Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population
Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population
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DOI：
10.1093/sleep/zsx197
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发表时间：
2018-02-01
期刊：
影响因子：
5.6
通讯作者：
Heinzer, Raphael
中科院分区：
文献类型：
--
作者：
Haba-Rubio, Jose;Frauscher, Birgit;Heinzer, Raphael
研究目的：快速眼动（REM）睡眠行为障碍（RBD）是一种与神经退行性突触核蛋白病相关的睡眠障碍。其流行程度在很大程度上是未知的。本研究使用金标准多导睡眠描记法确定了RBD在普通人群中的患病率和特征。方法：收集了来自1，997名参与者（年龄= 59 +/- 11.1岁，53.6%为女性）的多导睡眠描记数据，这些参与者参与了一项基于人群的研究（HypnoLaus，洛桑，瑞士）。使用包括慕尼黑睡眠异常筛查（MUPS）问卷在内的各种睡眠测量方法对睡眠相关主诉和习惯进行了调查，其中包括两个评估提示RBD的复杂运动行为的问题。在家中进行了完整的多导睡眠描记。对于参与者筛选RBD阳性，在REM睡眠期间的肌肉活动进行了量化诊断RBD.Results：三百六十八名参与者认可的两个MUPS的问题，和21个满足多导睡眠标准RBD，估计患病率为1.06%（95%CI = 0.61-1.50），男性和女性之间没有差异。与RBD参与者相比，RBD+更频繁地服用抗抑郁药和抗精神病药（分别为23.8%和5.4%，p= 0.005; 14.3%和1.5%，p= 0.004），并且更频繁地吸烟或戒烟（85%和56.6%，p= 0.011）。在多导睡眠图上，RBD+有更多的N2期睡眠（52 +/- 11.5% vs. 46.3 +/-10.2%，p= 0.024）和更少的REM睡眠（18 +/- 6.4% vs. 21.9 +/-6.2%，p= 0.007），REM睡眠时呼吸暂停低通气指数较低（3.8 +/- 5.2 vs. 8.9 +/- 13/小时，p= 0.035），以及较低的自主觉醒指数（31 +/- 14.9 vs. 42.6 +/- 19.5/小时，p=.002）。在我们的中老年人群样本中，RBD的患病率为1.06%，男性和女性之间没有差异。RBD与抗抑郁药和抗精神病药的使用以及睡眠结构的微小差异有关。
Study Objectives: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with neurodegenerative synucleinopathies. Its prevalence is largely unknown. This study determined the prevalence and characteristics of RBD in the general population using gold-standard polysomnography.Methods: Full polysomnographic data from 1,997 participants (age = 59 +/- 11.1 years, 53.6% women) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Sleep-related complaints and habits were investigated using various sleep measures including the Munich Parasomnia Screening (MUPS) questionnaire, which includes two questions evaluating complex motor behaviors suggestive of RBD. Full polysomnography was performed at home. For participants screening positive for RBD, muscle activity during REM sleep was quantified to diagnose RBD.Results: Three hundred sixty-eight participants endorsed dream-enactment behavior on either of the two MUPS questions, and 21 fulfilled polysomnographic criteria for RBD, resulting in an estimated prevalence of 1.06% (95% CI = 0.61-1.50), with no difference between men and women. Compared with RBD-participants, RBD+took more frequently antidepressants and antipsychotics (23.8% vs. 5.4%, p=.005; 14.3% vs. 1.5%, p=.004, respectively) and were more frequently smokers or exsmokers (85% vs. 56.6%, p=.011). On polysomnography, RBD+had more stage N2 sleep (52 +/- 11.5% vs. 46.3 +/- 10.2%, p=.024) and less REM sleep (18 +/- 6.4% vs. 21.9 +/- 6.2%, p=.007), lower apnea-hypopnea index in REM sleep (3.8 +/- 5.2 vs. 8.9 +/- 13/hour, p=.035), and lower autonomic arousal index (31 +/- 14.9 vs. 42.6 +/- 19.5/hour, p=.002).Conclusions: In our middle-to-older age population-based sample, the prevalence of RBD was 1.06%, with no difference between men and women. RBD was associated with antidepressant and antipsychotic use and with minor differences in sleep structure.