REM Behavior Disorder diagnostic challenges

Rapid eye movement (REM) sleep behavior disorder (RBD) is a relevant sleep disorder for neurologists, psychiatrists, and geriatricians since it is currently recognized as a condition that represents a prolonged prodromal state of neurodegenerative disorders, mainly alpha-synucleinopathies. Despite the importance of its early detection for adequate long-term care planning and counseling, RBD remains underdiagnosed, particularly in its mild form, with mild symptoms, in which patients or their bed partners do not experience harm, injury, or significant sleep disruption. In some cases, when the bed partner is injured, shame and concern about exposure may prevent patients and bed partners from seeking medical help. Finally, the combination of low health literacy in the general population and poor access to healthcare in Brazil poses additional challenges to the diagnosis of RBD in our context. Here, Poyare and Piovezan emphasize the contribution of the study by Pena-Pereira et al. in validating the RBDSQ scale in a Brazilian sample of patients.