ABSTRACT Objectives To investigate the prevalence of probable REM sleep behavior disorder (pRBD) in essential tremor (ET), identify associated risk factors, and evaluate its effects on motor and non‐motor symptoms. Methods Clinical data were collected from 1297 ET patients across multicenter. pRBD was assessed using the RBD Questionnaire‐Hong Kong (RBDQ‐HK). Risk factors associated with pRBD were identified through multivariable logistic regression. Furthermore, a meta‐analysis was conducted to synthesize existing estimates of pRBD/RBD prevalence in ET. Results In this study, pRBD was identified in 11.6% of ET patients. Meta‐analysis yielded pooled prevalence estimates of 16% for pRBD (ES = 0.16, 95% CI 0.10–0.21) and 14% for RBD (ES = 0.14, 95% CI 0.07–0.21). ET patients with pRBD were older (59.89 ± 13.99 vs. 54.63 ± 16.59 years, p < 0.001) and had a later tremor onset (47.55 ± 15.98 vs. 43.15 ± 17.62 years, p = 0.007) compared with those without pRBD. ET‐pRBD patients also exhibited a higher frequency of midline tremor (54.67% vs. 43.93%, p = 0.003), rest tremor (27.33% vs. 16.04%, p = 0.001), and elevated Non‐Motor Symptom Scale (NMSS) scores (20.30 ± 18.50 vs. 10.43 ± 12.42, p < 0.001). Multivariable logistic regression identified lower educational attainment (OR = 0.93, p = 0.002) and higher NMSS scores (OR = 1.03, p < 0.001) as independent risk factors. Conclusions pRBD is prevalent in ET and independently associated with lower education and increased non‐motor symptom burden. Recognition of pRBD may help identify an ET subgroup with distinctive clinical features.
Wang et al. (Sun,) studied this question.