Over 64,855 person-years of follow-up, 75 participants developed , including 47 cases of Parkinson's disease.
Worse self-reported sleep quality within the first 2 years was associated with an increased risk of parkinsonism, with a hazard ratio of 2.38 per standard deviation increase.
Shorter sleep duration in the first 2 years was linked to a higher risk of parkinsonism, showing a hazard ratio of 0.61 per standard deviation increase.
The association between poor sleep quality and Parkinson's disease was stronger, with a hazard ratio of 3.86 per standard deviation increase.
Shorter sleep duration significantly correlated with Parkinson's disease, with a hazard ratio of 0.48 per standard deviation increase.
Deterioration in sleep quality and duration over time was related to an increased risk of Parkinson's disease in the following 6 years.
Simplified
Sleep disturbances may signal presence of prodromal , including Parkinson's disease. Whether general sleep quality or duration in otherwise healthy subjects is related to the risk of parkinsonism remains unclear. We hypothesized that both worse self-reported sleep quality and duration, as well as a longitudinal deterioration in these measures, are associated with the risk of parkinsonism, including Parkinson's disease. In the prospective population-based Rotterdam Study, we assessed sleep quality and duration with the in 7726 subjects (mean age 65 years, 57% female) between 2002 and 2008, and again in 5450 subjects between 2009 and 2014. Participants were followed until 2015 for a diagnosis of parkinsonism and Parkinson's disease. Outcomes were assessed using multiple modalities: interviews, physical examination, and continuous monitoring of pharmacy records and medical records of general practitioners. We used Cox regression to associate sleep, and changes in sleep over time, with incident parkinsonism and Parkinson's disease, adjusting for age, sex, education and smoking status. Over 64 855 person-years in 13 years of follow-up (mean: 8.4 years), 75 participants developed parkinsonism, of whom 47 developed Parkinson's disease. We showed that within the first 2 years of follow-up, worse sleep quality {hazard ratio (HR) 2.38 per standard deviation increase [95% confidence interval (CI 0.91-6.23)]} and shorter sleep duration [HR 0.61 per standard deviation increase (95% CI 0.31-1.21)] related to a higher risk of parkinsonism. Associations of worse sleep quality [HR 3.86 (95% CI 1.19-12.47)] and shorter sleep duration [HR 0.48 (95% CI 0.23-0.99)] with Parkinson's disease were more pronounced, and statistically significant, compared to parkinsonism. This increased risk disappeared with longer follow-up duration. Worsening of sleep quality [HR 1.76 per standard deviation increase (95% CI 1.12-2.78)], as well as shortening of sleep duration [HR 1.72 per standard deviation decrease (95% CI 1.08-2.72)], were related to Parkinson's disease risk in the subsequent 6 years. Therefore, we argue that in the general population, deterioration of sleep quality and duration are markers of the prodromal phase of parkinsonism, including Parkinson's disease.
Key numbers
2.38
Increased Risk of
Hazard ratio (HR) per standard deviation increase in global score.
3.86
Increased Risk of Parkinson's Disease
Hazard ratio (HR) for worse sleep quality in the first 2 years.
0.48
Sleep Duration Effect on Parkinson's Disease
Hazard ratio (HR) for shorter sleep duration in the first 2 years.
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