Daytime Napping, Nighttime Sleeping, and Parkinson Disease
Daytime Napping, Nighttime Sleeping, and Parkinson Disease
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DOI：
10.1093/aje/kwq478
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发表时间：
2011-05-01
影响因子：
5
通讯作者：
Chen, Honglei
中科院分区：
文献类型：
--
作者：
Gao, Jianjun;Huang, Xuemei;Chen, Honglei
初步证据表明，白天嗜睡可能早于帕金森病的临床诊断。作者检查了1996-1997年220，934名美国NIH-AARP饮食和健康研究参与者报告的日间小睡和夜间睡眠持续时间与帕金森病诊断的3个临床阶段：确诊病例（1995年以前确诊的病例，n = 267）、近期病例（1995-1999年，n = 396）和诊断前病例（2000年及以后，n = 770）。优势比和95%置信区间来自多变量逻辑回归模型。在所有3个临床阶段，白天小睡时间较长与帕金森病的几率较高相关：（>1小时/天）与nonnapers是3.9（95%置信区间：2.8，5.6）对于确定的病例，2.2（95%置信区间：1.7，3.0）为近期病例，1.5（95%置信区间：1.2，1.9）为诊断前病例。对健康状况或夜间睡眠时间的进一步控制减弱了已确诊病例的相关性，但对近期或诊断前病例几乎没有影响。在夜间睡眠分析中，在已确诊的病例中观察到与帕金森病的明显U形关联;然而，这种关联在近期病例中明显减弱，在诊断前病例中消失。这项研究支持了白天嗜睡而不是夜间睡眠时间是帕金森病早期非运动症状之一的观点。
Preliminary evidence suggests that daytime sleepiness may predate clinical diagnosis of Parkinson disease. The authors examined daytime napping and nighttime sleeping durations, reported in 1996-1997 by 220,934 US NIH-AARP Diet and Health Study participants, in relation to Parkinson disease diagnoses at 3 clinical stages: established (cases diagnosed before 1995, n = 267), recent (1995-1999, n = 396), and prediagnostic (2000 and after, n = 770). Odds ratios and 95% confidence intervals were derived from multivariate logistic regression models. Longer daytime napping was associated with higher odds of Parkinson disease at all 3 clinical stages: the odds ratios comparing long nappers (>1 hour/day) with nonnappers were 3.9 (95% confidence interval: 2.8, 5.6) for established cases, 2.2 (95% confidence interval: 1.7, 3.0) for recent cases, and 1.5 (95% confidence interval: 1.2, 1.9) for prediagnostic cases. Further control for health status or nighttime sleeping duration attenuated the association for established cases but made little difference for recent or prediagnostic cases. In the nighttime sleeping analysis, a clear U-shaped association with Parkinson disease was observed for established cases; however, this association was attenuated markedly for recent cases and disappeared for prediagnostic cases. This study supports the notion that daytime sleepiness, but not nighttime sleeping duration, is one of the early nonmotor symptoms of Parkinson disease.