Environmental risk factors for REM sleep behavior disorder

Abstract

Objective: Idiopathic REM sleep behavior disorder is a parasomnia characterized by dream enactment and is commonly a prediagnostic sign of parkinsonism and dementia. Since risk factors have not been defined, we initiated a multicenter case-control study to assess environmental and lifestyle risk factors for REM sleep behavior disorder.Methods: Cases were patients with idiopathic REM sleep behavior disorder who were free of dementia and parkinsonism, recruited from 13 International REM Sleep Behavior Disorder Study Group centers. Controls were matched according to age and sex. Potential environmental and lifestyle risk factors were assessed via standardized questionnaire. Unconditional logistic regression adjusting for age, sex, and center was conducted to investigate the environmental factors.

Parkinson risk in idiopathic REM sleep behavior disorder

“…However, as awareness has expanded, diagnosis is more frequent. To illustrate, the RBD study group quickly recruited 347 patients for an epidemiologic study, 33 well within sample size calculations (multiple centers would still be required for most trials).…”

Alcohol consumption and probable rapid eye movement sleep behavior disorder

“…Given the risk of misclassification of RBD status with this methodology, we used the term pRBD in this report. However, in prior studies with RBD diagnosed by PSG, a similar association between alcohol and RBD was also observed 4. To reduce the effects of potential misclassification of RBD status, we also did sensitivity analyses by excluding participants with RBD mimics.…”

“…A multicenter case‐controlled study of environmental risk factors for idiopathic RBD (iRBD), with 347 cases and 347 controls, found a nonsignificantly higher alcohol intake frequency in the case group, relative to the control group 4. Another community‐based study with 3635 participants showed a significant association between use of alcoholic beverage and pRBD, with an age‐ and sex‐adjusted OR of 2.16 (95% CI: 1.03, 4.50) for current drinkers, versus never drinkers 12…”

“…Alcohol consumption was reported in association with higher risk of RBD or probable RBD (pRBD),4, 5, 6 though in some of the studies,4, 5 this association did not reach statistical significance. However, most studies to date were either relatively small or not specifically intended to evaluate the dose and type of alcohol beverage used 4, 5, 6. Alcohol has a strong effect on sleep, and thus may affect risk of sleep disorders.…”

“…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. However, most studies to date were either relatively small or not specifically intended to evaluate the dose and type of alcohol beverage used 4, 5, 6.…”