Obstructive sleep apnea and risk of Parkinson's disease: a population‐based cohort study

Abstract

Summary Sleep disorders could be associated with neurodegenerative diseases. This study aimed to determine the risk of Parkinson's disease in patients with obstructive sleep apnea. The incident cases of newly diagnosed obstructive sleep apnea were identified between 2000 and 2009 from the medical claims database of National Health Institute of Taiwan. The risk of Parkinson's disease onset at least 1 year after the diagnosis of obstructive sleep apnea was measured during and up to 11 years of period, compared to that of age‐ and gender‐matched controls estimated in the same period. A total of 5864 patients with newly diagnosed obstructive sleep apnea and 23 269 subjects without obstructive sleep apnea were identified for data analysis. The study reported that the incidence of Parkinson's disease in the obstructive sleep apnea cohort was approximately two times higher than that in the control cohort (2.57 versus 1.32 per 1000 person‐years), with an adjusted hazard ratio of 1.84. Furthermore, the risk of Parkinson's disease was particularly greater for the obstructive sleep apnea with insomnia subgroup (adjusted hazard ratio = 1.97, 95% confidence interval = 1.44–2.69) than for the control cohort. The sex–age‐specific analysis further discovered that the most elevated risk of Parkinson's disease onset was noted in female obstructive sleep apnea patients aged 50–69 years (adjusted hazard ratio = 2.82). This population‐based study indicated that patients with obstructive sleep apnea, especially those who suffered from insomnia, are at an increased risk of Parkinson's disease onset.

Sleep apnea and the subsequent risk of Parkinson’s disease: a 3-year nationwide population-based study

“…Several studies have reported that SA is associated with subsequent PD 33–35. However, the present study findings were different and had stronger implications than those of previous studies.…”

“…Fourth, because of the relatively short follow-up period of 3 years, it was difficult to determine whether SA occurred during the prodromal phase of PD before the onset of motor symptoms. Previous studies with longer follow-up periods have supported our findings, despite using different inclusion and exclusion criteria 33–35. Fifth, the actual number of patients with SA who developed PD was small, particularly in women and young patients, thus limiting the statistical power in subgroup analysis based on age and sex.…”

An overview of sleep and circadian dysfunction in Parkinson's disease

“…The OSA symptoms in patients with PD do not appear to be good predictors of non-motor PD symptoms, such as depressive symptoms, fatigue, cognitive impairment, daytime sleepiness and overall quality of life (Cochen De Cock et al, 2010;Neikrug et al, 2013). An increased risk for developing PD in patients with OSA was reported in a series of Taiwanese studies with 5-11 years follow-up (Chen, Tsai, Li, & Hwang, 2015;Yeh, Tien, Yang, Wang, & Weng, 2016), although in one study the difference was found only for women (Sheu, Lee, Lin, Kao, & Chung, 2015). ).…”

Sleep-wake disturbances in the premotor and early stage of Parkinson's disease

“…Recently, two population-based studies from Taiwan assessed the risk for developing Parkinson's disease in patients with OSA [64,65]. The incidence of Parkinson's disease in the OSA cohort was approximately two times higher than that in individuals without OSA with women aged 50-69 and individuals with insomnia being at high risk [64].…”