Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Sleep Disorders Center, Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Sleep Med. 2024 Jul;119:379-388. doi: 10.1016/j.sleep.2024.05.011. Epub 2024 May 10.
Dopamine agonists (DAs) constitute the standard therapeutic scheme for restless leg syndrome (RLS) because they have been proven to be effective. However, DAs may change sleep parameters, thus having adverse effects on patient condition. This meta-analysis clarified the effects of DAs used in RLS treatment on the sleep architecture.
PubMed, Embase, and Cochrane Central databases were searched for randomized control trials (RCT) (up to October 2023) that discussed the effects of DAs on sleep architecture in patients with RLS. A meta-analysis employing a random-effects model was conducted. The patients were divided into subgroups according to individual DAs and treatment duration (1 day or ≥4 weeks).
Thirteen eligible randomized placebo-controlled trials were included in the assessment. The effects of three DAs (i.e., pramipexole, ropinirole, and rotigotine) on rapid eye movement (REM) sleep, slow-wave sleep (SWS), and sleep efficiency (SE) were analyzed. Overall, pramipexole significantly improved SE but decreased the percentage of REM sleep among treated patients. Ropinirole also enhanced SE compared with the placebo group. Rotigotine did not affect SE and REM sleep. Subgroup analysis found that pramipexole used for 1 day and ≥4 weeks significantly diminished the percentage of REM sleep. Ropinirole used for 1 day showed similar REM sleep patterns. Finally, none of the three DAs affected SWS.
This meta-analysis demonstrated that DAs significantly affect sleep parameters.
多巴胺激动剂（DAs）构成了不安腿综合征（RLS）的标准治疗方案，因为它们已被证明是有效的。然而，DAs 可能会改变睡眠参数，从而对患者的病情产生不利影响。本荟萃分析阐明了 DAs 在 RLS 治疗中对睡眠结构的影响。
检索了 PubMed、Embase 和 Cochrane 中央数据库中的随机对照试验（RCT）（截至 2023 年 10 月），讨论了 DAs 对 RLS 患者睡眠结构的影响。采用随机效应模型进行荟萃分析。根据个体 DAs 和治疗持续时间（1 天或≥4 周）将患者分为亚组。
纳入了 13 项符合条件的随机安慰剂对照试验进行评估。分析了三种 DAs（即普拉克索、罗匹尼罗和罗替高汀）对快速眼动（REM）睡眠、慢波睡眠（SWS）和睡眠效率（SE）的影响。总体而言，普拉克索显著改善了 SE，但降低了治疗患者中 REM 睡眠的百分比。与安慰剂组相比，罗匹尼罗也增强了 SE。罗替高汀对 SE 和 REM 睡眠没有影响。亚组分析发现，普拉克索使用 1 天和≥4 周显著降低了 REM 睡眠的百分比。罗匹尼罗使用 1 天显示出相似的 REM 睡眠模式。最后，三种 DAs 均未影响 SWS。
本荟萃分析表明，DAs 显著影响睡眠参数。
