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Alcohol and Other Drug Abuse and Sleep Behavior Disorder-Reply

Carlos H. Schenck, MD; Scott R. Bundlie, MD; Mark W. Mahowald, MD
JAMA. 1987;258(3):323. doi:10.1001/jama.1987.03400030039017.
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In Reply.—  Alcohol and other drug abuse disorders were not detected in our patient sample, apart from one alcoholic woman previously reported,1 whose rapid eye movement sleep behavior disorder (RBD) emerged and disappeared in conjunction with the Guillain-Barré syndrome; pharmacologic control of her RBD was not required. Our routine screening for substance abuse includes review of past medical records, psychiatric and neurological history taking and examinations, interviews with all spouses, and completion by each patient and spouse of a standard sleep-wakefulness questionnaire, which contains nine questions from the Michigan Alcoholism Screening Test and 31 questions on drug use. Liver function tests are routinely performed and urine toxicology screening is ordered whenever warranted.Dr Westermeyer provides no details about the "sleep behavior disorder" that he states is often present in alcohol and other drug abusers, nor does he present any correlative polysomnographic evidence, which is essential for establishing a diagnosis.

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