Schenck Carlos H, Cochen de Cock Valérie, Lewis Simon J G, Tachibana Naoko, Kushida Clete, Ferri Raffaele
Minnesota Regional Sleep Disorders Center, and Department of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, USA.
Sleep and Neurology Unit, Beau Soleil Clinic, Montpellier, France.
Sleep Med. 2023 Oct;110:137-145. doi: 10.1016/j.sleep.2023.07.012. Epub 2023 Aug 7.
Updated guidelines for the video-polysomnography (vPSG) procedures for diagnosing rapid eye movement sleep behavior disorder (RBD) and the identification of its prodromal stages have recently been proposed by the Neurophysiology Working Group of the International RBD Study Group (IRBDSG). These guidelines were selected for review by a World Sleep Society (WSS) Parasomnias Task Force and the WSS International Sleep Medicine Guidelines Committee. A survey was completed by sleep society leaders and prominent sleep clinicians and researchers in 31 WSS member countries across six continents, focused on sleep technologist training and certification; extent of public/private health insurance coverage for the vPSG evaluation of RBD; extent of hospital-based sleep-technologist-attended overnight vPSG studies; availability of video during PSG studies; and sufficient specification of PSG machines to record and analyze REM sleep without atonia. The findings from this survey indicated that most health systems and medical communities across WSS member countries would not be capable of implementing the proposed more stringent guidelines, which would then strongly interfere with the diagnosis of RBD in a large portion of patients who would not be able to receive the required (often repeated) vPSG evaluation. Therefore, the WSS can only partially endorse the updated guidelines and concludes that the current International Classification of Sleep Disorders-3rd edition diagnostic criteria for RBD should still be retained as the standard reference for the diagnosis of RBD, and that further discussion across all members of the IRBDSG should take place to ensure the feasibility of any future proposed changes.
国际快速眼动睡眠行为障碍研究组(IRBDSG)神经生理学工作组最近提出了用于诊断快速眼动睡眠行为障碍(RBD)及其前驱期识别的视频多导睡眠图(vPSG)程序的更新指南。这些指南被世界睡眠协会(WSS)异态睡眠特别工作组和WSS国际睡眠医学指南委员会选定进行审查。一项针对六大洲31个WSS成员国的睡眠协会领导人以及杰出的睡眠临床医生和研究人员的调查完成,重点关注睡眠技术人员培训与认证;RBD的vPSG评估的公共/私人医疗保险覆盖范围;基于医院的有睡眠技术人员参与的夜间vPSG研究的范围;PSG研究期间视频的可用性;以及PSG机器对无张力快速眼动睡眠进行记录和分析的充分规格。该调查结果表明,WSS成员国的大多数卫生系统和医疗社区无法实施拟议的更严格指南,这将严重干扰很大一部分无法接受所需(通常是重复的)vPSG评估的患者的RBD诊断。因此,WSS只能部分认可更新后的指南,并得出结论,目前《国际睡眠障碍分类》第三版中RBD的诊断标准仍应作为RBD诊断的标准参考,并且IRBDSG的所有成员应进一步展开讨论,以确保未来任何拟议更改的可行性。