Department of Nutritional Sciences, Pennsylvania State University, University Park, MA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Social & Scientific Systems, Durham, NC.
Mayo Clin Proc. 2023 Oct;98(10):1449-1457. doi: 10.1016/j.mayocp.2023.06.018.
To examine the association between parasomnias, including rapid eye movement sleep behavior disorder (RBD) and sleep walking (SW), and mortality risk in a large-scale population-based cohort.
This prospective cohort study was based on 25,695 participants from the Health Professionals Follow-up Study, a population-based cohort of male health professionals in the United States. Probable SW (pSW) and probable RBD (pRBD) were measured by questions adapted from the Mayo Sleep Questionnaire in 2012. All-cause mortality and cause-specific mortality were ascertained through the national registry, reports by the families, and the postal system from January 1, 2012, through June 30, 2018.
Of the studied population, 223 reported pSW and 2720 reported pRBD. During 6 years of follow-up (2012 to 2018), 4743 mortality cases were documented. The co-occurrence of both probable parasomnias was associated with higher all-cause mortality risk (P=.008), and the adjusted hazard ratio (HR) of mortality was 1.65 (95% CI, 1.20 to 2.28) compared with participants without either probable parasomnia after adjustment for major lifestyle, sleep, and metabolic risk factors, and chronic diseases. Significant associations were found for mortality attributed to neurodegenerative diseases (adjusted HR for both parasomnias vs none, 4.57; 95% CI, 2.62 to 7.97) and accidents (adjusted HR for both parasomnias vs none, 7.36; 95% CI, 2.95 to 18.4). Having pSW alone was associated with all-cause mortality, and pSW and pRBD were individually associated with mortality attributed to neurodegenerative diseases and accidents too (P<.05 for all).
Probable parasomnia was associated with a higher risk of all-cause mortality and mortality attributed to neurodegenerative diseases and accidents.
在大规模基于人群的队列中，研究包括快速眼动睡眠行为障碍（RBD）和梦游（SW）在内的睡眠障碍与死亡率之间的关系。
这项前瞻性队列研究基于美国一项基于人群的男性健康专业人员队列——卫生专业人员随访研究中的 25695 名参与者。在 2012 年，通过对梅奥睡眠问卷进行改编的问题来测量可能的 SW（pSW）和可能的 RBD（pRBD）。自 2012 年 1 月 1 日至 2018 年 6 月 30 日，通过国家登记处、家属报告和邮政系统确定全因死亡率和死因特异性死亡率。
在所研究的人群中，有 223 人报告有 pSW，2720 人报告有 pRBD。在 6 年的随访期间（2012 年至 2018 年），记录了 4743 例死亡病例。同时存在两种可能性的睡眠障碍与更高的全因死亡率风险相关（P=0.008），与没有任何一种可能性的睡眠障碍的参与者相比，调整后的死亡率风险比（HR）为 1.65（95%CI，1.20 至 2.28），同时调整了主要生活方式、睡眠和代谢风险因素以及慢性疾病。在归因于神经退行性疾病（两种可能性的睡眠障碍与无可能性的睡眠障碍相比，调整后的 HR 为 4.57；95%CI，2.62 至 7.97）和事故（两种可能性的睡眠障碍与无可能性的睡眠障碍相比，调整后的 HR 为 7.36；95%CI，2.95 至 18.4）的死亡率方面，存在显著相关性。单独存在 pSW 与全因死亡率相关，pSW 和 pRBD 也与神经退行性疾病和事故导致的死亡率相关（所有 P 值均<.05）。
可能的睡眠障碍与全因死亡率以及神经退行性疾病和事故导致的死亡率增加有关。
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