Comorbidity and medication in REM sleep behavior disorder

Frauscher, Birgit; Jennum, Poul; Ju, Yo‐El S.; Postuma, Ronald B.; Arnulf, Isabelle; Cock, Valérie Cochen De; Dauvilliers, Yves; Fantini, María Livia; Ferini‐Strambi, Luigi; Gabelia, David; Iranzo, Álex; Leu‐Semenescu, Smaranda; Mitterling, Thomas; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Montplaisir, Jacques; Oertel, Wolfgang H.; Pelletier, Amélie; Prunetti, Paolo; Puligheddu, Monica; Santamaría, Joan; Šonka, Karel; Unger, Marcus M.; Wolfson, Christina; Zucconi, Marco; Terzaghi, Michele; Högl, Birgit; Mayer, Geert; Manni, Raffaele

doi:10.1212/wnl.0000000000000247

Cited by 103 publications

(77 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This association has been frequently reported in other studies [42][43][44][45] and may reflect a complex relationship. Antidepressants can trigger RBD, perhaps via a direct modulation of serotonergic innervation of spinal interneurons [46].…”

Section: Characteristics Of Rbd Positive Participantssupporting

confidence: 85%

Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population

Haba‐Rubio

Frauscher

Marques‐Vidal

et al. 2017

Sleep

204

131

View full text Add to dashboard Cite

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.Key words: polysomnography; synucleinopathies; parasomnia; sleep; REM sleep without atonia Statement of SignificanceRapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia frequently associated or preceding neurodegenerative diseases such as synucleinopathies. Its occurrence in the general population is largely unknown. Analyzing data from 1,997 participants to the population-based HypnoLaus study who completed the Munich Parasomnia Screening questionnaire and had a complete polysomnography at home, we estimate the prevalence of RBD at 1.06%, with no significant difference between men and women. RBD was associated with antidepressant and antipsychotic use, and with minor differences in sleep structure. Knowing the prevalence and characteristics of RBD has important implications, as people with RBD can be ideal candidates for neuroprotective approaches, and can help us to better understand the progression of neurodegenerative disorders.

show abstract

Section: Characteristics Of Rbd Positive Participantssupporting

confidence: 85%

Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population

Haba‐Rubio

Frauscher

Marques‐Vidal

et al. 2017

Sleep

204

131

View full text Add to dashboard Cite

show abstract

“…26 In another multicenter case-control study including 318 idiopathic RBD cases and 318 matched controls (181 sleep disorder controls and 137 healthy volunteers), RBD cases reported more cardiovascular disease (odds ratio [OR] 1.6; 95% CI 1.0-2.5) relative to the controls, and the association became stronger when 181 sleep disorder controls were removed (OR 2.4; 95% CI 1.3-4.6). 27 In the same study, a correlation between RBD and a higher odds of having selfreported cerebrovascular disease was also observed (OR 1.3; 95% CI 0.7-2.6), although the association was not significant, which could be due to small number of cerebrovascular disease cases (n 5 38) and misclassification due to self-report nature. 27 There are several biological mechanisms that may explain the observed association between RBD and stroke.…”

Section: Insomniamentioning

confidence: 83%

“…27 In the same study, a correlation between RBD and a higher odds of having selfreported cerebrovascular disease was also observed (OR 1.3; 95% CI 0.7-2.6), although the association was not significant, which could be due to small number of cerebrovascular disease cases (n 5 38) and misclassification due to self-report nature. 27 There are several biological mechanisms that may explain the observed association between RBD and stroke. The association could be due to a more profound change, resulting from the disturbed sleep.…”

Section: Insomniamentioning

confidence: 83%

See 1 more Smart Citation

Probable REM sleep behavior disorder and risk of stroke

Pavlova

Liu

et al. 2017

Neurology

View full text Add to dashboard Cite

Objective: To examine whether probable REM sleep behavior disorder (pRBD) was associated with increased risk of developing stroke in a community-based cohort. Methods:The study included 12,003 participants (mean age 54.0 years) of the Kailuan Study, free of stroke, cancer, Parkinson disease, dementia, and head injury at baseline (2012). We determined pRBD using a validated REM sleep behavior disorder (RBD) questionnaire in 2012. Incident stroke cases were confirmed by review of medical records. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke according to pRBD status, adjusting for several sleep measures (i.e., insomnia, daytime sleepiness, sleep duration, snoring, and use of hypnotics) and other potential confounders.Results: During 3 years of follow-up, we documented 159 incident stroke cases. Relative to participants without pRBD at the baseline, those with pRBD had a 157% higher risk (95% CI 59%-313%) of developing stroke. Presence of pRBD was associated with increased risk of both stroke types-the adjusted HR was 1.93 (95% CI 1.07-3.46) for ischemic stroke and 6.61 (95% CI 2.27-19.27) for hemorrhagic stroke.Conclusions: Presence of pRBD was associated with a higher risk of developing stroke, including both ischemic and hemorrhagic types. Future studies with clinically confirmed RBD and a longer follow-up would be appropriate to further investigate this association. Neurology ® 2017;88:1849-1855 GLOSSARY AIS 5 Athens Insomnia Scale; BMI 5 body mass index; CI 5 confidence interval; ESS 5 Epworth Sleepiness Scale; HDL-C 5 high-density lipoprotein cholesterol; HR 5 hazard ratio; ICD-10 5 International Classification of Diseases-10; LDL-C 5 lowdensity lipoprotein cholesterol; OR 5 odds ratio; OSA 5 obstructive sleep apnea; PD 5 Parkinson disease; pRBD 5 probable REM sleep behavior disorder; RBD 5 REM sleep behavior disorder; RBDQ-HK 5 RBD questionnaire-Hong Kong; RMB 5 renminbi.REM sleep behavior disorder (RBD) is associated with synucleinopathies, and a large proportion of individuals with RBD may already have or later develop Parkinson disease (PD), dementia with Lewy bodies, or multiple system atrophy. [1][2][3] Synucleinopathies were often associated with symptoms of autonomic dysfunction, such as impaired blood pressure control and reduced heart rate variability. 4,5 Consistently, individuals with idiopathic RBD experienced worse autonomic function, including cardiovascular, gastrointestinal, and urinary domains, relative to control participants. 6,7 The autonomic nervous system may have a role in the prepathologic state or contribute to the precipitating factors of the acute phase of stroke, such as atherosclerosis and sympathetic hyperactivity. 8 Some case reports suggested that stroke may cause RBD. 9-11 In a previous cross-sectional study, we also found that individuals with probable RBD (pRBD) had higher odds of several concurrent stroke risk factors, such as diabetes and hyperlipidemia. 12 However, whether RBD predicts subsequ...

show abstract

“…Understanding these risk factors is important, because besides risk of neurodegeneration, RBD carries the risk of sleep disruption and injury. From recent epidemiological studies of potential risk factors for RBD,3, 4, 5, 6 several identified risk factors are related to neurodegenerative diseases (e.g., head injury and olfactory dysfunction) and cardiovascular diseases (e.g., hyperlipidemia and physical inactivity) 3, 4, 5, 64, 5, 6 though in some of the studies,4, 5 this association did not reach statistical significance.…”

Section: Introductionmentioning

confidence: 98%

Alcohol consumption and probable rapid eye movement sleep behavior disorder

Pavlova

et al. 2018

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectiveTo systematically examine the association between alcohol intake and likelihood of having probable rapid eye movement sleep behavior disorder (pRBD) 6 years later.MethodsThe study included 11,905 participants (mean age: 47.7 years) of the Kailuan Study, free of stroke, cancer, Parkinson disease, dementia, and head injury in 2006. We determined pRBD using a validated RBD questionnaire–Hong Kong in 2012. Amounts and types of alcohol intake were collected with questionnaire. Participants were categorized into: nondrinkers, light (women: 0–0.4 servings/day; men: 0–0.9 servings/day), moderate (women: 0.5–1.0 servings/day; men: 1–2 servings/day), and heavy drinkers(women: >1 serving/day; men: >2 servings/day). To examine the alcohol‐pRBD relationship, we used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for demographic characteristics, smoking, hypertension, diabetes, physical activity, body mass index, and plasma concentrations of lipids and urate.ResultsCompared with nondrinkers, current drinkers had a 23% higher likelihood of having pRBD (adjusted OR 1.23, 95% CI 1.07–1.59). Both moderate (adjusted OR: 1.53, 95% CI 1.01–2.30) and heavy drinkers (adjusted OR: 1.29, 95% CI 1.00–1.66), but not light drinkers (adjusted OR: 1.16, 95% CI 0.94–1.44), had a significantly higher likelihood of having pRBD, relative to nondrinkers. There was a nonsignificant trend between consumption of each individual alcoholic beverages (i.e., beer, wine, or hard liquor) and higher likelihood of having pRBD (adjusted ORs ranged from 1.11 to 1.49).ConclusionsAlcohol consumption was associated with a higher likelihood of having pRBD. Future prospective studies with clinically confirmed RBD, large sample size for information on types of alcoholic beverage are warranted.

show abstract

Comorbidity and medication in REM sleep behavior disorder

Abstract: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.

Cited by 103 publications

References 10 publications

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

Probable REM sleep behavior disorder and risk of stroke

Alcohol consumption and probable rapid eye movement sleep behavior disorder

Contact Info

Product

Resources

About