Citation

Postuma RB, Montplaisir JY, Pelletier A, Dauvilliers Y, Oertel W, Iranzo A, Ferini-Strambi L, Arnulf I, Hogl B, Manni R, Miyamoto T, Mayer G, Stiasny-Kolster K, Puligheddu M, Ju Y, Jennum P, Sonka K, Santamaria J, Fantini ML, Zucconi M, Leu-Semenescu S, Frauscher B, Terzaghi M, Miyamoto M, Unger MM, Cochen De Cock V, Wolfson C. Neurology 2012; 79(5): 428-434.

Affiliation

Departments of Neurology (R.B.P., A.P.) and Epidemiology and Biostatistics and Occupational Health (J.Y.M.), McGill University, Montreal General Hospital, Montreal; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.Y.M.), Hôpital du Sacré-Cœur de Montréal, Montréal; Research Institute of the McGill University Health Center (C.W.), Montreal; Department of Psychiatry (A.P., C.W.), Université de Montréal, Montreal, Canada; Department of Neurology (Y.D., V.C.D.C.), Hôpital Gui de Chauliac, Montpellier, INSERM U1061, Montpellier, France; Philipps-Universität (W.O., K.S.-K., M.M.U.), Marburg, Germany; Neurology Service (A.I., J.S.), Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain; Sleep Disorders Center (L.F.-S., M.L.F., M.Z.), Università Vita-Salute San Raffaele, Milan, Italy; Unité des Pathologies du Sommeil (I.A., S.L.-S.), Hôpital Pitié-Salpêtrière, APHP, and Inserm U975-CRICM-Pierre and Marie Curie University, Paris, France; Department of Neurology (B.H., B.F.), Innsbruck Medical University, Innsbruck, Austria; Unit of Sleep Medicine (R.M., M.T.), National Institute of Neurology IRCCS "C. Mondino Foundation," Pavia, Italy; Department of Neurology (T.M.), Dokkyo Medical University Koshigaya Hospital, Saitama, Japan; Hephata Klinik (G.M.), Schwalmstadt-Treysa, Germany; Sleep Center (M.P.), Department of Cardiovascular and Neurological Sciences, University of Cagliari, Italy; Washington University Multidisciplinary Sleep Center (Y.J.), St. Louis, MO; Danish Center for Sleep Medicine (P.J.), University of Copenhagen, Denmark; Department of Neurology (K.S.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; and Department of Neurology (M.M.), Dokkyo Medical University School of Medicine, Tochigi, Japan.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0b013e31825dd383

PMID

22744670

Abstract

OBJECTIVE:Idiopathic REM sleep behavior disorder is a parasomnia characterized by dream enactment and is commonly a prediagnostic sign of parkinsonism and dementia. Since risk factors have not been defined, we initiated a multicenter case-control study to assess environmental and lifestyle risk factors for REM sleep behavior disorder. METHODS:Cases were patients with idiopathic REM sleep behavior disorder who were free of dementia and parkinsonism, recruited from 13 International REM Sleep Behavior Disorder Study Group centers. Controls were matched according to age and sex. Potential environmental and lifestyle risk factors were assessed via standardized questionnaire. Unconditional logistic regression adjusting for age, sex, and center was conducted to investigate the environmental factors. RESULTS:A total of 694 participants (347 patients, 347 controls) were recruited. Among cases, mean age was 67.7 ± 9.6 years and 81.0% were male. Cases were more likely to smoke (ever smokers = 64.0% vs 55.5%, adjusted odds ratio [OR] = 1.43, p = 0.028). Caffeine and alcohol use were not different between cases and controls. Cases were more likely to report previous head injury (19.3% vs 12.7%, OR = 1.59, p = 0.037). Cases had fewer years of formal schooling (11.1 ± 4.4 years vs 12.7 ± 4.3, p < 0.001), and were more likely to report having worked as farmers (19.7% vs 12.5% OR = 1.67, p = 0.022) with borderline increase in welding (17.8% vs 12.1%, OR = 1.53, p = 0.063). Previous occupational pesticide exposure was more prevalent in cases than controls (11.8% vs 6.1%, OR = 2.16, p = 0.008). CONCLUSIONS: Smoking, head injury, pesticide exposure, and farming are potential risk factors for idiopathic REM sleep behavior disorder.

Language: en