METHODS: Data from the Parkinson\'s Progression Markers Initiative program included 589 participants with assessments of sleep disorders using the Epworth Sleepiness Scale (ESS) and RBD Screening Questionnaire (RBDSQ). Olfactory dysfunction at baseline was measured using the University of Pennsylvania Smell Identification Test. Trajectories of sleep disorders over a 5-year follow-up were identified using group-based trajectory modeling, and the relationship between olfactory dysfunction and sleep disorder trajectories was examined through binomial logistic regression.
RESULTS: Two distinct trajectories of sleep disorders over the 5-year follow-up period were identified, characterized by maintaining a low or high ESS score and a low or high RBDSQ score. An inversion association was observed between olfactory function measures and trajectories of excessive daytime sleepiness (odds ratio [OR] = 0.97, 95% confidence interval [CI] 0.95, 1.00, p = 0.038), after controlling for potential covariates. Similarly, olfactory function showed a significant association with lower trajectories of probable RBD (OR = 0.96, 95% CI 0.94, 0.98, p = 0.001) among early PD individuals. Consistent findings were replicated across alternative analytical models.
CONCLUSIONS: Our findings indicated that olfactory dysfunction was associated with unfavorable long-term trajectories of sleep disorders among early PD.
方法:来自帕金森进展标志物倡议计划的数据包括589名参与者,他们使用Epworth嗜睡量表(ESS)和RBD筛查问卷(RBDSQ)评估睡眠障碍。使用宾夕法尼亚大学气味鉴定测试测量基线时的嗅觉功能障碍。使用基于组的轨迹模型确定5年随访期间睡眠障碍的轨迹,通过二项逻辑回归分析嗅觉功能障碍与睡眠障碍轨迹之间的关系。
结果:在5年的随访期内确定了两种不同的睡眠障碍轨迹,其特征在于保持低或高ESS评分和低或高RBDSQ评分。嗅觉功能测量值与白天过度嗜睡(EDS)的轨迹之间存在反转关联(比值比[OR]=0.97,95%置信区间[CI]0.95,1.00,P=0.038),在控制潜在协变量后。同样,在早期PD个体中,嗅觉功能与可能的RBD(pRBD)的较低轨迹显着相关(OR=0.96,95%CI0.94,0.98,P=0.001)。在替代分析模型中重复了一致的发现。
结论:我们的研究结果表明,在早期帕金森病中,嗅觉功能障碍与睡眠障碍的长期不良轨迹相关。