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Environmental risk factors for REM sleep behavior disorder: a multicenter case-control study.
R B Postuma1, J Y Montplaisir, A Pelletier
1Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada. ron.postuma@mcgill.ca
Neurology
|June 30, 2012
Summary
Smoking, head injuries, pesticide exposure, and farming are linked to idiopathic REM sleep behavior disorder (RBD). This study identified key environmental and lifestyle factors associated with this sleep disorder.
Area of Science:
- Neurology
- Sleep Medicine
- Epidemiology
Background:
- Idiopathic REM sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment.
- RBD often precedes the clinical diagnosis of parkinsonism and dementia.
- Risk factors for idiopathic RBD remain largely undefined.
Purpose of the Study:
- To investigate potential environmental and lifestyle risk factors for idiopathic REM sleep behavior disorder.
- To conduct a multicenter case-control study to identify associations.
Main Methods:
- Recruited 347 cases of idiopathic RBD (free of dementia/parkinsonism) and 347 matched controls from 13 international centers.
- Assessed environmental and lifestyle factors using standardized questionnaires.
- Employed unconditional logistic regression, adjusting for age, sex, and study center.
Main Results:
- Cases were more likely to be ever smokers (64.0% vs 55.5%, OR=1.43).
- Higher prevalence of reported head injury (19.3% vs 12.7%, OR=1.59) and occupational pesticide exposure (11.8% vs 6.1%, OR=2.16) in cases.
- Farming occupation (19.7% vs 12.5%, OR=1.67) and fewer years of schooling were associated with idiopathic RBD.
Conclusions:
- Smoking, previous head injury, and occupational pesticide exposure are potential risk factors for idiopathic RBD.
- Farming as an occupation may also be associated with an increased risk.
- Further research is warranted to elucidate the causal pathways.
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