To assess sociodemographic, socioeconomic, and clinical correlates of idiopathic REM
sleep behavior disorder (RBD) in a 30,097-person national cohort. Participants 45
to 85 years of age in Canada were collected as part of the Canadian Longitudinal Study
on Aging. Possible RBD (pRBD) was screened with the REM Sleep Behavior Disorder Single-Question
Screen, a questionnaire with 94% specificity and 87% sensitivity. To improve diagnostic
accuracy, those screening positive for apnea or non-REM parasomnia (young-onset pRBD)
and those self-reporting dementia or Parkinson disease were excluded. A series of
sociodemographic, lifestyle, and mental health variables were analyzed cross-sectionally.
Potential correlates were assessed via multivariable logistic regression. Of 30,097
participants, 958 (3.2%) were identified as having pRBD. Male sex (odds ratio [OR]
2.09, 95% confidence interval [CI] 1.78–2.44) and lower education (OR 0.95, 95% CI
0.92–0.98) were associated with pRBD. Participants with pRBD had smoked more (pack-years
OR 1.01, 95% CI 1.00–1.01) and were more likely to be moderate to heavy drinkers (OR
1.25, 95% CI 1.04–1.51). There was a strong association between pRBD and self-reported
antidepressant treatment for depression (OR 2.77, 95% CI 2.23–3.45), psychological
distress (OR 1.61, 95% CI 1.44–1.80), mental illness (OR 2.09, 95% CI 1.75–2.49),
and posttraumatic stress disorder (OR 2.68, 95% CI 1.97–3.65). Our study replicated
previous reported associations between pRBD and smoking, low education, and male sex
and found previously unreported links with alcohol use and psychological distress.
Risk factors for pRBD differ from those previously defined for neurodegenerative synucleinopathies.