Department of Nutritional Sciences, The Pennsylvania State University, University Park.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA Netw Open. 2021 Apr 1;4(4):e215713. doi: 10.1001/jamanetworkopen.2021.5713.
Previous studies conducted among patients with Parkinson disease (PD) reported that parasomnias other than rapid eye movement (REM) sleep behavior disorder (RBD), particularly sleepwalking (SW), are associated with PD severity. However, it remains unclear whether the presence of SW is associated with altered odds of having PD in a population-based study.
To evaluate whether probable SW, either alone or co-occurring with probable RBD, is associated with higher odds of PD in men.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 25 694 men from the Health Professionals Follow-up Study, a population-based cohort of male health professionals in the US with information on probable SW and probable RBD. Data collection took place between January 2012 and June 2018, and data analysis took place from July 2020 to October 2020.
Probable SW and probable RBD were measured by questions adapted from the Mayo Sleep Questionnaire in 2012.
PD, confirmed after review of medical records by a movement disorder specialist.
Of the 25 694 studied men (mean [SD] age, 75.6 [7.4] years), 223 (0.9%) had probable SW, 2720 (10.6%) had probable RBD, and 257 (1.0%) had PD. After adjusting for potential confounders (eg, age, smoking, caffeine intake, chronic disease status, and other sleep disorders), compared with individuals without probable SW and probable RBD, participants with probable SW, probable RBD, and both probable SW and probable RBD had higher odds of PD, (probable SW: odds ratio [OR], 4.80; 95% CI, 1.61-14.26; probable RBD: OR, 6.36; 95% CI, 4.83-8.37; both probable SW and probable RBD: OR, 8.44; 95% CI, 3.90-18.27).
In this cross-sectional study of a male population, probable sleep parasomnias, including both SW and RBD, were associated with higher odds of having PD. PD-related neurodegeneration may impair arousal regulation during sleep.
先前在帕金森病 (PD) 患者中进行的研究报告称，除了快速眼动 (REM) 睡眠行为障碍 (RBD) 以外的其他睡眠障碍，尤其是梦游 (SW)，与 PD 严重程度有关。然而，在基于人群的研究中，SW 的存在是否与 PD 的发病风险增加有关仍不清楚。
评估单独发生或与可能的 RBD 同时发生的 SW 是否与男性 PD 的发病风险增加相关。
设计、地点和参与者：这项横断面研究纳入了来自美国男性健康专业人员的基于人群的队列——卫生专业人员随访研究中的 25694 名男性，这些男性的信息中包含了关于 SW 和 RBD 的可能性的内容。数据收集于 2012 年 1 月至 2018 年 6 月进行，数据分析于 2020 年 7 月至 2020 年 10 月进行。
SW 和 RBD 的可能性是通过在 2012 年采用梅奥睡眠问卷中的问题进行测量的。
PD 通过运动障碍专家对医疗记录进行审查后确诊。
在 25694 名研究男性中（平均[标准差]年龄，75.6[7.4]岁），223 名（0.9%）患有可能的 SW，2720 名（10.6%）患有可能的 RBD，257 名（1.0%）患有 PD。在调整了潜在的混杂因素（例如，年龄、吸烟、咖啡因摄入、慢性疾病状况和其他睡眠障碍）后，与没有可能的 SW 和 RBD 的个体相比，患有可能的 SW、可能的 RBD 和同时患有可能的 SW 和 RBD 的个体患 PD 的风险更高，（可能的 SW：比值比[OR]，4.80；95%置信区间 [CI]，1.61-14.26；可能的 RBD：OR，6.36；95% CI，4.83-8.37；同时患有可能的 SW 和可能的 RBD：OR，8.44；95% CI，3.90-18.27）。
在这项针对男性人群的横断面研究中，包括 SW 和 RBD 在内的可能的睡眠障碍与 PD 的发病风险增加相关。与 PD 相关的神经退行性变可能会损害睡眠期间的觉醒调节。
