痴呆患者睡眠相关呼吸障碍及相关危险因素的患病率：一项荟萃分析。

Prevalence of sleep-related breathing disorders and associated risk factors among people with dementia: A meta-analysis.

机构信息

School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Nursing Department, Faculty of Health Science, University of Muhammadiyah Malang, Indonesia.

Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Sleep Med. 2023 Mar;103:51-61. doi: 10.1016/j.sleep.2023.01.020. Epub 2023 Jan 30.

DOI:10.1016/j.sleep.2023.01.020

PMID:36758347

Abstract

OBJECTIVE

Sleep-related breathing disorders (SRBD) have shown to cause worsened cognitive impairment among people with dementia. Therefore, we conducted the first meta-analysis to estimate the prevalence of SRBD among people with dementia.

METHODS

Comprehensive searches were conducted in Embase, Ovid-MEDLINE, PubMed, PsycINFO, Scopus, Web of Science, and CINAHL. The generalized linear mixed model (GLMM) was used for the pooled prevalence analysis and heterogeneity using I test and Cochran's Q-statistic in R-software. Study quality was assessed by Hoy's risk of bias assessment tool. Overall, 20 studies from 1282 studies were included with 1461 participants.

RESULTS

The pooled prevalence of SRBD among dementia was 59% (95%CI: 44%-73%) with 55% (95%CI: 34%-74%) for obstructive sleep apnea (OSA), 49% (95%CI: 25%-73%) for unspecified SRBD, and 11% (95%CI: 5%-21%) for central sleep apnea (CSA). Regarding dementia subtypes, the prevalence of SRBD was 89% (95%CI: 61%-97%) for Alzheimer's dementia, 56% (95%CI: 48%-63%) for Parkinson's and Idiopathic Parkinson's dementia, and 16% (95%CI: 8%-30%) for Huntington's dementia. Significant moderator variables were male, body mass index, larger waist and hip circumference, waist-hip ratio, and comorbidities including hypertension, dyslipidemia, renal disease, diabetes, heart disease, and stroke.

CONCLUSIONS

There is considerable high prevalence of SRBD among dementia people, with OSA and unspecified SRBD being fivefold higher than CSA. Regarding dementia subtypes, Parkinson's and Idiopathic Parkinson's, and Alzheimer's dementia had four to sixfold increased risk of presenting with SRBD than Huntington's dementia. Therefore, assessment and management of SRBD in Alzheimer's, and Parkinson's and Idiopathic Parkinson's dementia deserves more attention in future research.

摘要

目的

睡眠相关呼吸障碍（SRBD）已被证明会导致痴呆患者的认知障碍恶化。因此，我们进行了首次荟萃分析，以估计痴呆患者中 SRBD 的患病率。

方法

在 Embase、Ovid-MEDLINE、PubMed、PsycINFO、Scopus、Web of Science 和 CINAHL 中进行了全面检索。使用广义线性混合模型（GLMM）进行汇总患病率分析，并使用 R 软件中的 I 检验和 Cochran's Q 统计量进行异质性分析。使用 Hoy 偏倚风险评估工具评估研究质量。最终，共纳入了 20 项研究，包含 1461 名参与者。

结果

痴呆患者中 SRBD 的总患病率为 59%（95%CI：44%-73%），其中阻塞性睡眠呼吸暂停（OSA）为 55%（95%CI：34%-74%），未特指的 SRBD 为 49%（95%CI：25%-73%），中枢性睡眠呼吸暂停（CSA）为 11%（95%CI：5%-21%）。就痴呆亚型而言，阿尔茨海默病的 SRBD 患病率为 89%（95%CI：61%-97%），帕金森病和特发性帕金森病痴呆为 56%（95%CI：48%-63%），亨廷顿病痴呆为 16%（95%CI：8%-30%）。显著的调节变量为男性、体重指数、更大的腰围和臀围、腰臀比以及合并症，包括高血压、血脂异常、肾脏疾病、糖尿病、心脏病和中风。

结论

痴呆患者中存在相当高的 SRBD 患病率，其中 OSA 和未特指的 SRBD 是 CSA 的五倍以上。就痴呆亚型而言，帕金森病和特发性帕金森病以及阿尔茨海默病的 SRBD 患病率比亨廷顿病痴呆高四到六倍。因此，在未来的研究中，应更加关注阿尔茨海默病、帕金森病和特发性帕金森病痴呆患者的 SRBD 评估和管理。