Sleep related injury and its correlates in isolated rapid eye movement sleep behavior disorder

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-11-20 DOI:10.1016/j.sleep.2024.11.032

Yuhua Yang , Jing Wang , Li Zhou , Yaping Liu , Shi Tang , Siyi Gong , Ningning Li , Zhixuan He , Jianzhang Ni , Joey W.Y. Chan , Steven W.H. Chau , Yun Kwok Wing , Bei Huang

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Abstract

Objectives

To evaluate factors associated with sleep related injury (SRI) and persistent SRI (pSRI) in patients with isolated rapid eye movement sleep behavior disorder (iRBD).

Methods

This is a retrospective cohort study. A total of 388 patients with iRBD were involved for a comprehensive review of sleep related injuries. SRI is defined as a lifetime history of injurious behaviors to self and/or bed partner, and pSRI is considered if injurious symptoms continued to occur frequently (≥1/month). Correlations of SRI/pSRI with clinical, lifestyle and polysomnographic characteristics were analyzed.

Results

Lifetime SRI was reported in 322 (83 %) patients (66.3 ± 8.5 years old, male 77.0 %), with 19.3 % having severe injuries, including fractures (2.5 %) and subdural hemorrhage (1.2 %), while 7.5 % required medical attendance. SRI was related to more severe depressive features (P_adj = 0.017), current alcohol drinking (P_adj = 0.014) and higher mentalis phasic and tonic EMG activity (P_adj = 0.042 and 0.048). After a mean follow-up of 5.1 years, 18.2 % of SRI patients (38/209) had pSRI despite intense treatment. Frequent nightmare at baseline (OR [95 % CI] = 1.43 [1.01, 2.03]), restless leg syndrome (OR [95 % CI] = 5.68 [1.42, 22.64]) and adult-onset sleepwalking (OR [95 % CI] = 2.52 [1.10, 5.76]) were associated with an increased risk of pSRI.

Conclusions

SRI is common in patients with iRBD and 18 % had pSRI despite intensive treatment, emphasizing the importance of bedside safety. The identification of risk factors for SRI and pSRI underscores the need for systematic clinical screening and targeted interventions for at-risk patients.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.