背景快速眼动睡眠行为障碍(RBD)是帕金森病(PD)和其他α-突触核蛋白病的前驱标志。睡眠说话(ST)是一种孤立的症状,在PD和RBD中很常见。这里,我们调查了ST和RBD与PD患者死亡率的相关性.患者和方法从芬兰帕金森协会的登记处随机选择总共1,500名PD患者。在参加基线的855人中,645允许进行后续研究。我们从384名受试者中收集了完整的睡眠问卷和死亡率信息。Nelson-Aalen检验和Cox风险比(HR)用于死亡率分析。结果随访时间0.3~7.0年,平均4.3年。患有RBD或频繁ST的PD患者具有更多的非运动症状。抑郁症,幻觉,便秘,白天过度嗜睡在RBD患者中更为普遍。患有RBD和频繁ST(睡眠中说话≥每周一次)的受试者死亡率增加(HR:1.90,95%CI:1.18-3.06)。无频繁ST的RBD与死亡率无关(HR:0.77,95%CI:0.4-1.5)。经年龄调整后,频繁ST与死亡率增加相关,PD持续时间,抑郁症,性别,RBD,BMI,和幻觉(HR:2.22,95%CI:1.10-4.51)。此外,年龄,PD的持续时间,动脉高血压,较低的BMI与死亡率增加相关.男性,多巴胺能药物,抑郁症,幻觉与死亡率无显著相关.结论RBD伴频繁ST和单纯ST是PD患者死亡的危险因素。频繁的ST可能是代表更广泛的神经变性的体征。与没有RBD或ST的PD相比,RBD受试者和经常睡觉的人表现出更多的非运动症状。我们的发现具有临床意义。如果频繁的ST表明预后较差,还有待观察。需要进行前瞻性研究,以确定频繁的ST是否也是发生PD的危险因素。
Background REM sleep behavior disorder (RBD) is a prodromal marker for Parkinson\'s disease (PD) and other alpha-synucleinopathies. Sleep talking (ST) is an isolated symptom and is frequent in PD and RBD. Here, we investigate the associations of ST and RBD with the mortality of PD patients. Patients and methods A total of 1,500 PD patients were randomly selected from the registry of the Finnish Parkinson\'s Association. Of the 855 that participated at baseline, 645 gave permission for follow-up studies. We gathered a completely filled sleep questionnaire and mortality information from 384 subjects. The Nelson-Aalen test and Cox hazard ratios (HR) were used for mortality analyses. Results The mean follow-up time was 4.3 years (0.3-7.0). PD patients with RBD or frequent ST had more non-motor symptoms. Depression, hallucinations, constipation, and excessive daytime sleepiness were more prevalent among subjects with RBD. Subjects with RBD and frequent ST (talking in their sleep ≥ once per week) had increased mortality (HR: 1.90, 95% CI: 1.18-3.06). RBD without frequent ST was not associated with mortality (HR: 0.77, 95% CI: 0.4-1.5). Frequent ST was associated with increased mortality when adjusted for age, PD duration, depression, gender, RBD, BMI, and hallucinations (HR: 2.22, 95% CI: 1.10-4.51). Additionally, age, duration of PD, arterial hypertension, and lower BMI were associated with increased mortality. Male gender, dopaminergic medication, depression, and hallucinations were not significantly associated with mortality. Conclusions RBD with frequent ST and ST alone appear to be risk factors for mortality in PD. Frequent ST may be a sign representing wider neurodegeneration. RBD subjects and frequent sleep talkers demonstrated more non-motor symptoms compared to PD without RBD or ST. Our findings have clinical implications. It remains to be seen if frequent ST indicates a poorer prognosis. Prospective studies are needed to find whether frequent ST is also a risk factor for developing PD.