TY - JOUR
T1 - Comorbidity and medication in REM sleep behavior disorder
T2 - a multicenter case-control study
AU - Frauscher, Birgit
AU - Jennum, Poul
AU - Ju, Yo-El S
AU - Postuma, Ronald B
AU - Arnulf, Isabelle
AU - Cochen De Cock, Valerie
AU - Dauvilliers, Yves
AU - Fantini, Maria L
AU - Ferini-Strambi, Luigi
AU - Gabelia, David
AU - Iranzo, Alex
AU - Leu-Semenescu, Smaranda
AU - Mitterling, Thomas
AU - Miyamoto, Masayuki
AU - Miyamoto, Tomoyuki
AU - Montplaisir, Jacques Y
AU - Oertel, Wolfgang
AU - Pelletier, Amélie
AU - Prunetti, Paolo
AU - Puligheddu, Monica
AU - Santamaria, Joan
AU - Sonka, Karel
AU - Unger, Marcus
AU - Wolfson, Christina
AU - Zucconi, Marco
AU - Terzaghi, Michele
AU - Högl, Birgit
AU - Mayer, Geert
AU - Manni, Raffaele
PY - 2014/3/25
Y1 - 2014/3/25
N2 - OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort.METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis.RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease.CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.
AB - OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort.METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis.RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease.CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.
KW - Administration, Inhalation
KW - Aged
KW - Case-Control Studies
KW - Cohort Studies
KW - Comorbidity
KW - Depression
KW - Female
KW - Glucocorticoids
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Ischemia
KW - Questionnaires
KW - REM Sleep Behavior Disorder
KW - Risk Factors
KW - Serotonin Uptake Inhibitors
KW - Smoking
U2 - 10.1212/WNL.0000000000000247
DO - 10.1212/WNL.0000000000000247
M3 - Journal article
C2 - 24553425
SN - 0028-3878
VL - 82
SP - 1076
EP - 1079
JO - Neurology
JF - Neurology
IS - 12
ER -