Risk of neurodegenerative diseases in patients with sleep disorders: A nationwide population-based case-control study

Wei Lin; Yu-Kai Lin; Fu-Chi Yang; Chi-Hsiang Chung; Je-Ming Hu; Chang-Huei Tsao; Zi-Xeng Weng; Chien-An Ko; Wu-Chien Chien

doi:10.1016/j.sleep.2023.05.014

Risk of neurodegenerative diseases in patients with sleep disorders: A nationwide population-based case-control study

Sleep Med. 2023 Jul:107:289-299. doi: 10.1016/j.sleep.2023.05.014. Epub 2023 May 19.

Authors

Wei Lin¹, Yu-Kai Lin², Fu-Chi Yang³, Chi-Hsiang Chung⁴, Je-Ming Hu⁵, Chang-Huei Tsao⁶, Zi-Xeng Weng⁷, Chien-An Ko¹, Wu-Chien Chien⁸

Affiliations

¹ Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
² Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan. Electronic address: yukai0907@ndmctsgh.edu.tw.
³ Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
⁴ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taiwan.
⁵ Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
⁶ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Microbiology & Immunology, National Defense Medical Center, Taipei, Taiwan.
⁷ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
⁸ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, 114, Taiwan. Electronic address: chienwu@mail.ndmctsgh.edu.tw.

PMID: 37269705
DOI: 10.1016/j.sleep.2023.05.014

Abstract

Objective: Our study aimed to explore the associative relationship between neurodegenerative diseases and sleep disorders.

Patients: This 15-year retrospective longitudinal nationwide population-based matched case-control study used data extracted from the National Health Insurance Research Database. We evaluated 25,589 patients diagnosed with neurodegenerative diseases between 2000 and 2015 and a matched control of 102,356 patients without neurodegenerative diseases.

Results: Sleep disorders were an independent risk factor for the development of neurodegenerative diseases (adjusted odds ratio (OR): 1.794, 95% confidence interval (CI): 1.235-2.268, P < 0.001), with a positive dose-effect relationship (adjusted OR (95% CI): <1 year: 1.638 (1.093-2.872), P < 0.001; 1-5 years: 1.897 (1.260-3.135), P < 0.001; >5 years: 2.381 (1.467-3.681), P < 0.001. Moreover, patients with sleep disorder and comorbid depression had a significantly higher risk of neurodegenerative disorders (adjusted OR: 5.874). Subgroup analysis showed that insomnia was associated with Alzheimer's disease, Pick's disease and essential tremor (adjusted OR (95% CI): 1.555 (1.069-1.965), 1.934 (1.331-2.445) and 2.089 (1.439-2.648), respectively). Obstructive sleep apnea was associated with Parkinson's disease, essential tremor, and primary dystonia (adjusted OR (95% CI): 1.801 (1.239-2.275), 5.523 (3.802-6.977), and 4.892 (3.365-6.178), respectively). Other specific sleep disorders were associated with Pick's disease, Parkinson's disease, essential tremor, and primary dystonia (adjusted OR (95% CI): 8.901 (6.101-11.010), 1.549 (1.075-1.986), 2.791 (1.924-3.531), and 9.114 (6.283-10.506), respectively).

Conclusion: Sleep disorders are associated with the subsequent development of neurodegenerative disorders. Moreover, sleep disorder patients with comorbid depression have a higher risk of neurodegenerative diseases.

Keywords: Case-control study; Insomnia; Neurodegenerative disorder; Obstructive sleep apnea; Sleep disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
Dystonic Disorders* / complications
Essential Tremor* / complications
Humans
Neurodegenerative Diseases* / epidemiology
Parkinson Disease* / complications
Parkinson Disease* / epidemiology
Pick Disease of the Brain* / complications
Retrospective Studies
Risk Factors
Sleep Apnea, Obstructive* / complications
Sleep Wake Disorders* / complications
Taiwan