation are reviewed. Other sleep disorders such as hypersomnia, circadian rhythm disorders, movement disorders and parasomnias are discussed in the fourth section.

Since features of sleep disorders can vary by age, gender, and trauma history, a fifth section discusses the unique sleep problems associated with children, women, older adults, and veterans. The book concludes with a final section discussing how sleep disorders and psychiatric conditions overlap.

We hope this book highlights the importance of understanding and addressing comorbid sleep disorders among individuals with psychiatric conditions. We are confident that this book will be valuable in helping clinicians improve the management of sleep disorders in their clinical practice.

Are Alterations in Alpha Synchrony Discriminatory of PTSD?

Research Paper Title

Alterations in Sleep EEG Synchrony in Combat-Exposed Veterans With PTSD.

Background

The researchers assessed whether the synchrony between brain regions, analysed using electroencephalography (EEG) signals recorded during sleep, is altered in subjects with post-traumatic stress disorder (PTSD) and whether the results are reproducible across consecutive nights and sub-populations of the study.

Methods

Seventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive laboratory nights of high-density EEG recordings. They computed a measure of synchrony for each EEG channel-pair across three sleep stages [rapid eye movement (REM) and non-REM stages 2 and 3] and six frequency bands.

The researchers examined the median synchrony in nine region-of-interest (ROI) pairs consisting of six bilateral brain regions (left and right frontal, central, and parietal regions) for ten frequency-band and sleep-stage combinations.

To assess reproducibility, they used the first 47 consecutive subjects (18 with PTSD) for initial discovery and the remaining 31 subjects (13 with PTSD) for replication.

Results

In the discovery analysis, five alpha-band synchrony pairs during non-REM sleep were consistently larger in PTSD subjects compared to controls (effect sizes ranging from 0.52 to 1.44) across consecutive nights: two between the left-frontal and left-parietal ROIs, one between the left-central and left-parietal ROIs, and two across central and parietal bilateral ROIs.

These trends were preserved in the replication set.

Conclusions

PTSD subjects showed increased alpha-band synchrony during non-REM sleep in the left fronto-parietal, left centro-parietal, and inter-parietal brain regions.

Importantly, these trends were reproducible across consecutive nights and sub-populations. Thus, these alterations in alpha synchrony may be discriminatory of PTSD.

Reference

Laximinarayan, S., Wang, C., Ramakrishnan, S., Oyama, T., Cashmere, J.D., Germain, A. & Reifman, J. (2020) Alterations in Sleep EEG Synchrony in Combat-Exposed Veterans With PTSD. Sleep. doi: 10.1093/sleep/zsaa006. Online ahead of print.

Gaming Disorders & their Association with Mental Disorders for African Countries

Research Paper Title

Insomnia, Sleepiness, Anxiety and Depression Among Different Types of Gamers in African Countries.

Background

Gaming has increasingly become a part of life in Africa. Currently, no data on gaming disorders or their association with mental disorders exist for African countries.

This study for the first time investigated:

  1. The prevalence of insomnia, excessive daytime sleepiness, anxiety and depression among African gamers;
  2. The association between these conditions and gamer types (i.e. non-problematic, engaged, problematic and addicted); and
  3. The predictive power of socioeconomic markers (education, age, income, marital status, employment status) on these conditions.

Methods

10,566 people from 2 low- (Rwanda, Gabon), 6 lower-middle (Cameroon, Nigeria, Morocco, Tunisia, Senegal, Ivory Coast) and 1 upper-middle income countries (South Africa) completed online questionnaires containing validated measures on insomnia, sleepiness, anxiety, depression and gaming addiction.

Results

Results showed the sample of gamers (24 ± 2.8 yrs; 88.64% Male), 30% were addicted, 30% were problematic, 8% were engaged and 32% were non-problematic.

Gaming significantly contributed to 86.9% of the variance in insomnia, 82.7% of the variance in daytime sleepiness and 82.3% of the variance in anxiety [p < 0.001].

Conclusions

This study establishes the prevalence of gaming, mood and sleep disorders, in a large African sample.

The results corroborate previous studies, reporting problematic and addicted gamers show poorer health outcomes compared with non-problematic gamers.

Reference

Sosso, F.A.E, Kuss, D.J., Vandelanotte, C., Jasso-Medrano, J.L., Husain, M.E., Curcio, G., Papadopoulos, D., Aseem, A., Bhati, P., Lopez-Rosales, F., Becerra, J.R., D’Aurizio, G., Mansouri, H., Khoury, T., Campbell, M. & Toth, A.J. (2020) Insomnia, Sleepiness, Anxiety and Depression Among Different Types of Gamers in African Countries. Scientific Reports. 10(1):1937. doi: 10.1038/s41598-020-58462-0.

Is there a Link between Sleeplessness and Alzheimer’s?

Just one sleepless night raises levels of a protein linked to Alzheimer’s disease in the blood of young men (Benedict et al., 2020).

This suggests getting into good sleep habits at an early age may help ward off the illness.

People with Alzheimer’s have clumps of two sticky proteins –
beta-amyloid and tau – in their brains. Previous work has found that one night of sleep deprivation raises beta-amyloid levels in our brains, but less is known about tau.

Jonathan Cedernaes at Uppsala University in Sweden and his team
recruited 15 healthy young men. They measured tau levels in the
men’s blood after a full night’s sleep and after a night of no sleep.

After the sleepless night, tau levels in blood rose by 17%. After
the good night, the rise was 2%.

While it is a small study that looked only at men, the finding adds to growing evidence that people with poor sleep are more likely to develop Alzheimer’s decades later, says Cedernaes.

More research is needed to confirm that sleep deprivation increases tau in the brain, since blood levels are not necessarily indicative of amounts in the brain, says Cedernaes. And higher blood levels of tau after sleep deprivation could be a sign that the brain is clearing out the protein rather than accumulating it, he says.

The role tau plays in Alzheimer’s is unclear – it may be a side effect, not a cause. Similarly, while lack of sleep has been linked to Alzheimer’s disease, it is possible that this is an early sign of
the condition, rather than a contributing factor.

References

Benedict, C., Blennow, K., Zetterberg, H. & Cedarnaes, J. (2020) Effects of acute sleep loss on diurnal plasma dynamics of CNS health biomarkers in young men. Neurology. 94(11). DOI: https://doi.org/10.1212/WNL.0000000000008866.

Klein, A. (2020) Alzheimer’s Protein Rise Without Sleep. New Scientist. 18 January 2020, pp.17.

Sleeplessness & Anxiety, Get Some NREM

While a sleepless night can result in a 30% rise in anxiety levels, deep sleep could actually be a remedy against anxiety according to researchers at the University of California.

The researchers found that when the brain is in deep sleep (aka non-rapid eye movement or NREM) it has a calming effect on individuals with anxiety disorders.

MRI scans and other methods were used to measure brain activity in participants.

The results revealed that sleeplessness shuts down the brain’s medial prefrontal cortex – this helps to keep emotions in check.

However, a full night of slumber helps to restore prefrontal changes.