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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(06): s00451809543
DOI: 10.1055/s-0045-1809543
Original Article

Innsbruck REM Sleep Behavior Disorder Inventory may distinguish abnormal nocturnal movements related to obstructive sleep apnea

Gülçin Benbir Şenel 
1   Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neurology, Division of Clinical Neurophysiology, Istanbul, Türkiye.
,
Ayşın Kısabay Ak 
2   Celal Bayar University, Medical Faculty, Department of Neurology, Manisa, Türkiye.
,
Ayşegül Şeyma Sarıtaş 
2   Celal Bayar University, Medical Faculty, Department of Neurology, Manisa, Türkiye.
,
Hikmet Yılmaz 
2   Celal Bayar University, Medical Faculty, Department of Neurology, Manisa, Türkiye.
,
Kübra Mehel Metin 
3   University of Health Sciences, Ankara Training and Research Hospital, Department of Neurology, Ankara, Türkiye.
,
Burcu Gökçe Çokal 
3   University of Health Sciences, Ankara Training and Research Hospital, Department of Neurology, Ankara, Türkiye.
,
Kadriye Ağan 
4   Marmara University, Medical Faculty, Department of Neurology, Istanbul, Türkiye.
,
Murat Aksu 
5   Acibadem University, Atakent Hospital, Medical Faculty, Department of Neurology, Istanbul, Türkiye.
,
Utku Oğan Akyıldız 
6   Adnan Menderes University, Medical Faculty, Department of Neurology, Aydın, Türkiye.
,
Aylin Bican Demir 
7   Bursa Uludag University, Medical Faculty, Department of Neurology, Bursa, Türkiye.
,
Betül Çevik 
8   Tokat Gaziosmanpasa University, Medical Faculty, Department of Neurology, Tokat, Türkiye.
,
Ahmet Yusuf Ertürk 
9   Dokuz Eylul University, Medical Faculty, Department of Neurology, Izmir, Türkiye.
,
Derya Karadeniz 
1   Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neurology, Division of Clinical Neurophysiology, Istanbul, Türkiye.
,
İbrahim Öztura 
9   Dokuz Eylul University, Medical Faculty, Department of Neurology, Izmir, Türkiye.
,
Gülin Sünter 
4   Marmara University, Medical Faculty, Department of Neurology, Istanbul, Türkiye.
,
Selma Tekin 
10   Pamukkale University, Medical Faculty, Department of Neurology, Denizli, Türkiye.
,
İrsel Tezer 
11   Hacettepe University, Medical Faculty, Department of Neurology, Ankara, Türkiye.
,
Deniz Tuncel Berktaş 
12   Kahramanmaras Sutcu Imam University, Medical Faculty, Department of Neurology, Kahramanmaras, Türkiye.
,
Nazlı Totik 
13   Cukurova University, Medical Faculty, Department of Biostatistics, Adana, Türkiye.
,
Kezban Aslan-Kara 
14   Cukurova University, Medical Faculty, Department of Neurology, Adana, Türkiye.
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Abstract

Background

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by recurrent dream enactment behaviors like sleep-related vocalization and/or complex motor behaviors.

Objective

To investigate the discriminative role of the validated Turkish version of the 9-Item Innsbruck REM Sleep Behavior Disorder Inventory (IRBD-9-Turkish) for idiopathic RBD (iRBD) in patients with obstructive sleep apnea (OSA).

Methods

The current multicenter study was prospectively conducted in 13 accredited sleep centers in 10 different cities in Türkiye. Clinical data was obtained through a preformed questionnaire, and all participants were submitted to a full-night video-polysomnography (video-PSG) session in a sleep laboratory.

Results

A total of 105 patients (mean age: 58.3 ± 11.6 years; 68.6% of male subjects) were prospectively and consecutively enrolled in the study; 51 patients (48.6%) presented iRBD, and 54 (51.4%), OSA, 19 (35.2%) of whom presented abnormal nocturnal behaviors (NBs) demonstrated by clinical and video-PSG findings associated with arousal reactions secondary to apneas and hypopneas. The cut-off value of the IRBD-9 was higher in patients with OSA-NBs than in those with OSA without NBs (p < 0.001), with a sensitivity of 0.765 and a specificity of 0.667, resulting in a correct diagnosis of NBs in 75% of patients with OSA. The receiver operating characteristic (ROC) curves for Factor I (items 1, 2, 3, 6, and 8) and Factor II (items 4, 5, 7, and 9) of the IRBD-9-Turkish showed that both factors were able to distinguish patients with iRBD from those with OSA, but only Factor I distinguishes patients with iRBD from those with OSA-NBs.

Conclusion

The present study demonstrated a very high sensitivity and specificity of the IRBD-9-Turkish not only in patients with iRBD, but also in patients with OSA.

Keywords

REM Sleep Behavior Disorder - Sleep Apnea, Obstructive

Authors' Contributions

Conceptualization: GBS; Data curation: GBS, AKA, ASS, HY, KMM, BGC, KA, MA, UOA, ABD, AYE, DK, GS, IT, BC, IO, ST, DT, NT, KAK; Formal analysis: GBS, KA, MA, UOA, ABD, AYE, DK, GS, IT, BC, IO, ST, DT, KAK; Investigation: AKA, ASS, HY, KMM, BGC, KA, MA, UOA, ABD, AYE, DK, GS, IT, ST, DT, KAK; Methodology: GBS, AKA, ASS, HY, KMM, BGC, KA, MA, UOA, ABD, AYE, DK, GS, IT, BC, NT, KAK; Software: NT; Validation: NT, KAK; Writing - original draft: KAK; Writing - review & editing: GBS.


Data Availability Statement

The authors declare that the data supporting the findings of this study are available within the paper, and further data will be supplied by the corresponding author upon reasonable request.


Editor-in-Chief: Hélio A. G. Teive 0000-0003-2305-1073.


Associate Editor: Rosana Cardoso Alves 0000-0003-4258-2320.




Publication History

Received: 26 January 2024

Accepted: 19 April 2025

Article published online:
17 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Gülçin Benbir Şenel, Ayşın Kısabay Ak, Ayşegül Şeyma Sarıtaş, Hikmet Yılmaz, Kübra Mehel Metin, Burcu Gökçe Çokal, Kadriye Ağan, Murat Aksu, Utku Oğan Akyıldız, Aylin Bican Demir, Betül Çevik, Ahmet Yusuf Ertürk, Derya Karadeniz, İbrahim Öztura, Gülin Sünter, Selma Tekin, İrsel Tezer, Deniz Tuncel Berktaş, Nazlı Totik, Kezban Aslan-Kara. Innsbruck REM Sleep Behavior Disorder Inventory may distinguish abnormal nocturnal movements related to obstructive sleep apnea. Arq Neuropsiquiatr 2025; 83: s00451809543.
DOI: 10.1055/s-0045-1809543