Probable REM sleep behavior disorder and risk of stroke

Ma, Chaoran; Pavlova, Milena; Liu, Yesong; Liu, Ying; Huangfu, Chunmei; Wu, Shouling; Gao, Xiang

doi:10.1212/wnl.0000000000003902

Cited by 57 publications

(57 citation statements)

References 40 publications

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“…Consistently, in a previous study including 3635 Chinese adults, consumption of beer or spirit was both significantly associated with higher odds of having pRBD 12. The opposite direction for the alcohol‐pRBD relationship, particularly for beer, relative to its inverse association with PD, suggests that some RBDs might have different pathogenesis and hence risk factors from PD (i.e., synucleinopathies).…”

Section: Discussionsupporting

confidence: 81%

“…As detailed elsewhere,5, 12 participants of this study included 12,990 Chinese adults (10,725 men and 2265 women), who were free of Parkinson disease and dementia, a subset of an ongoing Chinese cohort, the Kailuan Study 5, 12, 13. In the current analysis, we further excluded 987 participants with a prior history of stroke, cancer, and head injury and 98 participants who did not provide information on alcohol intake or RBD, leaving 11,905 participants (9776 men and 2129 women).…”

Section: Methodsmentioning

confidence: 99%

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Alcohol consumption and probable rapid eye movement sleep behavior disorder

Pavlova

et al. 2018

Ann Clin Transl Neurol

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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.

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Section: Discussionsupporting

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Alcohol consumption and probable rapid eye movement sleep behavior disorder

Pavlova

et al. 2018

Ann Clin Transl Neurol

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“…It has been considered as a risk factor for stroke, with strong correlation with Aβ deposition. In fact, a single night of sleep deprivation is correlated with higher morning Aβ levels [95,96]. Impaired sleep is also a post-stroke symptom associated with poor functional recovery [97] and a consequence of AD [98].…”

Section: Aβ Clearance Through the Glymphatic Systemmentioning

confidence: 99%

From Stroke to Dementia: a Comprehensive Review Exposing Tight Interactions Between Stroke and Amyloid-β Formation

Goulay

Romo

Hol

et al. 2019

Transl. Stroke Res.

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Stroke and Alzheimer's disease (AD) are cerebral pathologies with high socioeconomic impact that can occur together and mutually interact. Vascular factors predisposing to cerebrovascular disease have also been specifically associated with development of AD, and acute stroke is known to increase the risk to develop dementia. Despite the apparent association, it remains unknown how acute cerebrovascular disease and development of AD are precisely linked and act on each other. It has been suggested that this interaction is strongly related to vascular deposition of amyloid-β (Aβ), i.e., cerebral amyloid angiopathy (CAA). Furthermore, the blood-brain barrier (BBB), perivascular space, and the glymphatic system, the latter proposedly responsible for the drainage of solutes from the brain parenchyma, may represent key pathophysiological pathways linking stroke, Aβ deposition, and dementia. In this review, we propose a hypothetic connection between CAA, stroke, perivascular space integrity, and dementia. Based on relevant pre-clinical research and a few clinical case reports, we speculate that impaired perivascular space integrity, inflammation, hypoxia, and BBB breakdown after stroke can lead to accelerated deposition of Aβ within brain parenchyma and cerebral vessel walls or exacerbation of CAA. The deposition of Aβ in the parenchyma would then be the initiating event leading to synaptic dysfunction, inducing cognitive decline and dementia. Maintaining the clearance of Aβ after stroke could offer a new therapeutic approach to prevent post-stroke cognitive impairment and development into dementia.

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“…Other SWD such as extremes of sleep duration (short and long sleep) as well as circadian rhythm disorders (e.g. related to shift work) have been linked to cardiovascular diseases, such as stroke, and have been suggested to negatively influence their course and outcome [26][27][28][29][30][31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke

et al. 2020

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@ERSpublicationsEvidence suggests a bidirectional relationship between sleep and stroke. However, the pathophysiological base of the associations and the possibilities of improving prevention and outcome through sleep-related interventions require further evaluation.ABSTRACT Sleep disorders are highly prevalent in the general population and may be linked in a bidirectional fashion to stroke, which is one of the leading causes of morbidity and mortality.Four major scientific societies established a task force of experts in neurology, stroke, respiratory medicine, sleep medicine and methodology, to critically evaluate the evidence regarding potential links and the impact of therapy. 13 research questions were evaluated in a systematic literature search using a stepwise hierarchical approach: first, systematic reviews and meta-analyses; second, primary studies postdating the systematic reviews/meta-analyses. A total of 445 studies were evaluated and 88 included. Statements were generated regarding current evidence and clinical practice.Severe obstructive sleep apnoea (OSA) doubles the risk for incident stroke, especially in young to middle-aged patients. Continuous positive airway pressure (CPAP) may reduce stroke risk, especially in treatment-compliant patients. The prevalence of OSA is high in stroke patients and can be assessed by polygraphy. Severe OSA is a risk factor for recurrence of stroke and may be associated with stroke mortality, while CPAP may improve stroke outcome. It is not clear if insomnia increases stroke risk, while pharmacotherapy of insomnia may increase it. Periodic limb movements in sleep (PLMS), but not restless limb syndrome (RLS), may be associated with an increased risk of stroke. Preliminary data suggest a high frequency of post-stroke insomnia and RLS and their association with a less favourable stroke outcome, while treatment data are scarce.Overall, the evidence base is best for OSA relationship with stroke and supports active diagnosis and therapy. Research gaps remain especially regarding insomnia and RLS/PLMS relationships with stroke. This article has an editorial commentary: https://doi.

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Probable REM sleep behavior disorder and risk of stroke

Cited by 57 publications

References 40 publications

Alcohol consumption and probable rapid eye movement sleep behavior disorder

Alcohol consumption and probable rapid eye movement sleep behavior disorder

From Stroke to Dementia: a Comprehensive Review Exposing Tight Interactions Between Stroke and Amyloid-β Formation

EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke

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