Epidemiology Of Important Sleep Disorders In A Chinese Rural Elderly Community

Aim:To examine the prevalence and other characteristics of rapid eye movement sleep behavior disorder(RBD),restless legs syndrome(RLS),excessive daytime sleepiness(EDS)in a Chinese rural elderly community.Methods:The community-based study included totally 1787 Chinese adults from five villages in Beijing.All respondents accomplished structured questionnaires,physical examination,laboratory tests,MRI scans,and validated questionnaires for RBD/RLS/EDS.We assessed the prevalence,impact on the health related quality of life(HRQL),risk factors of RBD/RLS/EDS,respectively.We also analyzed the complications of RBD,the impact of RLS on sleep,the impact of reproduction and menopause on RLS,MRI changes of EDS patients.Results:1.Prevalence of RBD was 4.51%.There was no risk factors for RBD in the whole group.However,hyperlipidemia(OR=1.90;95%CI:0.99-3.63;p=0.05)was a risk factor for RBD in male group.And drinking was a risk factor for RBD in female group(OR=3.92;95%CI:1.25-12.24;p=0.02).And the RBD group had a significantly increased score of the Parkinson's disease screening scale(p=0.006),impaired movement function,including fast rotation test of left hand(8.35�1.89s vs.7.89�2.24s,p=0.03),3-m walk test(4.73�3.06s vs.3.74� 1.23s,p=0.02)compared with the control group.The percentages of difficulty falling asleep(29.31%vs.14.96%,p=0.003)and nocturnal awakening(29.31%vs.16.29%,p=0.01)were increased in the RBD group compared with the control group.The prevalence of urinary incontinence in the female RBD group was increased(6.58%vs.3.29%,p=0.02).There was no difference of depression or cognitive scale scores between RBD and non-RBD groups.2.The prevalence of RLS was 4.59%.With symptoms of peripheral neuropathy was a consistent risk factor for RLS among the whole group(OR=3.80,95%CI:2.13-6.80;p<0.001),male subgroup(OR=3.26,95%CI:1.10-9.60;p=0.03)and female subgroup(OR=4.47,95%CI:2.20-9.08;p<0.0001).Hypertension(OR=0.53,95%Cl:0.29-0.98;p=0.04)was a protect factor in the whole group.Age(OR=0.93,95%CI:0.87-0.99;p=0.02)was a protect factor in the male group.And higher income(OR=2.30,95%CI:1.04-5.08;p=0.04)was a risk factor in the female group.The percentages of difficulty falling asleep(29.82%vs.15.43%,p=0.004)and nocturnal awakening(33.33%vs.16.13%,p<0.001)were increased in the RLS group.3.The prevalence of EDS was 7.54%.In the whole group,lower(OR=1.82,95%CI:1.09-3.05;p=0.007)and higher income(OR=3.88,95%CI:1.55-9.73;p=0.007)were both risk factors for EDS compared with middle income.And increased hemoglobin(OR=0.036,95%CI:0.004-0.310;p=0.003)was a protect factor for EDS in the female group,while depressive symptom(OR=10.16,95%CI:1.29-79.91;p=0.03)was a risk factor in the male group.There was no significant association between EDS and neuroimaging markers of cerebral small vessel disease.4.EDS was a risk factor for poorer HRQL scores in the dimensions of physical functioning,body pain,general health,vitality.RLS had an impact on the dimensions of physical role and vitality.And RBD had no impact on the HRQL.Conclusion:1.The prevalence of RBD,RLS,EDS were 4.51%,4.59%,7.54%,respectively,in the Chinese rural elderly community.2.The RBD group suffered from impaired movement function,insomnia,urinary problems.3.Symptoms of peripheral neuropathy was a risk factor for RLS.And RLS had a negative effect on sleep.4.EDS might had no association with cerebrovascular disease.5.EDS had more profound impact on the HRQL than RLS and RBD.