Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
Sleep Med. 2023 Jul;107:289-299. doi: 10.1016/j.sleep.2023.05.014. Epub 2023 May 19.
OBJECTIVE: Our study aimed to explore the associative relationship between neurodegenerative diseases and sleep disorders. PATIENTS: This 15-year retrospective longitudinal nationwide population-based matched case-control study used data extracted from the National Health Insurance Research Database. We evaluated 25,589 patients diagnosed with neurodegenerative diseases between 2000 and 2015 and a matched control of 102,356 patients without neurodegenerative diseases. RESULTS: Sleep disorders were an independent risk factor for the development of neurodegenerative diseases (adjusted odds ratio (OR): 1.794, 95% confidence interval (CI): 1.235-2.268, P < 0.001), with a positive dose-effect relationship (adjusted OR (95% CI): <1 year: 1.638 (1.093-2.872), P < 0.001; 1-5 years: 1.897 (1.260-3.135), P < 0.001; >5 years: 2.381 (1.467-3.681), P < 0.001. Moreover, patients with sleep disorder and comorbid depression had a significantly higher risk of neurodegenerative disorders (adjusted OR: 5.874). Subgroup analysis showed that insomnia was associated with Alzheimer's disease, Pick's disease and essential tremor (adjusted OR (95% CI): 1.555 (1.069-1.965), 1.934 (1.331-2.445) and 2.089 (1.439-2.648), respectively). Obstructive sleep apnea was associated with Parkinson's disease, essential tremor, and primary dystonia (adjusted OR (95% CI): 1.801 (1.239-2.275), 5.523 (3.802-6.977), and 4.892 (3.365-6.178), respectively). Other specific sleep disorders were associated with Pick's disease, Parkinson's disease, essential tremor, and primary dystonia (adjusted OR (95% CI): 8.901 (6.101-11.010), 1.549 (1.075-1.986), 2.791 (1.924-3.531), and 9.114 (6.283-10.506), respectively). CONCLUSION: Sleep disorders are associated with the subsequent development of neurodegenerative disorders. Moreover, sleep disorder patients with comorbid depression have a higher risk of neurodegenerative diseases.
目的：本研究旨在探讨神经退行性疾病与睡眠障碍之间的关联。
患者：这是一项为期 15 年的回顾性纵向全国人群匹配病例对照研究，使用了从国家健康保险研究数据库中提取的数据。我们评估了 2000 年至 2015 年间诊断为神经退行性疾病的 25589 名患者和未患神经退行性疾病的 102356 名匹配对照。
结果：睡眠障碍是神经退行性疾病发生的独立危险因素（调整后的优势比（OR）：1.794，95%置信区间（CI）：1.235-2.268，P<0.001），具有正剂量效应关系（调整后的 OR（95%CI）：<1 年：1.638（1.093-2.872），P<0.001；1-5 年：1.897（1.260-3.135），P<0.001；>5 年：2.381（1.467-3.681），P<0.001）。此外，患有睡眠障碍和合并抑郁症的患者患神经退行性疾病的风险显著增加（调整后的 OR：5.874）。亚组分析显示，失眠与阿尔茨海默病、匹克氏病和特发性震颤有关（调整后的 OR（95%CI）：1.555（1.069-1.965），1.934（1.331-2.445）和 2.089（1.439-2.648））。阻塞性睡眠呼吸暂停与帕金森病、特发性震颤和原发性肌张力障碍有关（调整后的 OR（95%CI）：1.801（1.239-2.275），5.523（3.802-6.977）和 4.892（3.365-6.178））。其他特定的睡眠障碍与匹克氏病、帕金森病、特发性震颤和原发性肌张力障碍有关（调整后的 OR（95%CI）：8.901（6.101-11.010），1.549（1.075-1.986），2.791（1.924-3.531）和 9.114（6.283-10.506））。
结论：睡眠障碍与神经退行性疾病的后续发展有关。此外，合并抑郁症的睡眠障碍患者患神经退行性疾病的风险更高。
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