A Meta-analysis Of The Risk Factors Associated With The Idiopathic RBD Converted Into ?-synucleinisopathies

Objectives:Idopathic rapid eye movement sleep behavior disorder(iRBD)is a form of heteromorphic sleep without comorbidities or causes.It is mainly characterized by the disappearance of skeletal muscle retardation during REM sleep and Dream interpretation behavior.Studies in recent years have shown that iRBD is not an independent sleep disease,but has a relationship with neurodegenerative diseases,especially ?-synuclein diseases(such as Parkinson's disease,Lewy body dementia,multiple system atrophy,etc.)can occur as a pre-symptom of these diseases.However,not all iRBDs will progress to ?-synuclein disease.Therefore,we searched for previous cohort studies related to iRBD and ?-synuclein disease,and collected data that may cause iRBD to progress to ?-synuclein.Factors related to protein diseases,and a meta analysis was performed to try to determine the risk factors for iRBD to progress to ?-synuclein disease,and to screen out some high-risk populations who may develop ?-synuclein disease in the future,which will help clinical work and scientific research.Methods:The key words in this study were "rapid eye movement sleep disorder" and "?-synuclein disease" as Chinese keywords,and "idiopathic RBD","RBD","neurodegenerative disease",and "?-synucleinisopathies" as the key words in English.Words,searched through Pubmed,Cochrance,Web of Science,China Knowledge Network(CNKI)full-text database,and by tracing the references of related literature,screen out those published on November 30,2019 about the primary rapid eye movement period Cohort study of sleep behavior disorder progressing to ?-synuclein disease,quality assessment by Newcastle-Ottawa Scale(NOS),integration and extraction of data included in literature,and meta-analysis of data using Stata12.0 The odds ratio and 95% confidence interval were used as the evaluation criteria to evaluate the relevant factors for the progression of iRBD into neurodegenerativediseases,and the sensitivity and bias analysis of the heterogeneity of the results was performed.Results:A total of 14 studies were included in this systematic review.The total number of iRBDs was 2305,and 744 were converted to ?-synucleinosis,with a conversion rate of 33.6%.The meta-analysis results showed that compared with the non-transformed population,the iRBD-transformed ?-synucleinosis population had the following characteristics: The population transitioned to ?-synucleinopathy was older and the difference was statistically significant(P<0.05);total sleep time is shortened,the difference is statistically different(P<0.05);sleep efficiency decreased,the difference was statistically significant(P<0.05);tonic sleep time increased,the difference was statistically significant(P<0.05).There were no significant differences between the transformed and non-untransformed groups in gender,education level,mini-mental state examination(MMSE),sleep latency,stage I sleep,stage II sleep,slow wave sleep,REM sleep,and phasic sleep time.Conclusion:1.Older age,reduced total sleep time,reduced sleep efficiency,and increased phase sleep time during REM phase are risk factors for iRBD to progress to?-synucleinosis;2.Gender,education,MMSE score,sleep latency,stage I sleep,stage II sleep,slow wave sleep,REM sleep,and phased sleep time were not associated with the progression of iRBD to ?-synucleinosis.