Feng Fei, Cai YingYing, Hou YanBing, Ou Ruwei, Jiang Zheng, Shang HuiFang
Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Neurology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Department of Neurology, Laboratory of Neurodegenerative Disorders, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Parkinsonism Relat Disord. 2021 Apr;85:133-140. doi: 10.1016/j.parkreldis.2021.02.016. Epub 2021 Feb 16.
To provide a robust estimate of the prevalence of excessive daytime sleepiness (EDS) and its clinical correlates in patients with Parkinson's disease (PD).
We searched the PubMed and Embase databases for studies investigating the prevalence and clinical correlates of EDS from inception to March 01, 2020. Quality assessment was performed using the Newcastle-Ottawa quality assessment scale. Random-effects models were set to pool the risk estimates. Sensitivity analyses were performed to evaluate the stability of the outcomes.
After screening 1367 titles and abstracts, 59 studies involving 12,439 participants were included in the systematic review and meta-analysis. The pooled prevalence of EDS in PD was 35.1%, which was higher in South America, North America, Europe, and Australia than that in Asia. Compared to patients without EDS, patients with EDS had higher effect size on disease duration (0.76 years; 95% CI: 0.16-1.37, I = 68.8%), Hoehn and Yahr (HY) stage (0.23 grade; 95% CI: 0.11-0.34, I = 69.1%), Unified PD Rating Scale (UPDRS)-III (3.02 points; 95% CI: 1.53-4.51, I: 61.2%), levodopa equivalent daily dose (LEDD) (141.46 mg; 95% CI: 64.17-218.77, I = 86.1%), depression symptoms (Hedges' g = 0.35; 95% CI: 0.15-0.55, I = 72.0%) and male sex (OR = 1.50; 95% CI: 1.30-1.72, I = 0).
Our results showed that approximately one-third of patients with PD had EDS, which may be associated with the severity of the disease, depression, and male sex, or a combination of neurodegeneration and medication.
对帕金森病（PD）患者日间过度嗜睡（EDS）的患病率及其临床相关因素进行可靠估计。
我们检索了PubMed和Embase数据库，查找自数据库建立至2020年3月1日期间调查EDS患病率及其临床相关因素的研究。使用纽卡斯尔-渥太华质量评估量表进行质量评估。采用随机效应模型汇总风险估计值。进行敏感性分析以评估结果的稳定性。
在筛选了1367篇标题和摘要后，59项涉及12439名参与者的研究被纳入系统评价和荟萃分析。PD患者中EDS的合并患病率为35.1%，南美洲、北美洲、欧洲和澳大利亚的患病率高于亚洲。与无EDS的患者相比，有EDS的患者在疾病持续时间（0.76年；95%可信区间：0.16 - 1.37，I² = 68.8%）、 Hoehn和Yahr（HY）分期（0.23级；95%可信区间：0.11 - 0.34，I² = 69.1%）、统一PD评定量表（UPDRS）-III（3.02分；95%可信区间：1.53 - 4.51，I²：61.2%）、左旋多巴等效日剂量（LEDD）（141.46毫克；95%可信区间：64.17 - 218.77，I² = 86.1%）、抑郁症状（Hedges' g = 0.35；95%可信区间：0.15 - 0.55，I² = 72.0%）以及男性（比值比 = 1.50；95%可信区间：1.30 - 1.72，I² = 0）方面的效应量更高。
我们的结果表明，约三分之一的PD患者存在EDS，这可能与疾病严重程度、抑郁和男性性别有关，或者与神经退行性变和药物治疗的综合作用有关。
