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REM sleep behavioral disorder may be an independent risk factor for orthostatic hypotension in Parkinson’s disease

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Abstract

Purpose

The purpose of this study was to evaluate the association between clinically possible rapid eye movement (REM) sleep behavioral disorder (pRBD) and orthostatic hypotension (OH) in PD patients, as well as to explore the mechanisms underlying the association.

Methods

PD patients (n = 116) were assigned to a group with OH (PD-OH) or without OH (PD-NOH). General demographic and clinical data were collected. A series of scales were used to assess the clinical symptoms in the two groups.

Results

A total of 27 patients (23.3%) had OH. The PD-OH group showed significantly higher H-Y staging score and significantly higher frequencies of pRBD, anxiety, depression, and cognitive impairment than the PD-NOH group. Binary logistic regression analysis identified the following factors as independently associated with PD-OH: H-Y staging [odds ratio (OR) 2.565, 95% confidence interval (CI) 1.160–5.673; P = 0.020], RBD (OR 7.680, 95% CI 1.944–30.346; P = 0.004), UPDRS II (OR 1.021, 95% CI 0.980–1.063; P = 0.020), depression (OR 7.601, 95% CI 1.492–38.718; P = 0.015), and cognitive impairment (OR 0.824, 95% CI 0.696–0.976; P = 0.025).

Conclusions

Our results suggest that pRBD is an independent risk factor for OH in patients with PD. We speculate that there may be a close relationship between RBD and OH, which requires attention. Early diagnosis of RBD may help predict the appearance of OH in PD patients.

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Acknowledgements

We thank the Parkinson’s disease patients for their participation in our study.

Funding

This work was funded by the National Natural Science Foundation of China (grant number 81960242), Yunnan Applied Basic Research Project (grant numbers 2019FE001-048 and 202001AT070001), Yunnan Provincial Health Science and Technology Project (grant number 2018NS0102), The Applied Basic Research of The Diagnosis and Treatment Center of Neurological Diseases in Yunnan Province (grant number ZX2019-03-05) and the 100 Young and Middle-aged Academic and Technical Scholars at Kunming Medical University (grant number 60118260105).

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Authors and Affiliations

  1. Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China

    Kangfu Yin, Chuanbin Zhou, Yongyun Zhu, Weifang Yin, Lei Yin, Bin Liu, Hui Ren, Zhong Xu & Xinglong Yang

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  1. Kangfu Yin
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  2. Chuanbin Zhou
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  3. Yongyun Zhu
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  4. Weifang Yin
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  5. Lei Yin
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  6. Bin Liu
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  7. Hui Ren
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  8. Zhong Xu
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  9. Xinglong Yang
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Contributions

KFY contributed to the acquisition of the data, statistical analysis, and interpretation of the data, and drafted the manuscript. ZX and XLY contributed to the study concept and design, acquisition of the data, statistical analysis, and critical revision of the manuscript for important intellectual content. YYZ, WFY, CBZ, LY, YFZ, BL and HR contributed to the acquisition of the data and clinical assessment.

Corresponding author

Correspondence to Xinglong Yang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all patients and their families for their anonymized clinical data to be published for research purposes.

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Yin, K., Zhou, C., Zhu, Y. et al. REM sleep behavioral disorder may be an independent risk factor for orthostatic hypotension in Parkinson’s disease. Aging Clin Exp Res 34, 159–166 (2022). https://doi.org/10.1007/s40520-021-01887-y

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  • DOI: https://doi.org/10.1007/s40520-021-01887-y

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