Risk factors for rapid eye-movement sleep-related behavioral disorders (RBDs): A systematic review and a meta-analysis

Zijing Wu; Junxin Wu; Caixia Xie; Luchun Wang; Huizi Li; Ming Zhang; Zhiqiang Fu; Yongsheng Lin; Bing Qian; Limao Zhu; Xin Yu; Jincai He; Wei Qi; Huali Wang

doi:10.1016/j.genhosppsych.2022.10.009

Risk factors for rapid eye-movement sleep-related behavioral disorders (RBDs): A systematic review and a meta-analysis

Gen Hosp Psychiatry. 2022 Nov-Dec:79:118-127. doi: 10.1016/j.genhosppsych.2022.10.009. Epub 2022 Oct 20.

Authors

Zijing Wu¹, Junxin Wu¹, Caixia Xie¹, Luchun Wang², Huizi Li², Ming Zhang³, Zhiqiang Fu⁴, Yongsheng Lin⁴, Bing Qian⁴, Limao Zhu⁴, Xin Yu², Jincai He⁵, Wei Qi⁶, Huali Wang⁷

Affiliations

¹ School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China.
² Dementia Care and Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing 100191, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
³ Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
⁴ Shangrao Third Hospital, Shangrao 334000, China.
⁵ Department of Neurology, First Hospital of Wenzhou Medical University, Wenzhou 325000, China.
⁶ Shangrao Third Hospital, Shangrao 334000, China. Electronic address: Wnzhy123@163.com.
⁷ School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China; Dementia Care and Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing 100191, China; NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China. Electronic address: huali_wang@bjmu.edu.cn.

PMID: 36375340
DOI: 10.1016/j.genhosppsych.2022.10.009

Abstract

Objective: The present study aimed to systematically analyze the risk factors for RBD.

Methods: A systematic review and meta-analysis of case-control studies, cohort studies, and cross-sectional studies derived from the articles published in eight electronic databases before December 1, 2021. The primary outcome was the odds ratio (OR) and 95% confidence interval (95% CI), and heterogeneity was quantified using I². Subgroup analyses and meta-regression were used to explore sources of heterogeneity. Egger's test and sensitivity analysis were performed. The PROSPERO ID number of the present study is CRD42021293942.

Results: We identified 26 studies (44,230 subjects) among 2022 citations, and 13 factors were considered. Male sex (OR = 1.36, 95% CI = 1.13-1.64), smoking (OR = 1.37, 95% CI: 1.26-1.50), depression (OR = 2.06, 95% CI = 1.66-2.56), antidepressant use (OR = 2.36, 95% CI = 1.98-2.82), duration of neuropsychiatric disorders(OR = 1.43, 95% CI = 1.13-1.73), levodopa equivalent daily dose (LEDD, OR = 60.15, 95% CI = 23.95-96.35) and observable motor dysfunction (OR = 2.43, 95% CI = 0.65-4.22) were associated with a higher risk of RBD. Tertiary education and above (OR = 0.58, 95% CI = 0.35-0.96) was associated with a lower RBD risk. Men (OR = 1.40, 95% CI: 1.10-1.78, I² = 0%, P = 0.005) and older individual (OR = 2.73, 95% CI: 1.03-4.43, I² = 60%, P = 0.002) were more likely to have iRBD.

Conclusion: Six modifiable risk factors and one protective factor were associated with RBD. Further research is required to understand the mechanisms and to develop preventative strategies.

Keywords: REM sleep behavior disorder; meta-analysis; risk factors.

Publication types

Systematic Review
Meta-Analysis
Review
Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Levodopa
Male
REM Sleep Behavior Disorder* / complications
REM Sleep Behavior Disorder* / epidemiology
Risk Factors
Sleep

Substances

Levodopa