{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T01:03:24Z","timestamp":1784941404728,"version":"3.55.0"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":53,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sleep Sci"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Video-polysomnography (VPSG) is indicated for cases of nocturnal motor behaviors, particularly rapid eye movement (REM) sleep behavior disorder (RBD), and different sleep complaints in the context of neurological disease, particularly neurodegenerative disease. In a location with limited VPSG availability, referral and poststudy diagnoses were reviewed to help create flow protocols for sleep centers in economically-disadvantaged areas.<\/jats:p>\n                  <jats:p>A total of 115 VPSG studies conducted at a public university-affiliated hospital in Porto Alegre, Southern Brazil, were divided into groups related to sleep complaints that were primarily motor (M; n\u2009=\u200954) or non-motor (NM; n\u2009=\u200961). Abnormal motor activity was more common in the M group, suggesting that clinical history was sensitive in identifying motor behaviors. However, while most M group referrals were related to RBD suspicion (n\u2009=\u200943; 79.6%), less than half of these were confirmed (n\u2009=\u200921; 48.8%). There was a high (n\u2009=\u200938; 70.4%) prevalence of obstructive sleep apnea (OSA) in the M group, with 14 (25.9%) subjects fully meeting the criteria for moderate-to-severe OSA. In cases of suspected RBD (n\u2009=\u200943), the rate of moderate-to-severe OSA (n\u2009=\u200920; 46.5%) was nearly the same as the rate of positive RBD diagnosis (n\u2009=\u200921; 48.8%). Prevalence of any severity OSA (n\u2009=\u200935; 81.4%) exceeded positive or incomplete findings for RBD (n\u2009=\u200928; 65.1%). The findings suggest that the suspicion accuracy for OSA and RBD could improve through more thorough history-taking in the prediagnostic workup. In world regions with limited VPSG availability, clinicians must recognize the likelihood of sleep apnea related to nocturnal motor activity. We suggest prioritizing type 1 polysomnography (PSG) to treat or exclude OSA rather than starting an empirical treatment for RBD while waiting for a VPSG study.<\/jats:p>","DOI":"10.1055\/s-0046-1825527","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:53:21Z","timestamp":1784940801000},"page":"001-010","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing Sleep Disorder Diagnosis in Underserved Regions: Insights from Video-Polysomnography Analysis in Southern Brazil"],"prefix":"10.1055","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3432-3803","authenticated-orcid":false,"given":"Marco A. S. B.","family":"Fleuri","sequence":"additional","affiliation":[{"name":"Medicine School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8117-8043","authenticated-orcid":false,"given":"G\u00fcnther J.L.","family":"Gerhardt","sequence":"additional","affiliation":[{"name":"Universidade de Caxias do Sul (UCS), Caxias do Sul, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5079-1686","authenticated-orcid":false,"given":"Denise M.","family":"Zancan","sequence":"additional","affiliation":[{"name":"Neuroscience Graduate Program, Department of Physiology, Instituto de Ci\u00eancias B\u00e1sicas da Sa\u00fade (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8345-6713","authenticated-orcid":false,"given":"Marino M.","family":"Bianchin","sequence":"additional","affiliation":[{"name":"Medicine School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil"},{"name":"Neurophysiology Unit, Neurology Division, Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil"},{"name":"Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil"},{"name":"Center for the Treatment of Refractory Epilepsy (CETER), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil"},{"name":"Basic Research and Advanced Investigations in Neuroscience (BRAIN) Thematic Laboratory, Centro de Pesquisa Experimental (CPE), Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8405-0966","authenticated-orcid":false,"given":"Suzana V.","family":"Sch\u00f6nwald","sequence":"additional","affiliation":[{"name":"Neurophysiology Unit, Neurology Division, Hospital de Cl\u00ednicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1378\/chest.130.2.605","article-title":"Parasomnias: clinical features and forensic implications","volume":"130","author":"M AC Bornemann","year":"2006","journal-title":"Chest"},{"issue":"12","key":"ref2","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1093\/sleep\/32.12.1637","article-title":"NREM arousal parasomnias and their distinction from nocturnal frontal lobe epilepsy: a video EEG analysis","volume":"32","author":"C P Derry","year":"2009","journal-title":"Sleep"},{"issue":"04","key":"ref3","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1093\/sleep\/28.4.499","article-title":"Practice parameters for the indications for polysomnography and related procedures: an update for 2005","volume":"28","author":"C A Kushida","year":"2005","journal-title":"Sleep"},{"key":"ref4","volume-title":"International Classification of Sleep Disorders. 3rd ed","author":"American Academy of Sleep Medicine (AASM)","year":"2014"},{"issue":"10","key":"ref5","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.5665\/SLEEP.1256","article-title":"Scoring sleep in neurological patients: the need for specific considerations","volume":"34","author":"J Santamaria","year":"2011","journal-title":"Sleep"},{"issue":"03","key":"ref6","doi-asserted-by":"publisher","first-page":"zsab257","DOI":"10.1093\/sleep\/zsab257","article-title":"Video-polysomnography procedures for diagnosis of rapid eye movement sleep behavior disorder (RBD) and the identification of its prodromal stages: guidelines from the International RBD Study Group","volume":"45","author":"M Cesari","year":"2022","journal-title":"Sleep"},{"key":"ref7","volume-title":"International Classification of Sleep Disorders\u2013Third Edition, Text Revision (ICSD-3-TR)","author":"American Academy of Sleep Medicine (AASM)","year":"2023"},{"issue":"06","key":"ref10","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.5664\/jcsm.9218","article-title":"Sleep medicine in Africa: past, present, and future","volume":"17","author":"M A Komolafe","year":"2021","journal-title":"J Clin Sleep Med"},{"key":"ref11","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 3","author":"M M Troester","year":"2023"},{"issue":"04","key":"ref12","doi-asserted-by":"publisher","first-page":"e429","DOI":"10.1055\/s-0044-1800886","article-title":"2024 Standardization of Polysomnography Reports - 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