The Severity and Pattern of Autonomic Dysfunction in Idiopathic Rapid Eye Movement Sleep Behavior Disorder

Abstract

Background: Autonomic dysfunction in idiopathic rapid eye movement sleep behavior disorder patients has not yet been quantified. The aim of this study was to characterize dysautonomia in patients with idiopathic rapid eye movement sleep behavior disorder using the Composite Autonomic Severity Score, which is a validated instrument for the quantitation of autonomic failure. Methods: We prospectively enrolled patients with idiopathic rapid eye movement sleep behavior disorder. A battery of standardized autonomic function tests was performed. Autonomic data obtained from the patients were compared to age- and sex-matched healthy controls. Results: Seventeen patients were enrolled. All but 1 patient showed at least one autonomic deficit. These deficits were predominantly adrenergic and cardiovagal and involved relatively few sudomotor problems. The degree of autonomic dysfunction according to the Composite Autonomic Severity Score was mild to moderate in most patients. Conclusions: Idiopathic rapid eye movement sleep behavior disorder is linked to mild-to-moderate autonomic dysfunction, which is predominantly adrenergic and cardiovagal.