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KMID : 1151920200020030123
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Chronobiology in Medicine
2020 Volume.2 No. 3 p.123 ~ p.128
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Automated Assessment of Quantitative REM Sleep without Atonia for Diagnosis of REM Sleep Behavior Disorder
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Yang Jeong-Hun
Choi Sang-Ho
Lee Mi-Hyun
Oh Seong-Min
Choi Jae-Won
Park Jee-Eun
Park Kwang-Suk
Lee Yu-Jin
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Abstract
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Objective: This study was performed to determine the diagnostic cutoff value of quantified tonic and phasic rapid eye movement (REM) sleep without atonia (RSWA) automatically calculated from chin and limb muscle electromyograms (EMG) for diagnosis of REM sleep behavior disorder (RBD).
Methods: Nocturnal video polysomnographic data of 57 patients diagnosed with RBD and 29 age- and sex-matched controls were reviewed. Tonic activity was measured using submentalis EMG, and phasic activity was measured using submentalis and bilateral anterior tibialis EMG. The proportion of epochs with tonic and phasic activity during the entire REM sleep period was quantified using a self-developed automated algorithm.
Results: The RBD group showed significantly more tonic activity compared with the control group (28.87±36.92% vs. 12.94±31.69%, respectively, p<0.001). The diagnostic cutoff value of quantified submentalis tonic RSWA for RBD showing the best optimal sensitivity and specificity was 0.99% [sensitivity, 77.2%; specificity, 79.3%, area under the receiver operating characteristic curve (AUC), 0.76]. Cutoffs of phasic RSWA were 47.53% when assessed in the submentalis only (sensitivity, 1.8%; specificity, 100%; AUC, 0.46), 0.10% in the anterior tibialis (sensitivity, 66.7%; specificity, 55.2%; AUC, 0.55), and 0.10% in both the submentalis and anterior tibialis (sensitivity, 70.2%; specificity, 51.7%; AUC, 0.53).
Conclusion: This study provided evidence for the diagnosis of RBD using an automated method by assessing RSWA. Tonic activity in the submentalis muscle showed better sensitivity and specificity for diagnosis of RBD than did phasic activity.
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KEYWORD
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REM sleep behavior disorder, REM sleep without atonia, Automated algorithm
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