From the Department of Research Programs (Beydoun), Fort Belvoir Community Hospital, Fort Belvoir, Virginia; Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP (Hossain, Beydoun, Zonderman), Baltimore, Maryland; Fort Belvoir Troop Command (Huang), Fort Belvoir, Virginia; Integrated Health Sciences Program, School of Health Sciences (Alemu), Western Carolina University, Cullowhee, North Carolina; and Department of Medicine (Eid), Johns Hopkins University School of Medicine, Baltimore, Maryland.
Psychosom Med. 2021 Jun 1;83(5):477-484. doi: 10.1097/PSY.0000000000000949.
This study aimed to examine patterns of sleep disorders among hospitalized adults 65 years and older as related to Parkinson's disease (PD) status and to evaluate sex differences in the associations between PD with sleep disorders.
A cross-sectional study was conducted using 19,075,169 hospital discharge records (8,169,503 men and 10,905,666 women) from the 2004-2014 Nationwide Inpatient Sample databases. PD and sleep disorder diagnoses were identified based on International Classification of Diseases, Ninth Revision, Clinical Modification coding. Logistic regression models were constructed for each sleep disorder as a correlate of PD status; adjusted odds ratios (aOR) with their 95% confidence intervals (CIs) were calculated taking into account patient and hospital characteristics.
Period prevalences of PD and sleep disorder were estimated to be 2.1% and 8.1%, respectively. Most sleep disorder types, with the exception of sleep-related breathing disorders, were positively associated with PD diagnosis. Statistically significant interactions by sex were noted for associations of insomnia (men: aOR = 1.29, 95% CI = 1.24-1.36; women: aOR = 1.17, 95% CI = 1.12-1.22), parasomnia (men: aOR = 3.74, 95% CI = 3.44-4.07; women: aOR = 2.69, 95% CI = 2.44-2.96), sleep-related movement disorder (men: aOR = 1.09, 95% CI = 1.07-1.11; women: aOR = 1.22, 95% CI = 1.20-1.25), and any sleep disorder (men: aOR = 1.06, 95% CI = 1.05-1.08; women: aOR = 1.15, 95% CI = 1.13-1.17) with PD status.
Overall, hospitalized men are more likely to experience PD with insomnia or parasomnia, whereas hospitalized women are more likely to experience PD with sleep-related movement disorder or any sleep disorder. Prospective cohort studies are needed to replicate these cross-sectional findings.
本研究旨在调查 65 岁及以上住院成年人的睡眠障碍模式与帕金森病（PD）之间的关系，并评估 PD 与睡眠障碍之间关联的性别差异。
使用 2004 年至 2014 年全国住院患者样本数据库中的 19075169 份住院记录（男性 8169503 份，女性 10905666 份）进行横断面研究。基于国际疾病分类，第九修订版，临床修正版的编码确定 PD 和睡眠障碍的诊断。针对每种睡眠障碍，构建 PD 状态的相关因素的逻辑回归模型；考虑患者和医院特征，计算调整后的优势比（aOR）及其 95%置信区间（CI）。
PD 和睡眠障碍的时期患病率估计分别为 2.1%和 8.1%。除睡眠呼吸障碍外，大多数睡眠障碍类型与 PD 诊断呈正相关。对于失眠（男性：aOR=1.29，95%CI=1.24-1.36；女性：aOR=1.17，95%CI=1.12-1.22）、睡眠相关障碍（男性：aOR=3.74，95%CI=3.44-4.07；女性：aOR=2.69，95%CI=2.44-2.96）、睡眠相关运动障碍（男性：aOR=1.09，95%CI=1.07-1.11；女性：aOR=1.22，95%CI=1.20-1.25）和任何睡眠障碍（男性：aOR=1.06，95%CI=1.05-1.08；女性：aOR=1.15，95%CI=1.13-1.17），性别之间存在统计学显著的交互作用。
总体而言，住院男性更有可能患有 PD 伴失眠或睡眠相关障碍，而住院女性更有可能患有 PD 伴睡眠相关运动障碍或任何睡眠障碍。需要前瞻性队列研究来复制这些横断面研究结果。
