Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy.
Medicine & Rheumatology Unit, IRCCS Rizzoli Ortopaedic Institute, Bologna, Italy.
Brain Behav. 2019 Mar;9(3):e01230. doi: 10.1002/brb3.1230. Epub 2019 Feb 15.
To investigate the prevalence of REM sleep behavior disorder (RBD) in patients with inflammatory arthritis (IA) to ascertain if RBD could be an internal red flag signaling a fluctuating state of inflammation based on the theory of "protoconsciousness".
MATERIALS & METHODS: One hundred and three patients with a confirmed diagnosis of IA were consecutively recruited. The patients underwent general (IA activity, functional status, laboratory tests) and neurological evaluations. A neurologist investigated RBD and REM sleep parasomnias in a semi-structured interview. Sleep quality was assessed with the Pittsburgh Sleep Quality Index, while the risk of obstructive sleep apnea syndrome (OSAS) was evaluated with the Berlin questionnaire. Beck Depression Inventory II and State-Trait Anxiety Inventory investigated depression and anxiety.
Patients had a mean age of 53.7 ± 14.6 years, 65% were women; 57.3% were in a clinically active phase of IA. Two women fulfilled ICSD-3 criteria for RBD appearing 11 years after and 20 years before IA onset respectively. 31 patients scored positive for nightmare disorder (ND), 8 for recurrent isolated sleep paralysis. 65 (63.1%) patients reported poor sleep quality and 25 (24.3%) resulted at high risk for OSAS. 32 (31.0%) patients scored positively for depression or anxiety.
The prevalence of RBD in patients with IA did not differ from that in the general population, whereas ND presented a 2-fold increased prevalence. Whether RBD can be considered a red flag signaling an internal danger remains an open question, while ND may be a new player in this intriguing relation.
调查炎症性关节炎 (IA) 患者 REM 睡眠行为障碍 (RBD) 的患病率，以确定 RBD 是否可以根据“前意识”理论成为炎症波动状态的内部标志。
连续招募了 103 名确诊为 IA 的患者。对患者进行了一般（IA 活动、功能状态、实验室检查）和神经评估。神经科医生在半结构化访谈中调查 RBD 和 REM 睡眠障碍。使用匹兹堡睡眠质量指数评估睡眠质量，使用柏林问卷评估阻塞性睡眠呼吸暂停综合征 (OSAS) 的风险。使用贝克抑郁量表第二版和状态-特质焦虑量表评估抑郁和焦虑。
患者的平均年龄为 53.7±14.6 岁，65%为女性；57.3%处于 IA 的临床活动期。两名女性分别在 IA 发病后 11 年和 20 年前符合 ICSD-3 的 RBD 标准。31 名患者恶梦障碍 (ND) 评分阳性，8 名患者反复发作孤立性睡眠麻痹。65 名患者（63.1%）报告睡眠质量差，25 名患者（24.3%）存在 OSAS 高风险。32 名患者（31.0%）抑郁或焦虑评分阳性。
IA 患者的 RBD 患病率与普通人群无差异，而 ND 的患病率则增加了一倍。RBD 是否可以被视为表示内部危险的标志仍然是一个悬而未决的问题，而 ND 可能是这种有趣关系中的一个新角色。
