Mortality and its risk factors in patients with rapid eye movement sleep behavior disorder
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AbstractStudy Objectives:
To determine the mortality and its risk factors in patients with rapid eye movement (REM) sleep behavior disorder (RBD).

Methods:
A total of 205 consecutive patients with video-polysomnography confirmed RBD (mean age = 66.4 ± 10.0 y, 78.5% males) were recruited. Medical records and death status were systematically reviewed in the computerized records of the health care system. Standardized mortality ratio (SMR) was used to calculate the risk ratio of mortality in RBD with reference to the general population.

Results:
Forty-three patients (21.0%) died over a mean follow-up period of 7.1 ± 4.5 y. The SMR was not increased in the overall sample, SMR (95% confidence interval [CI]) = 1.00 (0.73–1.33). However, SMR (95% CI) increased to 1.80 (1.21–2.58) and 1.75 (1.11–2.63) for RBD patients in whom neurodegenerative diseases and dementia, respectively, eventually developed. In the Cox regression model, mortality risk was significantly associated with age (hazard ratio [HR] = 1.05; 95% CI, 1.01–1.10), living alone (HR = 2.04; 95% CI, 1.39–2.99), chronic obstructive pulmonary disease (HR = 3.38; 95% CI, 1.21–9.46), cancer (HR = 10.09; 95% CI, 2.65–38.42), periodic limb movements during sleep (HR = 3.06; 95% CI, 1.50–6.24), and development of neurodegenerative diseases (HR = 2.84; 95% CI, 1.47–5.45) and dementia (HR = 2.66; 95% CI, 1.39–5.08).

Conclusions:
Patients with RBD have a higher mortality rate than the general population only if neurodegenerative diseases develop. Several risk factors on clinical and sleep aspects are associated with mortality in RBD patients. Our findings underscore the necessity of timely neuroprotective interventions in the early phase of RBD before the development of neurodegenerative diseases.
All Author(s) ListZhou J., Zhang J., Lam S.P., Mok V., Chan A., Xin Li S., Liu Y., Tang X., Yung W.H., Wing Y.K.
Journal nameSLEEP
Year2016
Month8
Day1
Volume Number39
Issue Number8
PublisherThe American Academy of Sleep Medicine
Place of PublicationUnited States
Pages1543 - 1550
ISSN0161-8105
eISSN1550-9109
LanguagesEnglish-United Kingdom
KeywordsMortality, Neurodegenerative disease, REM sleep behavior disorder, SMR

Last updated on 2021-19-02 at 00:46